As expected, the Senate has gutted Medicare Advantage, effectively killing the last hope of market-based Medicare reform. The “news” media, the AMA, and even some normally sensible medical bloggers are spinning this act of stupidity as a victory for beleaguered physicians over mean-spirited Republicans and insurance company robber barons.
But the physicians didn’t win a victory. All they got was a temporary stay of execution. The reimbursement cuts will be back with a vengeance, probably in 2010, and they will stick next time. Instead, the docs were duped into euthanizing their only real hope of escaping the endless cycle of pay cuts and metastisizing Medicare regulations.
And it wasn’t the insurance companies who lost. The real losers were low-income, rural and minority seniors. Medicare Advantage is very popular with these patients because of its lower co-pays, more comprehensive benefits, and the increased primary care access the program provides in underserved areas. Per the Heritage Foundation:
According to a 2007 CMS report, 57 percent of Medicare beneficiaries have incomes between $10,000 and $30,000 annually, compared to 46 percent of beneficiaries in traditional Medicare. Also, 27 percent of Medicare Advantage enrollees are minorities, compared to 20 percent of enrollees in traditional Medicare.
The Senate’s craven and short-sighted vote condemns these patients to the tender mercies of traditional Medicare which, due to its unsustainable fiscal situation, will increasingly be forced to cut benefits, raise co-pays, and restrict access. This is what the Democrats, the AMA, and a few pusillanimous Republicans (a tautology, I know) have accomplished.
Good work guys.