Oncologists on Medicare vote: Not in our name By Ryan Grim 2 Jul 08 (http://www.politico.com/blogs/thecrypt/0708/Oncologists_on_Medicare_vote_Not_in_our_name.html)
Sen. Arlen Specter (R-Pa.) sent the American Medical Association into a tizzy Thursday night by switching his vote and blocking passage of a crucial Medicare bill. The flip came after the White House offered to work with him on getting more money for oncologists, so you'd think that at least the oncologists would be pleased.
They're not. At least not all of them. A five-member team of lobbyists representing the American Society of Clinical Oncology met with Senate Democratic staff Wednesday to assure them that they had not lobbied Specter to make a deal, said both a Democratic aide and a spokeswoman for ASCO. Another Democratic aide referred to the message the oncologists delivered as "not in our name."
"They were horrified," said one Democratic aide, and afraid that oncologists would be blamed by Democrats and doctors for spiking a bill that would have staved off a 10.6 percent cut in Medicare reimbursements. Democrats were one vote short.
Specter, by working on behalf of the oncologists, has put the oncologists in a difficult situation, stuck between the AMA and Democrats on one side and a fear of alienating their champion, Specter, on the other. ASCO wouldn't comment on the meeting other than to confirm its goal.
Oncologists aren't of one mind, however. The Community Oncology Alliance sent a letter to its members after the failed vote urging them to push the Senate to include the money for oncology that Specter sought in the final Medicare bill.
U.S. Oncology has also been lobbying hard for the provision. "I was certainly pleased," said U.S. Oncology lobbyist Dan Cohen of Specter's talks with the White House. "If he was able to get a deal," he added, "we're all behind him."
Ultimately, the Medicare cut will be avoided because staving it off has "strong bipartisan support," said Cohen. "We certainly don't want to see our payment from Medicare getting cut. Medicare patients already cost us money to treat."
But he put little distance between his organization and Specter's vote. "Sen. Specter has been an extremely strong supporter of oncology and we're strong supporters of Sen. Specter," he said.
Specter, for his part, acknowledged the offer from the White House but said that the real reason he switched his vote was that Majority Leader Harry Reid (D-Nev.) wouldn't let him introduce amendments.
Specter's staff has been lobbying Reid to allow amendments when it's voted on again next week, but Reid's staff notes that Specter already signed on the unanimous consent agreement — negotiated between Reid and Minority Leader Mitch McConnell (R-Ky.) — that forbids amendments.
"I don't know what the hell McConnell agreed to, but that wouldn't be determinative with me," Specter told The Crypt.
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GOP fears fallout from Medicare fight By Ryan Grim & David Rogers 1 Jul 08 (http://www.politico.com/news/stories/0608/11456.html)
The Bush administration moved Monday to assure doctors that coming cuts in Medicare reimbursements would take a few days to kick in, buying time for Senate Republicans to recover from a vote that has Sen. Arlen Specter scrambling to explain himself and GOP aides wondering why their party's leadership has risked infuriating a loyal constituency.
A Democratic bill that would have blocked a 10.6 percent cut in Medicare payments to doctors fell just one vote short of the 60 needed for cloture Thursday. The measure would have passed if the ailing Sen. Edward M. Kennedy (D-Mass.) had been there to vote — or if Specter, who had supported a similar bill earlier, hadn't voted against cloture after some eleventh-hour dealing with the White House.
Specter said he voted against cloture because Senate Majority Leader Harry Reid (D-Nev.) refused to allow any amendments. But the Pennsylvania Republican — who has been diagnosed with Hodgkin's disease — also acknowledged that he voted no after White House representatives assured him that they would work with him on an administrative fix to increase Medicare reimbursements for oncologists.
Was there a deal made for Specter's vote?
"You've asked the question about a quid pro quo 15 different ways now," Specter told Politico on Monday.
"There was none. ... If that had been a determinative factor, I didn't get much assurance — didn't get much comfort — from the conversation."
But Specter did get a hearing on his desire for legislation to alter the Medicare formula that now dictates the drug payments for oncologists. And while the White House can't get around the current law administratively, people familiar with the meeting confirmed there was discussion of the White House's reinstituting a now-expired pilot program for the senator and thereby increasing payments to at least some oncologists.
Specter's vote became the decisive one, because Kennedy was absent and because Sen. George Voinovich (R-Ohio) — who previously opposed a similar measure — switched from no to yes, in a move that seemed to be aimed at protecting home-state oxygen tank manufacturers.
The failure of the bill Thursday night led to red-hot rhetoric on the Senate floor and to reverberations across the country as senators went home for the Fourth of July recess.
Reid accused Republicans of "wip[ing] out Medicare as we know it today" and said that he wanted "the record to spread: Democrats, to the number, every one of us, except Sen. Kennedy, who is ill, voted for this legislation." He promised that "next year at this time, there will be 59 Democrats, at least."
The American Medical Association, a longtime Republican ally, is outraged and is scheduled to begin running television ads on the issue Tuesday. On Friday, the Texas Medical Association withdrew its endorsement of Sen. John Cornyn (R-Texas) as a direct result of his vote on the Medicare bill.
"We're going to get killed, and we'll have no help from the doctors," lamented one Senate GOP aide, who called the leadership's position on the bill "unfathomable."
Having begun to hear from doctors back home, he asked, "Why the hell did we fight this as a party? You took a constituency that's very friendly and just flushed it down the toilet."
Senate Minority Leader Mitch McConnell (R-Ky.) argued on the Senate floor that passing the bill as is was futile because President Bush had promised to veto it. Republicans accused Democrats of failing to work with them to achieve a compromise measure.
All sides say they want to forestall the physician pay cut. But paying for the fix has grown into a larger ideological battle over the direction of Medicare and how best to both rein in the costs of medical equipment and drugs and balance demands for private market alternatives to traditional government-run care for the elderly.
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