The Future of Medicare

No one would argue that health care costs are high and still rising. The imperative to bring affordability and greater choice to patients has never been stronger. Our nation will see close to 20 percent of its population over the age of 65 by 2025, up from 12 percent in 2000. In fact, by 2012 Idaho will be the 8th oldest state in the nation. Many people in this group will be retiring and, as we know all too well, falling victim to age-related health issues. Health care, obviously, is intensely personal. It is also multi-faceted. A successful health care system gives patients choice, affordability, access, but most of all, control over their health care. It also gives providers the reasonable, timely compensation they deserve for rendering excellent healthcare. Finally, it provides cutting edge treatment and facilities to patients. History, particularly our American experience, has shown that choice, access and affordability result from market competition, not wealth redistribution. And, healthy competition for patients allows the best health care practices and providers to emerge. Competition in the insurance and research health care industry sectors accomplishes the same thing: excellence and choice for patients.

Millions of seniors and those with disabilities rely on Medicare to access our health care system. They should have access to superb care and cutting edge treatments. Reimbursing doctors so that they can continue to afford to serve these patients is critical--for this reason, I have consistently advocated, during my years in the Senate, to ensure that physicians are adequately reimbursed under Medicare. Systemic reform is also crucial. This is why, for the past nine years, I've worked very hard to support and pass policies that avail the Medicare system with strengths inherent in the market, namely, healthy competition that provides choice, flexibility and affordability--after all, isn't that what health care consumers demand? The Medicare Modernization Act of 2003 took this country in the right direction in terms of updating Medicare and introducing market forces into the system that have benefited millions of seniors since.

Unfortunately, the Senate voted to inflict great damage to the positive gains we’ve made in instituting market oriented reforms to Medicare over the past four years. The vote on H.R. 6331, the Medicare Improvements for Patients and Providers Act, was not about physician compensation. It was about whether or not this country will reject market-oriented reforms and move, instead, to a purely government run health care system. There are those who want to move this country backward, toward failed policies of socialized medicine that reduce choice, incentives for good service and access while increasing systemic and individual costs. They put forward a bill with controversial offsets that erode provisions that have made Medicare more responsive to recipients. This tactic is common, especially in such a divided Congress where every vote counts--incorporate an agenda that would fail on its own into a much more popular piece of legislation that will cause those who vote against it difficulties with constituents and organizations. When it comes right down to it, it's bullying, or, more accurately, coercion. That is what the vote over H.R. 6331 was all about, plain and simple. Those who want to reverse our successes in moving toward a more market-oriented Medicare system tried to turn my nay vote, and that of many of my colleagues, into an appalling misportrayal of our priorities. My priorities are and always have been patients, physicians and our entire health care system.

The fact of the matter is physicians still would have received their unreduced Medicare compensation; there was virtually universal support for that fix and it will be made under every proposal on the table. But linking the fix for physician compensation to removing market-oriented reforms in Medicare made for political manipulation in the extreme.

As Paul Krugman, an editorial writer for the New York Times and strong proponent of socialized medicine said in an article on the vote the day after it occurred: "Ostensibly, Wednesday’s [July 9, 2008] vote was about restoring cuts in Medicare payments to doctors. What it was really about, however, was the fight against creeping privatization...If the Democrats can win victories like this now, they should be able to put a definitive end to the privatization of Medicare next year. " Krugman concludes his article by stating, “ A lot can still go wrong with this vision. But the odds of achieving universal health care, soon, look a lot higher than they did just a couple of weeks ago.” Krugman has it exactly right. Contrary to Krugman, though, I do not support socialized medicine and do not view last week’s vote on Medicare with jubilation.

I strongly support and, time and again, have championed adequate and timely Medicare reimbursement for physicians. I’ve been a leader in the Senate Finance Committee in fighting for physician compensation for years. My voting record is a testament to my consistent efforts.

Let me repeat:

• Support for stopping the impending cuts in physician Medicare compensation is virtually universal, and bipartisan; physicians would have received updated compensation, regardless of the outcome of H.R. 6331.

• This vote and legislative battle were not about physician’s compensation. They were about rejecting market-oriented reforms and moving toward socialized medicine.

• I have been and will remain a leader in fighting for proper physician compensation. In fact, although I have a solid record in supporting the yearly fixes, I continue to support and work for a permanent fix to these payments, rather than the temporary fixes Congress continues to enact.

I've provided links below so that interested individuals can educate themselves about the true nature of The Medicare Improvements for Patients and Providers Act, which, incidentally, is NOT what this legislation does. I regret that this legislation in this form passed the U.S. Senate. What I regret even more is that the physicians who treat Medicare patients were the unfortunate hostages in this ongoing crisis.

Veto Message from the President, July 15, 2008

Emory University Study on Impact of Reductions in Medicare Advantage Funding on Beneficiaries

Estimated Impact of Medicare Advantage Funding Cuts in Idaho

What Others are Saying:

Senator Tom Coburn, M.D.

New Hampshire Union Leader, Editorial

Paul Krugman, New York Times

Scott Gottleib, M.D., American Enterprise Institute

Sholeh Patrick, Editorial, Coeur d'Alene Press

Robert E. Moffitt, Ph.D., Heritage Foundation

Representative Jeb Hensarling, Editorial, Washington Times