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Medicare

The Medicare program is the topic of a great deal of discussion in 2017. Created in 1965, its mission was to provide health coverage for older Americans.  It is a program I strongly support and it must be preserved, protected and strengthened.

But over the years, Medicare has been neglected and now the Congressional Budget Office, as well as the Medicare Board of Trustees, predict it will be effectively bankrupt by 2030

What some do not realize is that the very controversial, 2009 health “reform” law made Medicare even more financially unsound. Called the Affordable Healthcare Act, a bill which I strongly opposed, the new law takes a staggering $500 billion from Medicare to pay for new Obamacare health entitlements.

That was the wrong approach.  It does not take a fortune teller to predict what will likely happen when these massive cuts in Medicare’s physician and hospital reimbursement rates and devastating cuts to the Medicare Advantage program begin: Medicare beneficiaries will suffer.

Access to physicians is already a problem. A recent survey of doctors reveals nearly a third of primary care physicians restrict the number of Medicare patients in their practice mainly on account of low and unreliable government payments.  The American Academy of Family Physicians reports that more than 12 percent of its doctors simply do not accept Medicare patients, up from 8 percent in 2008 and 6 percent in 2004. 

And what will be the impact on access of much lower doctor and hospital reimbursement? In this area, the experience of the Medicaid program is instructive.  Years of inadequate payment rates, below the cost of care at times, have contributed to widespread access problems for needy people for both primary and specialist care: inadequate payment is the most common reason for physicians not to accept Medicaid patients.

I also have very real concerns that lower Medicare reimbursement rates, greater levels of government intrusion into the doctor-patient relationship and exorbitant medical insurance liability costs (in the absence of any lawsuit reform) will discourage young students from entering the medical field.  And yet, the Association of American Medical Colleges (AAMC) released a study which found that the U.S. will need to add 91,500 new physicians in the next 10 years just in order to keep up with the demands of Obamacare!

And if that damage was not enough, the new law establishes an Independent Payment Advisory Board (IPAB) - a group of 15 unelected Washington-based bureaucrats, appointed by the President to lengthy six year terms, who will, in effect, have the power to decide which medical procedures Medicare will pay for.  In other words, they will have the power to ration health care.  You should know that I was a cosponsor of H.R. 849, the Protecting Seniors’ Access to Medicare Act, to repeal IPAB immediately, which passed the House, with my support, on November 2, 2017. I think you would agree, it should be left to patients and their physicians to determine what care is to be provided and how to pay for it.

The future of Medicare is already very challenging and it must be preserved, protected and strengthened.  To my mind, the new health care law violated the unofficial Hippocratic oath to ‘first do no harm.’  As a result, millions of older Americans, who just want to continue to see their own doctor and have that doctor choose their treatment, will be personally affected.