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Ted Kennedy Shows Up to Vote; McCain Absent

When Ted Kennedy came onto the Senate floor, his colleagues cheered.

He was there to vote on the bill that would prevent a 10.6 percent cut to physicians who treat Medicare patients.

Just before Congress broke for the July 4 holiday, the bill missed the 60 votes needed to pass by just one vote.

Today, Kennedy, who is battling a brain tumor, brought that vote to the Senate floor. “Aye,” the 76-year-old Kennedy said, grinning and making a thumbs-up gesture as he registered his vote.

Meanwhile, it appeared that Republican members of the Senate had been released to vote as they wished after it became apparent that the 60-vote threshold would be met. Pressure from seniors,  the AARP, and the AMA  had been mounting on members who voted against the bill June 26.

Republicans resisted voting for the legislation because while it spares physicians, it  would reduce the fat subsidy that Congress has been giving  private insurers who offer Medicare Advantage.  President Bush and Senate Republicans had been strongly against any cut in the Advantage program.

In the end, the vote was 69 to 30 in favor of the bill. President Bush had threatened to veto the bill if it passed the Senate, but 67 votes make it veto-proof. And since the House has already voted 355-59 in favor of the bill, Congress appears able to over-ride any veto.

According to Roll Call, 18 Republicans broke with their party to pass the House-backed bill.

Sighs of relief could be heard on the Democratic side as lawmakers, beginning with Sen. Kay Bailey Hutchison (R-Texas), chairwoman of the Republican Steering Committee, joined with Democrats to pass the bill. Hutchison’s Texas colleague, Sen. John Cornyn (R), who was on the receiving end of an American Medical Association ad blitz slamming his pre-recess position, also ended up voting for the bill.Other Republicans who voted to proceed to debate on the politically charged bill included Sens. Elizabeth Dole (N.C.), George Voinovich (Ohio), Susan Collins (Maine), Norm Coleman (Minn.), Pat Roberts (Kan.) Gordon Smith (Ore.), Lisa Murkowski (Alaska), Bob Corker (Tenn.), Johnny Isakson (Ga.), Arlen Specter (Pa.) and Mel Martinez (Fla.).

McCain did not appear.

McCain’s Predicament

Today, Bloomberg News did an excellent job of explaining why McCain might not show up:

“Senator John McCain will be on the spot, in person or by his absence, when the Senate takes up a measure today to halt a cut in Medicare payments to doctors.

“Republicans have stalled Democratic-backed legislation to reverse the 10.6 percent cut in doctors’ fees by reducing payments to insurance companies instead. Democrats on June 26 fell one senator short of the 60 they will need to force a floor vote. Two senators were absent: Edward Kennedy, a Democrat from Massachusetts who is being treated for brain cancer, and McCain of Arizona, the presumptive Republican presidential nominee.

“For McCain, whose schedule indicates he will campaign today in Pennsylvania and Ohio and whose office won’t say whether he’ll show up in the Senate, the vote is a political dilemma. “

“In one case McCain could be voting against his party and in the other he could be voting against an issue framed as pro- senior and pro-physician,” Robert Blendon, a health policy professor at Harvard University’s School of Public Health in Boston, said in a telephone interview yesterday.”

It is worth noting that McCain is one of few Republican senators who voted against the original legislation that created Medicare Advantage and provided what many view as windfall subsidies for private insurers.

Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron’s and Institutional Investor. She is the author of Money-Driven Medicine: The Real Reason Why Healthcare Costs So Much, an examination of the economic forces driving the health care system. A
fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of our favorite health care reads, where this piece first appeared.

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JeffMaggie MaharTammyJohn BGreg Pawelski Recent comment authors
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Jeff
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Jeff

It is really sad that insurance companies are making more and more profit, and yet the senior coverage is decreasing everyday. Doctors are paid so little now that they have to see the double the amount to make up for it. This means, they will miss things for sure simply beacause of the time restraints. Seniors don’t have better access either. Healthcare is a different animal, and when it’s privatized, people will be cared for significantly less. They (insurance co) just want to keep the majority of the money to themselves. keep on denying good drugs. Requesting more paper work… Read more »

Maggie Mahar
Guest

Greg, John B., Tammy, Greg–You’re entirely right–this fight was not about the docs. (No one really wanted to take an axe to their fees. It’s a crude solution. Some doctors are over paid for certain services; others are underpaid. Medicare needs to go through its fee schedule and re-distribute some of the dollars.) The fight was over whether Medicare should continue paying private insurers 13-17% more than traditional Medicare woudl spend if it covered these services directly. The Bush administration (and many conservatives) want to privatize Medicare. They hoped that if they gave insurers enough extra money, they would give… Read more »

Tammy
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Tammy

My mother is 72 lives with me because she can’t afford to live on her own, can’t get any additional benefits because she live with me and I according to the state make to much money.
When my mother is sick and needs to go to the doctor it’s a battle she refuses to go because it creates a bill that neither she or myself can afford to pay. So, tell me how many other families are doing the same? They need the health care but can’t afford to go?
http://www.totalhealthanddiet.com

Greg Pawelski
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Greg Pawelski

Medicare Advantage penetration is just over 22%. Medicare Advantage plans are more generous because Medicare has been paying Medicare Advantage plans much more per enrollee compared with what the same enrollees would have cost in the traditional Medicare fee-for service program. It comes out of traditional Medicare. These extra payments could be used to provide better benefits for traditional Medicare, like filling in the doughnut hole and reduce out-of-pocket costs for seniors, as well as filling out the bone to doctors by creating a viable alternative to the ineffective sustainable growth rate mechanism currently used to determine the physician payment… Read more »

John B
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John B

Based on data from CMS (http://www.cms.hhs.gov/HealthPlanRepFileData/02_SC.asp#TopOfPage), in December 2005, MA plan enrollment was at 14.0342% of medicare eligibles. This probably has increased since then because of Part D, but as the majority of seniors joined stand-alone plans, it still is most likely not more than 25% in full risk MA plans.

John B
Guest
John B

To be sure, Greg, you should take one more look at how Medicare Advantage plans are financed. It is not true that “Every senior in Medicare is paying more to fund insurance industry overpayments.” In fact, they’re not paying anything at all because for most plans Medicare pays the beneficiary’s full premium. (Some more generous plans have an additional premium for the beneficiary to pay.) And who pays Medicare? Not the seniors, but all people who work in this country and their employers via the 1.45% tax that we both pay. Add to all this the fact that most MA… Read more »

Greg Pawelski
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Greg Pawelski

This is not about the docs. This is about Seniors and what the privatization of Medicare (thru Medicare Advantage) has really meant to their pocketbooks. Every senior in Medicare is paying more to fund insurance industry overpayments. The money used to pay Medicare Advantage insurers is coming out of traditional Medicare. It is time for the Congress to examine whether the extra payments to Medicare Advantage plans are the best use of tax-payers dollars for the beneficiaries the program is designed to serve. These payments could be used to provide better benefits, like filling in the doughnut hole and reduce… Read more »