Older? Live in the country or a small town? Too bad!

Bad news for rural & small town seniors;

The Senate voted 47-53 against invoking cloture on a Medicare doctors' reimbursement bill on Wednesday, falling 13 votes short of stopping a filibuster.

The bill, S. 1776, would have fixed a formula in Medicare that currently would have doctors' reimbursements cut 21% in 2010 and another 5% in years beyond 2010. All Republicans voted against the bill, as well as the following 13 Democrats: Evan Bayh (IN), Robert Byrd (WV), Kent Conrad (ND), Byron Dorgan (ND), Russ Feingold (WI), Herb Kohl(WI), Joe Lieberman (CT), Claire McCaskill (MO), Bill Nelson(FL), Jon Tester (MT), Mark Warner (VA), Jim Webb (VA), and Ron Wyden (OR).

Congress for the last several years has stopped the cuts in a piecemeal fashion - often one year or 18 months at a time, and S. 1776 would have permanently fixed the problem. It is likely that the Senate will now go back and again do a one-year fix. Opponents wanted the bill "paid for" in budget terms, although this Congress had passed a resolution earlier this year exempting this and other crucial issues, like war funding, from the normal budget process.

"Seniors need certainty and security to know that their doctor will always be there for them. This bill would have given seniors on Medicare the security they need," said Barbara J. Easterling, President of the Alliance for Retired Americans. The bill was especially important in smaller communities and rural areas, where there are fewer patients and where seniors need to make sure that there are enough doctors to treat them.

This issue deserves a permanent fix. Rural areas and small towns already have a difficult time recruiting family-practice physicians and since the populations of these areas are top heavy with older Americans who rely on Medicare for their health care, it is patently obvious that until a permanent fix is in place these people will see a decline, if not an exodus, of family practise physicians.