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.