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Tom Foreman | BIO
One of the truisms of politics and of piles of laundry in a teenager’s room is that no problem is so big it can’t be pushed aside, at least for a while.
Case in point: The growing issue of Medicare payments to doctors. I know it sounds boring, but stick with me … like Betty White’s career, it gets better as it goes.
President Obama and Democratic members of Congress made a great fuss in the run up to the health care vote about how the whole matter was deficit neutral at worst, a deficit reducer at best. And the Congressional Budget Office confirmed that they were telling the truth. The trouble is, with the ink barely dry, Dems are already considering another major piece of medical legislation which, had it been included in the original bill, would have turned reform into a budget buster and possibly torpedoed chances for passage.
Here is the tale in a nutshell (or a bedpan, take your pick.) When President Lyndon Johnson signed Medicare into law in 1965 to give care to the elderly, doctors were allowed to pretty much decide what was fair compensation and the government paid it. Then the costs ballooned, debates broke out, and in 1992, the government adopted a formula to govern those payments. And now everything is a mess.
While the cost of tests, procedures, supplies, and doctors’ time has steadily risen, the amount being paid to doctors under the Medicare formula has fallen. At the end of this month, the formula calls for a 21 percent cut in Medicare payments to doctors. You can imagine how thrilled they are. And you can imagine how many may finally throw up their hands and say, “no more Medicare patients for me.”
It’s a puzzle. Fixing the formula and restoring those payments would cost $210 billion. Adding that to the health care bill would have poured red ink all over the Capitol carpets. But leaving it until later looks like a pea and shell game aimed at hiding the true cost of reform.
The House has approved a fix already. But many pol watchers expect it to die in the Senate. Budget hawks there will likely prefer what they’ve done before: a quick payment to the docs to buy some time. In other words, treating the symptoms, not the disease.
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