December 18, 2007

Sigh. Some things stay the same; other things stay the same. This time, dear Readers, during our holiday season of joy, good feelings toward all men, and, most important, golden-brown latkes of recent memory, we find our beloved Congress engaged in the time-honored mating rituals needed to forge majorities and supermajorities in the House and Senate, respectively. There is looming before us a 10 percent cut in physician reimbursements for services given Medicare patients, you see, and now there is a scramble to reverse it before the pumpkin reappears just as the countdown ends in the New Year.

So: Why did they pass this little stink-bomb in the first place, only now to abandon it in favor of reduced stupidity? Well, the reasons are numerous and obvious: The 10 percent cut enabled the ghost of Congress past to claim adherence with some arbitrary budget ceiling that everyone---and I mean everyone---knew was phony from the get-go. It served as honey for campaign contributions from the physician horseflies, oops, lobbyists, forced by government medical compassion to behave like johns on a street corner rather than practitioners of the art and science of medical practice in pursuit of reduced suffering for their patients. And it served as part of the glue needed to forge a coalition in favor of transforming SCHIP into a middle-class entitlement to the joys of socialized medicine, a gambit that would have worked beautifully had it not been for a veto from El Presidente W.

And now the Dems in the Senate want to "pay" for eliminating this reduction in payments to Medicare physicians---who, by the way, already are abandoning Medicare patients in ever-increasing numbers, as the reimbursements authorized by Congress and the bureaucrats even now do not cover the cost of service---by cutting payments to Medicare Advantage plans. This is part of the "paygo" fraud, in which the newly elected Congress last winter made a solemn pledge to "pay for" any spending increases or tax reductions by finding other budget cuts or new revenues. This iron promise, by the way, already was abandoned formally last week when the House passed a bill containing a temporary fix for the Alternative Minimum Tax monster now looming huge over a large slice of the middle class, oops, The Rich. That's right: without "paying for" it. Did they think that no one was watching?

Medicare Advantage, of course, is the private sector alternative to standard Medicare, which is to say that it provides varied plans and options in response to the heterogeneous needs of patients, as opposed to the one-size-fits-all uniformity that such single-payer monstrosities as Medicare are and always must be. That is why Medicare Advantage has been under attack from the political left from the beginning, and why it now is the favored source of "paygo" savings needed to bail out the other machinations of Beltway medicine for another year.

Accordingly: Please raise your hand if you actually believe that a vastly bigger single-payer system, the daydream of so many, would yield effiency, a focus on patients, less politicization, and a chicken in every pot. And then go stand in the corner.

Posted by Benjamin Zycher at December 18, 2007 08:47 AM

Comments

Post a comment