Robert Laszweski has been a fixture in Washington health policy circles for
the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. You can read more of his thoughtful analysis of healthcare industry trends at The Health Policy and Marketplace Blog.

Ted Kennedy came to the Senate floor and led Senate Democrats to an amazing victory in their first real attempt to rein-in private Medicare spending and rescind the 10.6 percent physician fee cuts.

The veto-proof margin puts President Bush’s threat to veto the Senate bill, which was approved by the House on another veto-proof 354-59 vote just before the holiday, in doubt. Why bother?

I was not surprised to see Senator Kennedy on the floor.

This vote was not about the doc cuts. It was about Medicare and its future. The doc cut was just the leverage Democrats were using to get at the private Medicare program.

Medicare is part of the Democratic legacy, and it is at the core of the Kennedy legacy.

Private Medicare is seen by Democrats as an attack on the universality
of the program. Many believe the privatization of Medicare will lead to
a two-tiered system. If that were to happen, the reasoning goes, the
program would be undermined as wealthier people abandoned it. Without
everyone, including the powerful, in the system, there would not be the
broad-based support to continue it.

Republicans, on the other hand, believe that the big entitlement costs can’t be reined in without the market.

It was this clash — market versus government and the future direction of
Medicare — that was the real issue on the Senate floor today.

The Democrats have won their first big battle over Medicare since the Republicans won control of the Congress in 1994.

Oh, by the way, the one Senator who did not come to the floor and vote?
John McCain. Maybe Senator Kennedy should have offered him a ride.

Here is a comprehensive look at the debate.

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19 Responses for “Senate votes to reign in private Medicare”

  1. botetourt says:

    For too long this has been less about allowing the “market” to work, and much more about campaign contributions. It’s surprising to hear that this actually passed, but I do not think it represents a major changing of the guard. If the Repubs and some Dems were really interested in allowing market forces to work, they would pay Medicare Advantage plans the standard Medicare rates (maybe this is a start), they would allow competitive bidding for DME under Part B and also for pharmaceuticals under Part D.

  2. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  3. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  4. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  5. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  6. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  7. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  8. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  9. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  10. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  11. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  12. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  13. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  14. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  15. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  16. Preserve Social Security & Medicare says:

    Over the last five years, seniors have begun to understand what the privatization of Medicare (Advantage) has really meant to their pocketbooks. Taxpayers don’t understand why the insurance industry needs billions in overpayments if what they provide is truly a more efficient healthcare model. We’re all asking, what happened to the magic of the marketplace private insurers promised us just a few years ago?
    Every senior in Medicare, whether enrolled in a private Medicare Advantage plan or not, is paying more in Part B premiums to fund insurance industry overpayments. The Medicare Actuaries estimate private industry subsidies will total $150 billion over the next decade, eliminating almost two years of solvency from the Trust Fund.
    Medicare will continue to be there for millions of Americans 65 and older, just as it has since 1965. In fact, the Medicare program will be stronger without the massive fiscal burden Medicare Advantage plans impose. Removing this liability from Medicare could also be the first step towards strengthening the program’s long-term solvency.

  17. Peter says:

    Good discussion about this issue on the Diane Rhem Show yesterday. Medicare advantage enjoys a 17% payment to private insurance over Medicare AND private insurance uses marketing schemes that target (read cherry pick) younger healthier premium payers. Add that to how inapropriate plans are sold to unsuspecting seniors and there’s a whole lot money go’n round. As usual Conservatives play that same tired song about “competition” bringing costs down when actual experience shows this is just financial pork payback to corporate political supporters and the usual corporate tax raiders. The WSJ panelist on the show was pathetic and transparent in his support of MedAdv. When will Americans wake up and realize this Republic has gone back to the corporate robber baron times of the 30′s courtesy of the Republican conservative movement.

  18. bev M.D. says:

    Not to be nitpicky, but I am old enough to still care about grammar and spelling. It should be “rein” in private Medicare, not “reign” in. The former is what you do to a horse (or anything else) to restrain it; the latter is how you behave as a king or queen.

  19. Young and Literate says:

    bev M.D.
    Still in my youth, I also concern myself with grammer, but not spelling. Perhaps, you should have started, “To be nitpicky”. Also, you should have defined ‘rain’ for those readers would might otherwise be confused.

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