Medicare madness

Yes, Sen. Jim Bunning of Kentucky was responsible for holding up a bill intended to stop a 21-percent reduction in Medicare payments to doctors on March 1, but it is not the irascible Republican's fault that the funding problem was left to the last minute or that Congress refuses to consider a permanent fix.

Sen. Bunning has conveniently made himself the whipping boy on the spending issue. The same bill would extend unemployment benefits for millions and reauthorize the Highway Trust Fund that directs federal highway construction funds to the states.

The Senate leadership considered these matters routine and so placed the $10 billion bill on the "unanimous consent" calendar, but Sen. Bunning refused to consent, saying he wanted corresponding cuts, not borrowing, to pay for it all. Democrats pointed to the hypocrisy, since Sen. Bunning did not object when Congress, under a Republican president, allowed President Bush to conduct the Iraq War with borrowed money.

Sen. Bunning's theatrics aside, the gap between Medicare allocations and actual expenses is a serious problem, yet each year since 2003 Congress has opted for a temporary fix. The intent of the annual Medicare reimbursement cuts is to reduce the deficit, but they've proved unrealistic. So every year as the March 1 date for the cut arrives, this year 21 percent, Congress passes a temporary measure to maintain funding. Only this time Sen. Bunning got in the way.

The federal government is urging doctors to hold their claims for 10 days until a Senate bill passes and they can get full reimbursements. The American Medical Association warns that if doctors had to actually take a 21-percent reimbursement cut, most would reduce the number of Medicare patients they see and thousands of older doctors would close their practices and retire.

The solution, of course, is to eliminate the planned reductions permanently and focus on realistic ways to bring down Medicare spending. But that would require honest legislating.