You may have noticed recent advertisements by the American Medical Association urging Congress to not allow cuts in reimbursement for Medicare, the health insurance for all U.S. seniors over age 65. This is an even larger issue because some medical doctors who are specialists in certain areas – from vision to heart surgery – could simply opt to not accept seniors as clients if they are using Medicare as payment.
The pressure is being placed on Senate Republicans, who sort of just let the bill drop before they left for their 4th of July holiday. The House of Representatives passed a bill to prevent the Medicare pay cut by 355 to 59. The cut then took effect on July 1st, as required. The Bush Administration has delayed processing of new claims to give Congress a chance to make this right.
Why would anyone want to deny this benefit for seniors? Some insurance companies with deep pockets don’t want their payments reduced and they can afford to have lobbyists in D.C. to represent their interests.
The bill would reverse the 10.6 percent cut and increase Medicare payments to doctors by 1.1 percent in January. Under the current formula, doctors would still face cuts of more than 5 percent a year from 2010 to 2012.
Many low-income seniors have not had health insurance until they were old enough to quailfy for Medicare. Military personnel, military retirees and their dependents receive care through a government insurance program called Tricare, which mirrors Medicare’s fee structure.
There are about 44 million seniors receiving Medicare benefits and of those about 10 million have opted for a private Medicare Advantage program which offer extra benefits – even though studies show they cost the government more than traditional Medicare.
Many Republicans oppose the bill because it would finance an increase in doctors’ fees by reducing federal payments to insurance companies that offer private Medicare Advantage plans as an alternative to the traditional government-run Medicare program.
Medicare receives 15 million claims a week. It will be interesting to watch what happens – and if I have time, I’ll look to see which insurance companies have donated to which candidates up for re-election.
And we won’t even mention the lack of Medicare payments to provide for senior care in the home.
