The October 26 edition of US News and World Report discusses the importance of Medicare reform in the health care debate:
About 45 million elderly or disabled people get their health insurance from Medicare. In 2008, it cost the government about $450 billion. The figure is growing rapidly, consuming ever larger chunks of the federal budget, something Congress desperately wants to fix as part of healthcare reform. But as events last week showed, Congress so far isn't up to the task. The challenge played out over what might seem like a mundane topic: a mathematical formula. Called "the sustainable growth rate," it determines how much the government pays doctors for seeing Medicare patients. And by almost all accounts it's deeply flawed...
The White House and Democrats definitely want doctors' support for healthcare reform, so last week Senate leaders tried to address their concerns--not easy, given that the problem goes back to 1997, when the formula was created. Back then, Congress wanted to balance the budget, and one of the things it did was to tell doctors that the government would pay them only so much for their services and would cut those amounts if necessary. But in the past decade, Congress has basically pushed off cuts, year after year, letting them add up instead. That means that in January, unless Congress steps in again, doctors are looking at a 21 percent cut.
"It leaves the physician community in a very difficult spot," says James Rohack, president of the American Medical Association. If that cut goes into effect, it's basically telling doctors, "OK, we want you to limit access to Medicare patients," he says.
Last week, in an attempt to get physician support for health care reform, Senate Democrats put forth a bill that would have put a 10 year freeze on any more cuts to reimbursement rates but the bill only got 47 of the 60 votes it needed to reach the Senate floor.
[T]he vote ... underscores a very real dilemma facing Congress and the country. On one hand, government spending on healthcare continues to go up, so there is pressure to find ways to curb spending. On the other hand, the government pays doctors only part of what it costs to treat a patient (about 80 percent of the full cost, according to estimates), meaning that any deep cuts to doctors will most likely drive some out of business, as Rohack suggests. So the pressure is on Congress to find some way to spend less on healthcare without making it harder for the most vulnerable patients to find a doctor.
Read the full story here.
