Medicare Showdown

I think that this over-ride of the Medicare bill is going to be a landmark for healthcare reform. To underscore it's importance, I just noticed that the New England Journal just issued it's web edition and there is a very interesting analysis of the veto over-ride vote that just occurred yesterday (talk about up-to-the-minute!). As with the Krugman Op-Ed and the New York Times editorial (not to mention our own blog post), this NEJM "Perspective" sees this as good for physicians and for Medicare.
I personally also feel that this over-ride may be a turning point in what I believe is an outright war against Medicare and other publicly financed healthcare by the current Federal administration. Until this vote there has been an all-out push to "privatize" all aspects of Medicare, giving every advantage to the private sector so (and I believe this was a deliberate aim) that "public" Medicare will collapse.
Now, I know that Medicare is not perfect, but I think that many of us in the health care delivery end of the issue see that "public" Medicare is more user friendly to both patients and healthcare providers and is more fiscally efficient. In fact, the introduction of these "privatized" plans have only benefited the health insurance industry and made our jobs more difficult (as with the introduction of "pre-approvals" for Medicare patients) and have driven up costs.

Getting back to the NEJM piece; it closes with this;

Although the temporary fix for physician fees will alleviate the immediate concerns of many doctors, the remuneration problem remains unresolved for the longer term. No one is satisfied with the current formula by which Medicare calculates physician fees, but Congress has hesitated to act because of the hefty price tag that would be attached to any change deemed acceptable to both policymakers and physicians. Members of Congress have urged physician groups to develop their own proposals, but because any viable plan is certain to result in both winners and losers, organized medicine, too, has been reluctant to act. So for the time being, annual Band-Aids will continue to be the standard of care for Medicare's physician-payment woes.

So I want to thank Congress for this important vote!... but at the same time it is clear that there is still a great need for a new politically viable system.
Gil