However, in a peculiar Washington dilemma, official budget scorekeepers typically appraise proposals for Medicare preventive services as increasing the program's spending, albeit initially. That makes the benefits a tougher sell. And Congress must approve new preventive benefits before Medicare can cover them on a nationwide scale. In a recent report, the Institute of Medicine noted that Congress ignored expert clinicians' recommendations in passing osteoporosis and prostate cancer screening benefits in 1997. A Medicare bill could well include preventive benefits, he said.
More proposals are in the works.
Meanwhile, ophthalmologists are pushing for glaucoma testing coverage, while other therapists are advocating payment for vision rehabilitation services. It comes down to priorities. Prevention advocates are competing for Medicare dollars with hospitals, HMOs, and other groups who say that 1997 pay cuts went too far. All rights reserved. All rights reserved.