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Health Care Reform Schedule and Medicare

Posted Oct 19 2009 10:02pm

category_bug_politics.gif If email messages I've been getting is an indication, some people are confused about the process of the health care reform in Congress. A couple of them seemed to think that the bill passed by the Senate Finance Committee last week was the final bill. Not so, as many who read this blog know.

On Friday, several other elderbloggers and I had another telephone conference call with aides to Senate Majority Leader Harry Reid in which we discussed the schedule for a final Senate bill and some Medicare issues.

Senate Health Care Reform Bill
The next step is to combine the two Senate bills – the HELP bill from the Health, Education, Labor and Pensions Committee and the Baucus bill from the Senate Finance Committee. Work on that merger begins this week and on an optimistic timetable, will be finished by Friday 23 October.

The biggest difference between the two bills is the much-argued public option provided for in the HELP bill but not in the Baucus bill.

Whether a combined bill emerges on Friday or later, the bill must then be scored (calculate the cost) by the Congressional Budget Office (CBO), a task that may take two weeks. Senator Reid's aides predict that it should be done by early November. Then it goes to the Senate floor for a vote.

Given the glacial speed at which Congress ordinarily moves, along with whatever monkey wrenches various senators may throw into the negotiations, my estimate is by Thanksgiving. When I suggested this to Senator Reid's aides, they said they believe that would be the latest date.

Meanwhile, the three reform bills in the House must go through the same merger, scoring and vote procedure.

Then, those two bills go to a conference committee of the two houses of Congress from which one final health care reform bill emerges. (CSPAN may broadcast the conference committee which should be fascinating to watch.)

Maybe I'm just a pessimist, but I don't see how there can be a bill on the president's desk, as Obama wants, by the new year. I think very early in 2010 is more likely but I could be wrong...

Medicare Physician Payments Over the years here at Time Goes By, I've heard from readers who are Medicare beneficiaries that they have been “fired” by their doctors or that they have had trouble finding a physician who will take new Medicare patients. A lot of this has to do with physicians' pay.

As the current law stands, beginning 1 January 2010, physicians will see a 21.5 percent pay cut for their Medicare patients. And according to a 2007 study, Medicare payments to doctors were then 20 percent below what private insurers pay. In another 2007 study, from the American Medical Association, 60 percent of physicians said they would limit the number of new Medicare patients with only a ten percent cut.

Faced with a growing elder population (the oldest boomers will become eligible for Medicare in 2011) and the need for more Medicare physicians, Congress intends to do away with the pending 1 January 2010 cut, which should happen this week. New and more reasonable payments for Medicare patients will be forthcoming in the final Senate version of the health care reform bill, according to Senator Reid's aides.

Contacting Your Senators
Although I mentioned this a week or two ago, it bears repeating. The senator's aides tell us that our phone calls, email and letters to our Senators count a great deal. They are tallied and tracked and discussed with senators' offices. And multiple contacts from us help.

So make your positions on health care reform known to your senators, and keep doing it. You can contact your senators here.

At The Elder Storytelling Place today, William Weatherstone: Alzheimer's: Part 8 – The Final Day

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