If the fiscal train wreck Medicare is chugging toward isn’t prevented, none of the health-care reform ideas currently under debate will matter. Without dramatic action now to curb costs, the Medicare trust fund could be exhausted in a decade. Today’s health-care challenges will seem trivial in comparison.
Washington Sen. Maria Cantwell, along with health-care providers here and in several other states, has long argued that an essential part of the solution is changing the way Medicare pays providers. Cantwell, a member of the Senate Finance Committee, has gotten such an amendment into the health-care bill that panel is currently writing. The legislation could move to the Senate floor next week.
The importance of Cantwell’s amendment to the success of any health-care overhaul — and to the long-term survival of our health-care system — would be hard to overstate.
It would fundamentally change the flawed reimbursement rate formula that has long penalized doctors and hospitals here and in other states that deliver efficient, cost-effective care. Rather than rewarding the quality of care, it rewards the quantity of billable procedures. Providers are financially better off treating patients after they’re sick, because they get paid for each visit, each test, each surgery. The financial incentive, perversely, doesn’t lie in keeping seniors healthy in the first place.
That not only results in huge waste — Cantwell says Medicare currently wastes $120 billion a year, partly because of the flawed payment structure — is creates geographic disparities in what providers are paid. In Washington, some providers won’t see new Medicare patients because they lose too much money on them.
Unlike other points in the health-care debate, this one isn’t drawn along partisan lines. Cantwell and 27 other senators — including six Republicans and independent Joe Lieberman — wrote to President Obama earlier this month urging the Medicare payment change. All six senators from the Pacific Northwest signed the letter.
Cantwell’s amendment also has the enthusiastic backing of leading-edge providers such as The Everett Clinic, Virginia Mason Medical Center and The Mayo Clinic. They recognize it will result in more efficient, better coordinated and higher quality care for seniors.
Getting more Americans insured, and eliminating pre-existing conditions as a barrier to coverage, requires getting health-care costs under control. It’s the crux of the entire debate.
If we’re going to have health-care reform that truly works, now and for future generations, Cantwell’s amendment must be part of the final package.
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