Pay cuts to doctors who take medicare (this would be virtually all of us) have been blocked by Congress today after a dramatic vote led by Senator Edward Kennedy.  It was a heady day in the world of medical politics.

A few years ago, the government decided it would be a good idea to ‘balance the budget’.  A balanced budget is nothing more than making sure you spend at least a teensy bit less than you make.  My readers of conservative mind will probably find this balancing act a rather good idea.  This includes me.  Always good to not spend money you don’t have.

The problem is that under the guise of ‘balancing the budget’, politicians decided to cut doctors’ pay.  This decision does nothing to help fiscal matters, but is very politically-expedient.  Insurance companies have a tremendously powerful lobbing organization, and most officials figured it was smarter to knee-cap docs than insurance billionaires.  Thus, they voted to continue directing the jet-wind of dollars toward an industry that exists by preying on sick people.

Recently the first of two MAJOR pay cuts finally arrived, set to begin on July 1st.  The AMA – an organization I generally regard as a lifeboat filled with “The Others” from Lost (they’ll probably kill you…but they just might save you if they feel like it) – actually focused themselves and put up a good fight.  They lobbied hard, went public and pressured wavering lawmakers.  Eventually, the Democrats (Max Baccus kinda got the ball rolling) put up a proposal to block the cuts, and after some wrangling, a law passed in the House by a landslide vote 355 to 59 vote.  Good.  Now all that was needed was the Senate to pass the same law.  Then doctors across America could go back to wondering how they’re going to pay for the rising costs of insurance with Medicare payments that haven’t kept up with inflation since the ’90’s.

The problem is that the Senate is where the insurance lobby has more traction.  It put more lobbying effort there in the first place.  Furthermore, they have George Dub in their pockets as well.  He’s so strung to them he has vowed to flat-out veto a bill that blocks the pay cuts.

“WHY?”  You might ask.  “WHY would he do that?  Oh, that’s RIGHT!  Dubbage is a conservative.  He’s hewing to good, conservative economics.  It must be that the one expense we can’t pay for while keeping a balanced budget is doctor’s salaries. “

Not even close.  Bush is more liberal than Clinton when he was a barefoot hippie not inhaling Russian weed and perpetually copulating in the back of astro-turfed pick-ups.  Bush has no principles.  He did once, but he’s been bought.  By insurance companies, among others.  He threatened to veto the new law for the simple reason that it pays for itself by lowering payments to something called “Medicare Advantage”.

Medicare Advantage is medical insurance from a commercial insurance company, but instead of the patient paying the company – like normal – the government pays for it instead.  Medicare pays for medical care for 44 million elderly and disabled Americans.  For 80% of these people, Medicare simply sends money to doctors when the doctor sends Medicare a bill after seeing a patient.  The other 20% (approximately 8.7 million people) use MA (Medicare Advantage). Enrollment varies widely across states.  Over half of the enrollees are located in CA, FL, NY, OH, PA and TEXAS.  Most of the rest are in a smattering of states and some states have almost nobody on the plan.  The plan is ostensibly accessible to everyone, but in fact is unevenly utilized and by definition costs the system more because TWO payers are in the mix rather than just one.

Bush wants to protect this system by lowering doctors’ salaries.

Medicare doesn’t pay great (if the doc bills $100, they’ll just sorta figure they’ll send about $75…somewhere in the world, that’s called stealing, but not here), but they do pay.  Until we come up with a more comprehensive system, Medicare is worth keeping around.

The Senate was initially dead-locked on the bill.  Democrats were united in favor of it, but a number of conservatives were against it (the ‘big business’ thing, you see).  Today, however, just at the Senate began to re-vote on the issue, in walked a weakened but determined Ted Kennedy – recently released from the hospital – leaning on many assisting arms.  He slowly made his way to the podium and cast his vote in favor of the bill to thunderous applause from both the gallery and the representatives – traditionally a no-no in the staid and musty Senate chambers.  Caught up in the moment, numerous Republicans switched their votes, and the bill passed by a solid margin, 69-30.  If Bush has the bald temerity to veto the bill, and everyone re-votes just as they did today, the bill would survive even the President’s craven attempt at pandering.

The answer to the woes of our medical system do no lie in harassing doctors or paying them less – a trend that has been gaining prominence over the past 20 years.  Sensible liability, insurance profit constraint and funding for primary care is what will save American Health Care.  Our government needs to figure this out quickly, because currently we’re relying on the common-sense and courage of a feeble, white-haired lawmaker dying of brain cancer.