I echo many of the comments from the July 11 LJS opinion “Medicare games show why confidence ebbs.” Unfortunately, election-year decisions show many of our elected representatives “playing to the sound bite crowd of today” rather than considering the long-term ramifications of their actions. That was especially true in the recent debate over Medicare reform.

For decades, America’s seniors were promised prescription drug coverage as well as new and improved health care options. The Medicare Prescription Drug Plan program, begun in 2006, provided a competitive environment between private carriers that not only has saved seniors thousands of dollars, but has resulted in premiums averaging nearly 20 percent less than the government had anticipated and has saved the program millions of dollars. Medicare Advantage plans were expanded at the same time and gave people eligible for Medicare several options other than original Medicare to receive their health care.

They are especially popular with those having low incomes, being disabled under age 65 and requiring few healthcare services. So popular, in fact, that almost 10 million beneficiaries enrolled in just the first three years. Unfortunately, having found programs that saved people money, Congress decided they needed to be changed.

“The Medicare Improvements for Patients and Providers Act of 2008” sounds grand but, as we all know, the devil is in the details. The original intent of the legislation was to fix the automatic 10.6 percent cut in reimbursements to Medicare physicians.  The cut already had been delayed since January while Congress attempted to find a remedy and was further delayed beyond the July 1 implementation date while they played “political football.”

Few argue that the cuts would reduce the number of doctors willing to accept Medicare patients and, thus, reduce accessibility for that more vulnerable population. But, where to get the money? How about the Centers for Medicare/Medicaid Services’ recommendation to institute competitive bidding for Durable Medical Equipment? That alone is estimated to save the government $1 billion and individuals another $280 million in co-pays annually.  No, the bill delays that savings for another 18 months of “study.”

According to the Congressional Budget Office, Medicare Advantage plans receive approximately 12 percent more per beneficiary than traditional Medicare. These extra benefits are the result of Congress’ original decision to ensure that most of the savings from competitive bidding would be given back to seniors through better benefits or lower premiums … and they have been. But, the success of the private program became an easy target for those seeking greater government control.

On July 15, both the House and Senate overrode the presidential veto of the bill. As a result, the legislation will turn back the clock for millions of seniors at the expense of the old, poor and disabled. These private plans may now be reduced or eliminated and leave seniors with no choice other than traditional Medicare and the more expensive supplements. Many will be forced to live without the additional benefits the private Medicare Advantage plans provided at a lower cost. Now, perhaps, we see why the approval rating for Congress has dropped to just 9 percent.

And no, the fun isn’t over. Another automatic cut in reimbursements is scheduled in just 18 months. Where will Congress look for money then? You may be getting nervous, and you should be! The problems in funding and services we see Medicare and Medicaid experiencing are symptomatic of what happens with a government-controlled health care system (also note the VA).

To squeeze the expanding desire for health care within ever-tightening government budgets, rationing must occur. Whether it is the amounts paid to providers or the services allowed for patients, there will be greater limitations at higher costs to all health-care consumers. Studies show that the cost shifting because of the already low Medicare and Medicaid provider reimbursements has increased private health insurance premiums by nearly 25 percent.

The American people have tough decisions to make and expect our legislators to do likewise. Will we continue to expand under-funded government-run health plans that further limit the services we can access, like our Canadian and European neighbors, or will we embrace private health plans vying for our business through innovation and competition? We still have a choice. You can’t afford to sit this one out. Contact your legislators and make your desires known.

Bob Grundman of Senior Benefit Strategies in Lincoln is chair Medicare Advisory Group of the National Association of Health Underwriters, which has 20,000-plus members.