Jul. 14, 2008 (McClatchy-Tribune Regional News delivered by Newstex)  ─ Now that the bill has passed Congress by an overwhelming majority in both chambers, President Bush should withdraw his threat to veto legislation that would restore a 10.6 percent cut in Medicare payments to doctors who care for millions of elderly Americans and members of the armed services and their families. This bill needs to take effect to ensure continuing healthcare for both groups of Americans.

Decisive vote

Because the Senate delayed passing the bill until last week, the physicians' payment cut took effect July 1. In response, some doctors have stopped enrolling new Medicare patients while others are closing practices to all but emergencies. Because the U.S. military healthcare program -- called Tricare -- uses Medicare fee schedules, doctors who treat troops and their families are in the same boat.

The House overwhelmingly approved the bill and, with pressure from the American Medical Association and a decisive vote from Sen. Ted Kennedy, enough Republican senators voted for it to make it veto proof. Mr. Kennedy's surprise appearance in the Senate drew applause from both sides of the aisle. He has not been in the Capitol since his diagnosis of a cancerous brain tumor, for which he is being treated. With his vote, the Democrats broke a deadlock that Republicans maneuvered two weeks ago to delay a vote on the bill.

Mr. Bush and many Senate Republicans don't like a provision in the bill that would pay for the increase in doctors' reimbursements by taking some funding from a federal program that pays private insurers that insure seniors. The privatization was intended to reduce costs. Instead, every independent study has found that it is costing U.S. taxpayers more than government-run Medicare.

At this point the veto threat is pointless because of the veto-proof majority. The House, which authored the remedial bill, was simply exercising fiscal responsibility by finding money to pay for the hike in doctors' reimbursements. It took the money from a less efficient program -- the privatized insurance plan.

Inefficient program

What's more, the reduction in payments to doctors is a problem that Congress has to repair almost every year because it relies on an outdated formula that dictates where Medicare dollars can be spent. As more people sign up for Medicare, the program needs more doctors to treat them.

The problem is that the formula for annual allowable Medicare expenditures on physicians' fees hasn't been changed to keep pace, which explains why Congress must fix this glitch so frequently. The solution would be to redo the formula to reflect today's reality. Unless it chooses to act in this sensible way, Congress will continue to operate the Medicare program in this inefficient manner for years to come, to the benefit of no one.

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