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Additional Views on H.R. 4986 "Provisions Relating to Part B"
We are generally supportive of the provisions included in H.R. 4986. We believe, however, that more should be done to address the cuts in physician reimbursement under Medicare. Flaws in Medicare’s physician payment formula have led to payment cuts this year, and expected reductions in the next few years as well. These payment reductions have deeply affected physicians. Some are questioning whether to remain in the program; others are reducing the number of Medicare patients they see or not accepting new patients. This is troubling because physicians are the bedrock of the Medicare program. Currently, nearly all physicians across the country participate in the Medicare program. They are the providers that beneficiaries see most often, providers that seniors often have known for years, providers that they trust. It is imperative that Congress address the problems with the sustainable growth rate formula to eliminate the projected reductions in physician payments. We have only to look to the Medicaid program, which has a long standing history of inadequate payment rates, to see how dramatically this can affect beneficiaries access to care. Continued cuts to physician payments threaten the continued viability of fee-for-service Medicare. This bill does a curious thing in this regard. It addresses the problem of physician payments -- but only for the next three years -- through 2005. The next year, doctors will face a significant reduction in payments -- as much as 18% -- due to the formula, which will mean cuts stretched out over a number of years. Coincidentally, this is right at the time that the Republican "privatization" plan is set to begin. If physicians are troubled now and are re-evaluating their participation in Medicare after a 5.4% cut -- imagine the situation when they are facing an 18% cut. We will see doctors dropping out of the Medicare program and seniors left with no choice but to enroll in private plans. Therefore, we believe that a permanent solution is required to ensure that physician payments are stable for years to come. Some will say that the provision in the bill is just a temporary fix so that we have time to examine the problem and find a better solution. Democrats, however, believe that our first goal should be to shore up the fee-for-service program and ensure that providers that seniors depend on are not facing uncertainty in payments. Democrats believe that the fee-for-service program is worth investing in so it can continue to provide the same dependable quality health care that seniors have counted on for more than 35 years. John D. Dingell
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