In a unique event, Senators Max Baucus and Chuck Grassley - the Chairman and Ranking Member of the Senate Finance Committee, the Committee in charge of Medicare in the Senate – have taken to the blogosphere to debate competing pieces of legislation with regard to Medicare. Below you'll see each of them explain their respective bills to readers of AARP's ShAARP Sessions blog.
If you are so inclined, we would greatly appreciate you weighing in on the debate, regardless of what side you fall on in the complex issue.
The following statements from Senators Baucus and Grassley regarding their competing Medicare bills are unedited and do not reflect AARP's position.
The laws governing Medicare have a big influence on seniors' access to health care, and on the quality of the care they receive. As Chairman of the Senate Finance Committee, I've introduced the "Medicare Improvements for Patients and Providers Act of 2008" to update Medicare laws and make the program work better for every single American senior. It's the best bill Congress can pass for seniors this year.
The Baucus bill starts by helping more low-income seniors get help with their Medicare premiums. It has incentives for more primary care doctors to take Medicare patients. It allows for more preventive care in Medicare, to keep seniors healthier, and lowers co-payments for mental health services. It provides more money to rural hospitals, ambulance services, and other facilities to make sure seniors get quality care no matter where they live. It cracks down on shady marketers selling seniors on private plans they don't need or want. And it makes sure local pharmacists get paid promptly for dispensing medicines under the drug benefit, to keep affordable medications available everywhere.
The Baucus bill is responsible, too, paying for these improvements with smart savings found elsewhere in Medicare. It's important for you to know that these savings in no way endanger any senior's access to health coverage, health care, or medical equipment. Rather, savings come from strengthening the rules applied to private fee-for-service plans – which are paid 17 percent more than the amount paid to other Medicare providers – and by reducing overpayments to wheelchair and oxygen providers, who sometimes receive more than 1000 percent of the cost of the equipment they supply. In most cases, these changes will even reduce seniors' out-of-pocket co-payments while also saving taxpayer dollars.
The President threatens to veto this bill, but I believe Congress should do the very best it can for seniors, and pass the Medicare bill that does the most for all who use the program. The Baucus bill goes the extra mile – particularly for rural and low-income seniors – while giving doctors a decent payment increase that won't explode costs or inflate premiums. And the Baucus bill saves money in Medicare without endangering anyone's access to care. I'll work with other Senators and even the White House to get a good bill signed into law. But the Medicare Improvements for Patients and Providers Act is the right start to make Medicare better for every American senior.
If Congress doesn't act, the physicians who treat Medicare patients will face a 10.6 percent pay cut, effective July 1. Such a dramatic cut would very likely hurt older Americans' access to their doctors. A big number of doctors might stop dealing with Medicare altogether.
The Republican bill prevents the cut and gives a small payment increase to keep doctors serving Medicare patients. The physician payments are the same as in the Democratic leaders' bill. Neither bill is more generous than the other to doctors.
The Republican bill has several other Medicare improvements. It increases payments to doctors who report quality data to the government to help link payments with quality. It promotes value-based purchasing, e-prescribing to reduce medication errors, and electronic health records. It includes responsible proposals to preserve Medicare access in rural areas, including much-needed payment improvements for rural hospitals and home health care. It returns the ownership of oxygen equipment to the supplier, not the beneficiary, so the beneficiary doesn't have to get the equipment serviced. It cracks down on abusive sales tactics by Medicare Advantage plans and makes plan quality information available to beneficiaries for comparison shopping. It improves cardiac and pulmonary rehabilitation, renal care, diabetes prevention, and outpatient therapy. It extends programs to help low-income seniors and families.
Unlike the Democratic leaders' bill, the Republican bill does not:
*cut payments for power wheelchairs;
*reduce payments for oxygen;
*make large, unwarranted cuts to Medicare Advantage, altering policy decisions designed to maximize patient choice;
*eliminate the fund that Congress specifically created to help avert future physician cuts; or
*expand eligibility for low-income Medicare programs, which although well-intentioned, would increase long-term entitlement spending and expand coverage under an already fiscally challenged program.
Maybe most important, the President will sign the Republican bill. The President would veto the Democratic leaders' bill. Meanwhile, the Democratic leaders walked away from bipartisan negotiations and put a timely outcome of this effort in jeopardy. The Republican bill does everything Medicare beneficiaries need to protect their access to doctors and prevent a physician revolt. There's nothing in it that Democratic leaders would find objectionable if they put aside their political lens and looked at it as Medicare beneficiaries and taxpayers.