Will reforming Medicare fees keep doctors in the program? Yes: Fair payment and quality treatment

December 25, 2011 

20090708 Hospital costs

Color illustration of surgeons working to repair a downward-moving economic index. (MCT)

NEIL NAKAHODO / THE KANSAS CITY STAR

No matter how you slice it, the Medicare program as it stands today is financially unworkable.

More than 10,000 baby boomers reach retirement age every single day, which puts a huge strain on a system that the chief actuary for Medicare projects will be insolvent in 2024.

Clearly, that is unacceptable. Medicare is a promise and a lifeline for our country's seniors. Few things are as important as having affordable, quality health coverage in retirement. Consequently, the important question is how we save the program from insolvency while preserving the greatest access to quality health care choices for America's seniors.

If fewer and fewer physicians are able to participate in Medicare because of regulations and low reimbursement, the promise of Medicare and the health of our nation will be compromised.

Some have suggested we should squeeze more savings out of Medicare by cutting payments to physicians. This might make Washington bureaucratic bean counters happy, but it will have a devastating impact on seniors' access to care.

Already, nearly one in three primary care doctors are forced to limit the number of Medicare patients they see. Another "solution" was offered by President Barack Obama and his Democratic allies last Congress when they created, as part of their health-reform law, the Independent Payment Advisory Board — 15 bureaucrats given the power to deny payment for treatment of seniors.

These are the types of so-called solutions that some believe allow the fiscal health of Medicare to trump the personal health of beneficiaries.

The good news is that there are positive, patient-centered solutions that would put Medicare on sound financial footing and ensure physicians remain able to participate in the program and provide the highest level of quality care to seniors.

Early this year, House Republicans drafted, debated and passed a budget plan that would address the challenges facing Medicare and strengthen and secure it for future generations.

Rather than getting the program's finances in shape by eliminating choices or access to physicians, or by empowering a government agency to deny care, our plan allows seniors to choose from a list of guaranteed coverage options to find the one that best suits their needs. It would be personalized health coverage while also making certain that the program is around for current and future retirees.

Because we don't believe the plans of those currently on Medicare or near retirement should be disrupted, no changes would be made to those 55 and older. Our budget shows that we can solve the challenge of unsustainable spending projections by providing greater choice and greater flexibility for seniors.

Because the status quo is unacceptable, there are even more efforts under way to further empower seniors — including the Medicare Patient Empowerment Act, which would allow Medicare beneficiaries and physicians to contract freely for items and services outside of the Medicare system while retaining their Medicare benefits.

This is the type of pressure-valve release that will contribute to saving the viability of the entire system. Washington shouldn't be allowed to force you to have only the care it wants you to have.

These are positive, patient-centered reforms that would allow doctors to remain in the Medicare system, enhance access to affordable, quality health care and address the fiscal challenges facing the Medicare program.

Bureaucratic-driven price controls or misguided cuts to physician reimbursement rates will not ensure long-term financial security for Medicare and will do great harm to current and future retirees.

When we put patients' care and choices first, and not the government's bottom line, we will enact positive reforms that will allow Medicare to keep its promise to America's seniors and keep physicians able to serve their patients.

Rep. Price, R-Ga., is chairman of the House Republican Policy Committee.

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