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Sen. Barack Obama (D. Ill.), with just a few words in Wednesday night's presidential debate, reconfirmed what he'd said in the second debate: If he is elected president, he will terminate subsidies for Medicare Advantage.

Replying to a question about potential cutbacks, the Democratic candidate said: "We spend $15 billion a year on subsidies to insurance companies ... under the Medicare plan. It doesn't help seniors get any better. It's not improving our health care system. It's just a giveaway."

This is not entirely a surprise, as it is well-known that this subsidy for Medicare Advantage is considered by the Democratic party to be an unnecessary expense burden on the American public; however, in today's economic climate and with pressure to reduce spending, it appears to be a priority item for Obama's potential administration. Could this be the end of Medicare Advantage?

Pressure on insurance companies has already started. In July, the Senate voted to approve the Medicare bill that reversed cuts in the reimbursements to physicians. The Democrats, in order to "pay" for this, introduced a measure to cut the level of payments to Medicare Advantage plans.

Permanent cuts to Medicare Advantage reimbursement are now officially the position that Obama has adopted and apparently he will not support a rate higher than that paid under Medicare. Emails to the campaign asking for clarification were not responded to by the time of this column's publication.

At the time the Medicare Act was voted through, Bill Novelli, CEO of the American Association of Retired Persons, praised the Senate, saying the "AARP applauds the bipartisan majority of senators who voted to pass a bill that would protect and improve Medicare for the 44 million Americans who depend on it."

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