Through a glass darkly.

Congress, today, overrode President Bush's veto and passed H.R. 6331, a bill originally designed to delay a scheduled decrease in Medicare reimbursements that became so packed with Congressional fodder it was guaranteed to be vetoed by the administration. Doctors now anticipate a reimbursement increase instead of a sizable decrease. Competitive bidding on durable equipment contracts has been limited, or removed, stalling market forces. The political power grab is obvious and benefits anyone in favor of big government and national healthcare. Setting aside the political loss to the White House, which is a non-issue, some claim the big losers are insurance companies that participated in Medicare Advantage, a program that enabled recipients to choose among various health plans based on price versus coverage, and introduced market forces to Medicare. Generally, recipients received expanded coverage at reduced rates, so it's hard to figure why Congress should want it removed; nevertheless, millions of recipients will now see their coverage go down and premiums go up without Medicare Advantage.

I can't fault physicians for wanting fair reimbursements for their services. Who doesn't? But at what point do reimbursements become subsidies? We must acknowledge that Medicare is failing and someone is going to foot the bill. Regardless of how long this obfuscation takes or how dark it becomes, Medicare's insolvency is assured, unless some group accepts a loss to save the nation. Currently, that sacrificial lamb is our grandchildren's generation, who will likely see healthcare absorb 50 percent of America's GDP, and who will fund through exorbitant taxation, an entitlement program on which they cannot personally rely.

Congress voted Medicare into law in 1965 against 30 years of vigorous public opposition. Forty-three years later, dire predictions are coming true. During U.S. House Hearings in 1964, Senator Karl Mundt (R., S.D.) said that Medicare "would be exceedingly difficult to discontinue without breaking faith with those who have to pay the tax." After Medicare's passage in 1965, Senator Mundt described it as, "another step toward destroying the independence and self-reliance in America, which is the first best hope of individual freedom for all mankind."

As it was in 1965, Congress' victory today is America's failure tomorrow.