By John Brummett

A woman spent Tuesday afternoon with good friends who share her interest in ceramics but are culturally and politically conservative while she most certainly is not.

She came to me quite concerned. One of her friends, a woman of retirement age, had issued an ominous warning to the others as they worked on their birdbaths. It was that President Obama was planning to extend health insurance to the uninsured by cutting Medicare for seniors.

My friend wanted me to tell her that wasn’t so and give her talking points to take back to the group.

My hesitation did not encourage her. When I said, “This is complicated,” she seemed distressed.

So the short and correct and most vital answer is that the warning was wrong. No one would dare suggest that any senior on Medicare will lose one iota of benefits or services.

But one problem with energizing a solid Democratic base for extending health insurance to the uninsured is that there really is nothing in reform beyond the status quo for Medicare recipients. Well, that’s except for something already accomplished outside the bill, meaning the negotiated agreement to plug that so-called “donut hole” in which some seniors’ drugs costs were going uncovered by falling in a gap between basic and catastrophic.

Here was the coincidence Tuesday afternoon: While a group of women did ceramics projects in Arkansas and spread misleading warnings about dire consequences for Medicare recipients, the president was assembling U.S. Rep. Mike Ross and others to discuss how to make real health care spending cuts to try to pay for reform. And the main thing they came up with was to cut, well, Medicare … reimbursement rates to providers, that is, not — again, let me stress not — benefits for folks on Medicare.

A politically troublesome fact remains. Ross and centrist Blue Dogs resist both a surtax on the wealthy and an income tax on the more generous employer-provided health insurance benefits to pay for extending health insurance to everyone. They contend that we instead need to make cost cuts that will get health care spending down to the rate of inflation. So, to oblige them, the movers and shakers seem to be settling on finding some of those savings in the existing health insurance program for seniors.

What they’re talking about is giving binding power to a currently advisory group on Medicare reimbursement rates. This refers to what Medicare pays to providers — hospitals, suppliers, doctors — not to the care that gets covered for persons 65 and older who rely on Medicare benefits.

Alas, these essential distinctions can be lost, either by deliberate partisan misrepresentation or honest confusion arising from the difficult nuances of health care policy, or both.

Ross, for example, is advocating a glaring contradiction. He wants to find cost savings and is generally agreeable to this new commission’s binding authority over Medicare reimbursement rates to bring them down. But he simultaneously argues that existing Medicare reimbursement rates in rural areas are insufficiently low for country hospitals and doctors.

At this writing Ross was in meetings with members of the House leadership trying to hammer out an agreement on this issue and others among the 10 objections that Blue Dogs have raised while blocking the bill in the House Energy and Commerce Committee.

Obama was gearing up for a nationally televised news conference to try to make a clear and compelling case for … something.

Ideally, here’s how all this would work: Stricter reimbursement rates for Medicare set by a politically independent group would reduce unacceptably spiraling government costs and hold the deficit down. That would preserve existing benefits and levels of care for seniors. It would not run providers out of business. Meantime, extending health insurance to everyone would end the existing subsidy by the insured of the uninsured.

The worst case scenario? There are two. One is that we would fail to find the political will or common ground to do anything, in which case we would continue an unjust system leading us to bankruptcy. The other is that we would agree on something and get beset by unintended consequences.

So take your pick — the certain doom of inaction or the conceivable doom of action.

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John Brummett is a columnist for the Arkansas News Bureau in Little Rock. His e-mail address is jbrummett@arkansasnews.com; his telephone number is (501) 374-0699.