Yesterday, Tuesday, US Congress quashed President George W Bush’s veto of a bill to prevent cuts in doctors’ payments from Medicare, the government funded health insurance scheme for seniors and disabled. The House of Representatives voted 383 to 41, and the Senate voted 70 to 26, in both cases more than enough to override the White House veto, for which a two thirds majority in each house is required.

The Republicans broke rank, 153 in the House and 21 in the Senate, and voted with Democrats to stop a planned reduction in Medicare doctors’ payments which would have automatically come into force at the start of this month because of a formula that ties the payments to spending targets that were not attained, reported the Washington Post. The planned reduction would have led to a 10.6 per cent cut in doctors’ fees. Congress voted instead for cuts in reimbursements to the insurance companies that provide services via Medicare.

The Democrats introduced the legislation to stop doctors leaving the Medicare program, maintaining that private insurers were being over-funded under Medicare Advantage, which offers beneficiaries treatments via private insurers like UnitedHealth Group and Aetna, who are then reimbursed by the government scheme.

The Democrats argue that over 80 per cent of the mostly elderly patients in the Medicare scheme prefer to be treated by doctors in the scheme, and that this more traditional way was being undermined by generous subsidies to private insurers.

House Speaker Nancy Pelosi (Democrat, California), is reported by the Washington Post to have said:

“I guess the president is voting with them [the insurers] and not with America’s seniors and those with disabilities when he vetoed this bill.”

Bush said he supported the move to stop the cuts in doctors’ fees but objected to the 13 billion dollars’ worth of cuts to insurers, saying it would result in fewer choices for seniors and would undermine the managed care program:

“I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong. This bill is objectionable, and I am vetoing it,” said Bush in a statement to the House, according to Reuters.

The Washington Post that said the President called the bill “fiscally irresponsible” and was destined to “undermine the Medicare prescription drug program.”

The White House position was not supported by the medical profession. The American Medical Association and the seniors’ group AARP mounted a large and aggressive advertising and lobbying campaign to put pressure on Republicans to team up with the Democrats on this issue.

AARP’s executive vice president Nancy LeaMond told the press:

“This bill will improve Medicare for the 44 million Americans who depend on it for quality, affordable health care.”

However, some experts say all that Congress has done is simply delay the problem, since the same issue will come up again in a year’s time. ” The major spending or organizational issues concerning Medicare” remain unresolved, said the president of the Federation of American Hospitals, Charles N “Chip” Kahn III, in a report by the Washington Post.

How to organize and pay for Medicare will no doubt be high on the agenda of the next US president, who is due to take office on 20th January 2009. The problem grows bigger every day, as the baby boomer generation enters its senior years, bringing over 75 million new beneficiaries into the government funded scheme.

Sources: Washington Post, Reuters.

Written by: Catharine Paddock, PhD