If the Senate were going to write a new rule for Medicare payments meant to slow the growth of medical costs, you might think that the rule would apply to hospitals and doctors. A fair amount of medical care is, after all, provided by hospitals and doctors. But the Senate's health reform bill exempts hospitals from just such a rule until 2019. Doctors, meanwhile, are likely to be effectively exempt, the Congressional Budget Office says. And come 2019, a separate part of the rule will change, making the entire thing mostly moot. This odd situation is just one of the opportunities that awaits those senators who don't yet seem to have a firm position on health reform.