Medicare games show why confidence ebbs

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If Congress wants to know why it recently recorded the lowest confidence level ever measured by the Gallup organization for any U.S. institution in the past 35 years, its handling of the Medicare program would be one place to start.

The Senate finally got around to reversing an automatic 10.6 percent cut in Medicare reimbursements for physicians on Wednesday, but not until Republicans and Democrats finished playing a game of chicken that most voters neither understand nor want to.

The American Medical Association called the latest standoff the “Medicare Meltdown.” The term fits. This time the blame falls on the Senate. The House approved its version of the legislation weeks ago.

Congress ordered the automatic cuts in Medicare rates years ago, but it’s never allowed them to go into effect. There’s little debate that if there were cuts, the ramifications would be drastic. As reported in a Journal Star story last month, some local doctors would stop taking Medicare patients because they couldn’t afford it.

Technically, the cuts were to take effect July 1. But the administration granted the Senate a little more time by agreeing to delay processing claims for 10 business days. That stopgap solution was bad enough. But it’s better than the mess created two years ago when the cuts actually went into effect for a short time. Congress restored the cuts retroactively, but the bookkeeping was horrendous.

The rhetoric that flew around the Senate chamber was revealing. “If we don’t get 60 votes, the Republicans are going to have to live with that,” said Majority Leader Harry Reid.

Well, the Democrats would have to live with that too, along with every other American.

Meanwhile, as political one-upmanship continues, major structural problems with Medicare continue to be ignored. Medicare’s board of trustees said recently that the program’s trust fund will be gone by 2019.

Long-term solutions are needed in the program. Most imperative is the need to reduce fraud. A recent congressional investigation revealed that con artists used the identities of dead doctors to fraudulently collect Medicare reimbursements. The loss in that particular scam might be as much as $923 million. A Government Accountability Office review found that Medicare improperly paid $900 million for medical equipment in fiscal 2004.

Members of Congress seem to be deluding themselves that Americans are keeping score with them at home. Wrong. The vast majority of Americans want effective problem-solving and management competency from their government.

Sen. Ben Nelson deserves credit in the recent Medicare struggle for winning approval for a provision that allows rural hospitals to continue providing off-site laboratory testing.

But the overall impression left by the Medicare squabble is negative. As long as Congress handles its responsibilities in such a sloppy and sluggish fashion, its approval rating is likely to continue to slide.