Kennedy’s Vote on Medicare Was Crucial
When Sen. Kennedy flew to Washington — against the advice of his brain-cancer doctors — to vote on the Medicare bill which President Bush and Congressional Republicans had tried to block, he wasn’t just protecting doctors from cuts in fees, although that was critical for patients as well as physicians.
Kennedy was defending traditional Medicare, not the type called “Medicare Advantage,” which is offered by private insurers, usually for-profit corporations.
Medicare Advantage is the result of the “Medicare Modernization Act of 2003,” enacted by President Bush and the Republican-controlled Congress of Bush’s first term.
This is the legislation that led to the Medicare prescription drug program with its infamous “doughnut hole.”
You may recall that the 2003 law prohibits the government from negotiating drug prices. (Why would Republicans, who rail about the cost of government programs, want to avoid the best deal for taxpayers?)
The 2003 law also increased the privatization of Medicare by paying insurers to offer health plans.
Medicare Advantage has been an extremely expensive program, costing far more than the Bush administration had forecast to Congress. (The administration threatened an official with termination if he revealed the true estimate before Congress voted. A month later, the cost estimate was revealed to be $100 billion more than the administration had told Congress.)
Medicare Advantage offers managed-care plans in which Medicare pays private insurance companies to provide care rather than paying doctors and hospitals directly.
The private-sector plans cost the government an average of 12 percent more than traditional Medicare for the same services, and they have been taking up a larger and larger slice of Medicare funding.
Senator Obama has expressed concern about “the exploitation of senior citizens by private insurers participating in the Medicare Advantage program. According to an analysis by the New York Times, tens of thousands of Medicare recipients have been the victims of deceptive sales practices by these private insurance companies, had claims improperly denied or denied without explanation, and received poor customer service in trying to get their questions answered. In some cases, the practices of these companies were found to have affected the health of patients by delaying access to urgently needed health care services and medications.”
(Obama has said that as president, “I will reduce costs in the Medicare program by enacting reforms to lower the price of prescription drugs, ending the subsidies for private insurers in the Medicare Advantage program and focusing resources on prevention and effective chronic disease management.”)
One of the biggest companies in the business is UnitedHealth, whose shares are traded on Wall Street. The firm’s president had total compensation in 2007 of $5 million and was recently charged in court as having had a role in the backdating of stock options. (His predecessor “stepped down” as a result of that scandal.)
One of UnitedHealth’s divisions offers the Evercare Special Needs Plan for People with Limited Income. The Boston Globe recently reported that Massachusetts officials have received numerous complaints about the plan’s marketing techniques.
The Globe quoted an attorney for Greater Boston Legal Services: “We’ve heard of cases where brokers have signed up people who don’t speak English … They didn’t tell seniors that there are networks, and they may not be able to see their own doctors. They promise that taxi rides to doctors’ offices and bingo games are part of the program. Some said they were from Medicare itself and that it was going under and they needed to sign up.”
As a result of the state’s review, UnitedHealth has decided to temporarily stop sales of the plan in Massachusetts. Will they now train brokers not to use misleading sales tactics?
The reason that Kennedy went to Washington while undergoing brain-cancer treatment was to prevent the private-sector plans from taking funding away from traditional Medicare.
When Medicare spending exceeds certain limits, automatic cuts are triggered. This year, the cuts could have meant a steep drop in payments to physicians.
The Democratic leadership proposed instead to reduce the excessive subsidies to private insurance companies. President Bush and Congressional Republicans wanted to protect the insurance companies.
At first Democrats couldn’t prevent a Republican filibuster because they needed one more vote — hence Kennedy’s selfless return to the Senate.
With our courageous lion in action, a few Republicans were persuaded to switch their position and voted with Democrats, ensuring passage of the bill.
This vote illustrates fundamental philosophical differences between the parties. Democratic plans usually emphasize the common good. Republican plans usually favor private profit, often at enormous cost to taxpayers.
