Sunday, June 29, 2008

Failing America's Seniors

There continues to be a great deal of political fall-out, and deservedly so, from the Senate Republicans move last week to filibuster bipartisan legislation, the Medicare Improvements for Patients and Providers Act, that would have prevented the impending 10.6 percent cut in payments to physicians who care for the 44 million American seniors in Medicare, and made other key improvements to the program.

The Senate's failure to pass this legislation means a 10.6 percent pay cut for doctors will go into effect July 1. In addition, people with Medicare recovering from a stroke or other injury will face an arbitrary cap on the rehabilitation therapy they can receive, since a policy allowing exceptions to the cap also expires July 1. Over 1.5 million older adults and people with disabilities living on less than $1,171 per month ($1,576 for a couple) now face being dropped from programs that help pay their Part B premiums and prescription drug costs. (The bill would have also) improved coverage of mental health and preventative services under Medicare and removed bureaucratic obstacles that prevent low-income people with Medicare from receiving assistance with premiums and copayments for medical care and prescription drugs.

Senate passage of the bill appeared certain after the House overwhelmingly approved the legislation by a vote of 355 to 59, but the audacity of Senate Republicans to recklessly cast aside good policy and judgment and hitch their political fortunes to an unpopular President (who had issued a veto threat) was greatly underestimated. Those upholding the filibuster included Senator John Sununu of New Hampshire, who appears willing to concede his inevitable loss in November to Democrat Jeanne Shaheen. Also leading the way were Bush lackeys Jim Inhofe, who is being challenged by the promising Democratic State Senator Andrew Rice, and John Cornyn, who currently leads Democratic state legislator Rick Noriega in the polls but whose support continues to hover below 50%. In Cornyn's case, a doctors’ group quickly rescinded their endorsement following his vote:

“The Texas Medical Association Political Action Committee is outraged that you made the decision to follow the direction of the Bush administration and voted to protect health insurance companies at the expense of America’s seniors,” Dr. Manuel Acosta, its chairman, wrote to Mr. Cornyn

Here are some more perspectives on the legislation and the vote:

Medicare Rights Center President Robert M. Hayes: "The 39 Republican senators who lined up behind President Bush to oppose this sensible and humane bill are agents of harm to older Americans. People with Medicare, as well as the doctors who care for them, should know that and tell them that as they go home for their July 4th recess. The vote shows a callous disregard for the older adults and people with disabilities in their states and a craven submission to the insurance industry."

Nancy H. Nielsen, M.D., President of the American Medical Association: "The physicians of America are outraged that a group of Republican senators followed the direction of the Bush Administration and voted to protect health insurance companies at the expense of America's seniors, disabled and military families. These senators leave for their 4th of July picnics knowing that the most vulnerable Americans are at risk because of the Senate's inability to act to stop drastic payment cuts for health care services that are needed by our Medicare and TRICARE patients. The House voted to preserve access to care for Medicare patients in a bipartisan landslide vote to pass H.R. 6331 by an overwhelming margin of 355 to 59. The House made seniors, the disabled and military families a top priority. The AMA appreciates the courage of the 59 Senators, including 9 Republicans, who voted to put patients ahead of partisan politics and vote for H.R. 6331. Today, thanks to some senators, we stand at the brink of a Medicare meltdown. On July 1 - just four days from now - the government will slash Medicare physician payments by 10.6 percent, forcing many physicians to make the difficult choice to limit the number of Medicare patients in their practices. The Senate must return from their recess and make seniors' health care their top priority. For doctors, this is not a partisan issue - it's a patient access issue."

Senate Majority Leader Harry Reid: “Our seniors and the health-care providers who care for them have only Senate Republicans to blame when Medicare payments are cut and other key protections expire. The House overwhelmingly passed a good bill in bipartisan fashion that ensures Medicare works better for every American senior and saves taxpayers billions of dollars – but Senate Republicans insist on standing with President Bush to protect insurance companies at the expense of patients and providers. This is nothing short of putting politics above the seniors and people with disabilities who depend on Medicare.”

Senator Max Baucus, Chairman of the Senate Finance Committee: “Senators who voted against the Medicare bill last night just voted wrong. This bill was bipartisan, with huge support in the House, and its failure in the Senate jeopardizes seniors’ access to medical care, plain and simple.”

Rep. John Dingell, Chairman of the House Committee on Energy and Commerce: "Republican Senators were wrong to block legislation that helps beneficiaries and doctors so that they could protect payments to the insurance companies that are scamming our seniors. This week, the House approved this bill with an overwhelming bipartisan vote. We came together in an effort to improve Medicare's preventive and mental health benefits, help low-income beneficiaries and rural communities, and ensure that seniors and disabled Americans can continue to see the doctors they know and trust. It's unfortunate that Senate Republicans have joined the Administration in looking out for insurance industry profits instead of patients. I urge Senate Republicans to reconsider their misguided position and join House leaders in our bipartisan effort to improve Medicare and support the program's beneficiaries."

Rep. Pete Stark, Chairman of the House Ways and Means Health Subcommittee: “Republicans in the Senate tonight rejected a modest and overwhelmingly bipartisan compromise on Medicare. This was the last chance to prevent a July 1st pay cut to physicians. Their willingness to ignore the needs of physicians, seniors, people with disabilities, pharmacies and other small businesses, show that Senate Republicans are truly captive to the health insurance industry. I hope those Republican Senators who voted no don’t plan on making doctor appointments, visiting their local pharmacies, or going to any senior centers over this Congressional break. There are an awful lot of angry Medicare beneficiaries and providers in this country right now – all because Senate Republicans insisted on protecting the insurance industry.”

A list of the many organizations who strongly supported this legislation can be found here. Below are excepts from some of their statements of support:

American Medical Association: “This is a critical vote for the physician community... These cuts threaten to undermine access to care for millions of Medicare beneficiaries.”

Leadership Council of Aging Organizations: “This legislation would strengthen the Medicare program and significantly improve the lives of seniors and people with disabilities throughout the nation. In our view, a vote against the H.R. 6331 is a vote against America's seniors.”

National Community Pharmacists Association: “Pharmacists must be treated fairly by government programs so that they can continue to provide access to our most vulnerable patients—children and the elderly. H.R. 6331 goes a long way to ensure community pharmacists can continue to provide quality prescription care and DMEPOS to help contain health care costs and promote the best possible patient outcomes.”

National Rural Health Association: “The NRHA applauds your efforts to prevent these devastating cuts. Additionally, H.R. 6331 also includes several other critical provisions for rural providers which, cumulatively, create a rural package that will help both protect the rural health safety net and the health of tens of millions of seniors who call rural America home.”

AAHomecare: “We are writing to voice our strong support for HR 6331… the legislation would make meaningful improvements to the bidding program aimed at ensuring that beneficiaries continue to receive high quality homecare items and services of care while also promoting fairness in the bidding process.”

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