MEDICARE HARDBALL….Paul Krugman has a good column today about the vote to cut back on subsidies to Medicare Advantage and use the savings to maintain current payment rates to doctors. In June an identical bill failed by one vote:

But then Democratic leaders decided to play brinkmanship. They let the doctors’ cuts stand for the Fourth of July holiday, daring Republicans to threaten the basic medical care of millions of Americans rather than give up subsidies to insurance companies. Over the recess period, there was an intense lobbying war between insurance companies and doctors.

And when the Senate came back in session, it turned out that the doctors — and the Democrats — had won: Senator Kennedy was there to cast the extra vote needed to break the filibuster, a number of Republicans switched sides and the bill passed with a veto-proof majority.

Krugman thinks this show of Democratic backbone bodes well for the chances of passing universal healthcare next year. I don’t know that I’d read quite that much into it, but at least it’s a step in the right direction.

UPDATE: Jon Cohn agrees with Krugman that this is a good sign, but for a different reason: it pits doctors against insurers, and Democrats with doctors. If this carries over to next year, with doctors deciding that Dems and universal healthcare are preferable to the dubious embrace of the insurance industry, that would be a very big interest group that’s made the switch away from the dark side.

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