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The SPOTLIGHT Nov/Dec Health & Fitness Supplement

Congress Sickens Seniors with Bad Care Bill

  • Lawmakers Attempting to Return Freedom of Choice to the Elderly
Now that lawmakers have read the omnibus budget bill and have seen how seniors were mistreated, some want to reverse changes that should never have been enacted.
By James P. Tucker, Jr.

An obscure provision of this year's Balanced Budget Act, Section 4507, effectively bars Medicare patients from making private arrangements with their physicians.

This is yet another example of Congress voting on a massive bill or how it effects you. Other examples are legion. The North American Free Trade Agreement, the World Trade Organization implementation legislation, various omnibus crime bills and annual budget bulls are a few examples.

In recent years, as Medicare "savings" were achieved by cutting back on reimbursements, many patients have paid a small extra fee to retain the services of their physician.

Some doctors simply quit seeing Medicare patients because it was unprofitable. Many continued seeing some Medicare patients as a matter of principle.

Here's what Section 4507 does: If you are on Medicare and want to go outside the system to pay your doctor directly, with your own money, for medical treatment or procedure already covered by Medicare, you can do so. But there is a catch.

Your doctor will first have to sign an affidavit agreeing not to submit a payment claim to Medicare for any other Medicare patient for a full two years.
In other words, your doctor will be slapped with a serious financial penalty if he does business with you on a private basis. Your right to contract privately with him outside of Medicare will depend entirely on your doctor's ability or willingness to give up all other Medicare patients for two years.

Congress refuses to say why the government objects to such deals, which involve personal funds and makes more services available to those willing to pay for them.

In Britain, which has a socialist system of medical care patients are allowed to pay more than what the government authorizes in order to see the doctor of choice with no penalty.

Sen. Jon Kyl (R-Ariz.), who is leading a fight to rescind the law, said if it were applied to Social Security, beneficiaries would be effectively banned from doing business with a stockbroker.

The Medicare Beneficiary Freedom to Contract Act, expected to come up early in the next session, would kill the provision.

"There's very much a head of steam building under this," Kyl said. "The leadership in both houses is committed to seeing this done."

Kyl is leading the repeal movement in the Senate, while Ways and Means Chairman Rep. Bill Archer (R-Texas) is seeking its abolition in the House.

Republican leaders "should be embarrassed by this," Kyl said. It is wrong that "the people who negotiated the budget deal allowed it to be imposed on us in the first place.

The American Medical Association, other physician groups and a coalition of self-avowed "conservative" organizations are supporting repeal.


But the American Association of retired Persons (AARP), the nation's largest organization of elderly, supports the measure. Since AARP membership is built mostly on economic inducements, it is unable to really speak for its members.

On occasion, when members would read of an AARP position, they would flood the office and members of Congress with calls renouncing the position. It released this position:

"AARP believes the new Kyl bill would weaken critical protections in the budget bill for beneficiaries and the fiscal integrity of the Medicare program."

But another organization of the elderly, with a membership built more around ideology than low-interest credit cards and low-cost travel, supports the Kyl amendment. Said Mike Korbey of the United Seniors Association: "As Medicare keeps ratcheting down payments to health care providers, it may be the private sector will serve as a safety valve for people to go outside the system to get the care that they need.