Ted Kennedy comes back to the Senate in order to block cuts in Medicare payments for doctors. The New York Times rather gleefully calls this a stinging defeat for Republicans. This makes it sound as if the whole thing were some sort of glorified athletic contest, where the important thing is that our team wins. But the question is rather more important than that. Basically in the late 1990s Congress passed a law tying Medicare payouts to GDP--if they grow too fast, relative to GDP, reimbursements automatically drop. Ted Kennedy came back from medical leave to override that automatic cut, just as Congress has every year in recent years.

All very well, and many physicians will tell you that they just can't afford to treat Medicare patients for much less. But this--not some bogeyman in a pharma marketing department--is why the cost of Medicare is rising so fast. If we don't have the political courage to slash reimbursements, or to ration care, then the Democrats should give up any pretense that they are going to slow the growth of entitlements, and just admit that they're for the thing growing as fast as it can, forever.

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