McAllen Monitor: Fairly reforming Medicare based on quality, not quantity, of care

McAllen, Texas, March 30, 2014

Fairly reforming Medicare based on quality, not quantity, of care

This year, Congress came closer than it ever has before to finding a permanent fix to the flawed formula that provides Medicare reimbursement to doctors. I signed on to the legislative fix, H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, which would transition Medicare away from a system where doctors are paid based on the number of patients they treat toward a system that is based on the quality of care they provide.

For more than a decade, Congress has had to step in and prevent Medicare from cutting physician payments and every time, it has robbed doctors and seniors of their peace of mind in the Medicare system. Congress has been kicking the can down the road to reform this broken system by passing short term fixes every year. Continuing to enact short-term patches, however, is bad fiscal policy — equivalent to paying the monthly minimum on a credit card bill — and ultimately increases the cost of full repeal.

H.R. 4015 was a significant step forward to finding a permanent solution for this broken system and is legislation that Democrats and Republicans, as well as the House and the Senate, have been able to agree on. This bipartisan, bicameral agreement was the result of months of hard work done by the committees, staff and concerned stakeholders.

That is why this breakthrough was so significant, with Democrats and Republicans coming together to fix the problem. Congress is closer than ever to enacting legislation that would repeal the dysfunctional Medicare physician payment system because it has worked in a bipartisan, bicameral manner for over a year. In a Congress that stands out for its levels of discord and inability to reach common sense solutions, this bill stands out as a success story.

Unfortunately, House Republican leadership has effectively killed the compromise, first by politicizing the vote and tying it to a delay of the individual mandate of the healthcare law and second by further kicking the can the road this past week by passing a one year extension of the current rates.

Texas Medical Association’s (TMA) President Stephen Brotherton stated the following in a letter: “We fervently plead with members of both parties in both chambers to stop playing politics with our patients and our practices.We’ve made it this far only because of a bipartisan, bicameral agreement on the need to replace the SGR. Crafting the appropriate healthcare policy precepts of the bill was the hard part. Please don’t stop here.”

Various organizations representing Medicare providers and beneficiaries across the country have come out in strong opposition of HR 4015 including: AARP, American Medical Association, National Association of Area Agencies on Aging, Alliance for Retired Americans, and Families USA. In a March 12 letter, these organizations unanimously urged Congress to oppose this vote stating: “The current effort to link SGR reform with changes to the Affordable Care Act, however, injects partisan politics into the bipartisan legislation. Access to health care for the more than 50 million Americans with Medicare is a serious matter — scheduling a vote on a bill which does not have bipartisan support undermines the months of hard work done by the Committees, their staffs, and concerned stakeholders.”

We had hoped that Republicans would bring a clean bill to the Floor but instead they added a poison pill and continue to waste the taxpayer’s time by delaying a serious vote on this issue.

I hope my Republican colleagues will put the permanent proposal back on the table so we can create a responsible solution and a permanent repeal of the Doc Fix.