Sen. Patty Murray has the right intention. She wants to make Medicare work better for patients and health care providers alike in this state.
Murray and the rest of the state’s congressional Democrats have united around a plan that would raise Medicare reimbursements to health care providers in states where payments are below the national average. Washington is among the 10 lowest states in reimbursement rates, which actually punish areas with relatively efficient health care systems.
Murray’s Medi-Fair Act would remedy the inequity by raising all payment rates to at least the national average and, over time, forcing improvements elsewhere. It’s a good plan, but one that is more likely to raise much-needed discussions rather than solve the problem immediately.
The short-term political reality is that the potential solutions run into a double-whammy. On one side, the Bush administration appears determined to avoid domestic spending increases — unless there is a high enough political gain, such as with the farm bill. On the other side, major states — including California, New York and Florida — aren’t about to help others address the equity issue unless their higher Medicare reimbursements can be protected.
The best hope is that Murray and potential allies in both parties, including Republican Sen. Charles Grassley of Iowa (where reimbursement rates are the lowest of all), can raise the level of discussion to the point that a solution becomes politically necessary.
Certainly, for Medicare patients and aging baby-boomers who will soon use the system, the need for action is becoming increasingly serious. The inequities have been around for years, but their effects have become more severe. In this state, many doctors are now refusing to take new Medicare patients because the reimbursements don’t cover physicians’ costs. The problems extend beyond doctors, though, to other providers.
For the entire health care system, the paper work accompanying Medicare is also a serious issue. It aggravates the low reimbursements here by running up the expenses in medical offices. There is a need for a system that simplifies administration, just as there is a need for a health care system that provides broader access for all people, regardless of age and income.
Action on reforming Medicare’s inequities should not be made to wait for such larger solutions. Medicare is America’s most significant achievement in assuring health care access. Its erosion cannot be tolerated. Whatever the politics obstacles to immediate action, the Murray initiative helps bring forward the issue of massive inequities in reimbursements. That’s a step in the right direction.
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