MEDICARE CUTS: Seniors Not So Sympathetic

      Many advocacy groups for senior citizens "are expressing skepticism about providers' ongoing campaign to persuade lawmakers to increase their [Medicare] payments," having seen no evidence that the reduced reimbursements create access problems. AARP Legislative Director John Rother said, "The cries of pain heard in the boardroom haven't translated yet -- and may never -- into delivery of patient care. We're taking a wait-and-see approach." Ron Pollack, executive director of Families USA, said, "It's always hard to sort out where various providers are crying wolf and making claims that are aimed at padding their pocketbooks as opposed to (raising concerns about) access." And Howard Bedlin, vice president of public policy at the National Council on the Aging, added, "We have not been hearing a great hue and cry from members," questioning whether providers' financial difficulties are the result of poor management. Some congressional Democrats echo the skepticism. One staffer said, "We're not hearing from real people. We're hearing from people who are having trouble paying for a second Mercedes. This is the dog that wouldn't bark." Indeed, Modern Healthcare reports that the payment restriction may not be all that historically egregious. Over its five years, the Balanced Budget Act sets inpatient payment increases from 2.7 to 1.1 percentage points below the hospital inflation rate known as the market basket index. Since 1984, the payment update has only exceeded the market basket index once, and in 1986, the rate was set at 3.8 percentage points below. Hospital groups concede that without the support of seniors, they will have a tougher time lobbying Congress. Thomas Scully, CEO of the Federation of American Health Systems, said seniors' help "would help us a lot -- no question," adding, "I don't think they've seen any compelling evidence. I personally think they're going to see that in six months" (Gardner, 5/17 issue).