Thursday, October 22, 2009


The Senate voted down an attempt to put through a Medicare payment fee change that would restore doctor payment cuts (that were set to take effect in Jan. by the Balanced Budget Act of 1997), 47-53. Most who voted against are for the change (which is effectively increasing how much docs get paid by Medicare compared to what they will be paid absent any action), but revolted because the $237 Billion cost over 10 years wasn't paid for by reductions in planned federal spending.

Harry Reid was saying this is not part of health reform and lets do this now and then move to reform....but 12 Dems defected. Also, about 20 Republicans who originally were for it also revolted, so it was an odd coalition both for and against.

Now any Republican who was in Congress from 2001-2008 (esp. 2001-05) claiming to be deficit hawks is ironic at best....that was essentially the season of the great national Visa card splurge. But, I believe in redemption, so I am glad to see that 12 Dems went against the Senate leadership to stop this. Also, I would prefer a shorter term fix. We need to address physician payment in Medicare in a more fundamental way, so I wouldn't be locking in too much for too long. But, this is a risky move, as the AMA and docs generally wanted this and wanted it for 10 years (the full fix). So, they (organzied medicine) will not be happy. Not sure who they will be the maddest at, the 12 Dems who voted no or the Repubs who were going to vote yes and then changed their mind.

The Dems who voted no inlcude Kent Conrad, Chair of budget committee and a deficit hawk type, and more liberal types such as Bernie Sanders, Ron Wyden and Russ Feingold.

It is being sold in some quarters as a set back for reform, but I disagree. It shows focus on trying to do it and be responsible at the same time. Again, quite a break from the past 8 years. Not clear if this is just plain dead or if there will be an effort to do this bill with budget offsets outside of the reform bill.

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