Statement of Congressman John D. Dingell, Ranking Member
Committee on Energy and Commerce

SUBCOMMITTEE ON HEALTH HEARING
ENTITLED “MEDICARE PHYSICIAN PAYMENTS:
2007 AND BEYOND”

September 28, 2006

Mr. Chairman, I look forward yet again to the testimony of the organizations represented at this hearing regarding the looming Medicare physician payment cut. I note that this is the fifth hearing in 12 months this Committee has held on physician payment issues. But what we need at this juncture is action to provide doctors with adequate Medicare payments, not more hearings.

Given the late date and with no legislation being marked up in Committee, it appears that Congress has neglected our responsibility to provide a remedy for the anticipated 5.1 percent cut that will take place early next year. Even if a remedy is eventually enacted, this lack of progress creates not only uncertainty for both beneficiaries and their doctors, but it also shows a lack of Congressional leadership on an issue that has been looming for years and for which holding hearings has become the response of choice.

Of course some will say that paying physicians adequately will cost too much. But why can’t we simply shift the billions in Medicare overpayments to HMOs to pay an adequate wage to doctors? There is absolutely no reason that HMOs should receive more generous payments than a senior’s doctor. We should ensure fairness and fiscal integrity by creating a payment system that adequately compensates providers, whether HMOs or physicians.

And if Congress does belatedly act to improve physician payments, we must do so without increasing Medicare patient premiums. To those who say it would be too expensive to protect beneficiaries, I would counter that failure to protect them is too costly. More hardships should not fall on those seniors and people with disabilities who live on fixed incomes.

I note that some in Congress believe that if Congress increases physician payments this year, it must also include an intricate and complex system for reporting quality data that is sometimes called “pay-for-performance.” We would be hard pressed to enact such an ambitious system in the time remaining, at least not in a careful and thoughtful way. And the physician payment issue should not be held hostage because of it.

 While such a reporting system is a laudable goal, we must ensure that this system is crafted with care and through collaboration with the medical community, otherwise we could end up causing more harm than good for both providers and beneficiaries.

There is a way to do all this right. I, along with my Committee Democratic colleagues, introduced H.R. 5916 to provide for a two-year period of stable payments for Medicare providers. This bill would allow ample time for Congress to thoroughly explore the issues associated with quality reporting data (pay-for- performance) and to develop a system that is meaningful to providers as well as offers the right incentives for real care improvement.

We must work on a bipartisan basis through the remaining time available to us to improve physician payments. We must also work with the provider groups, beneficiary organizations, and policy experts to create a fair and patient-centered quality reporting and pay-for-performance system, but this will require a longer time frame.

In the meantime, we cannot delay in devising a remedy to the coming physician pay reductions. Let us act to immediately stabilize Medicare payments to doctors and protect premium increases for patients while Congress explores other longer-term issues.

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(Contact: Jodi Seth, 202-225-3641)