As a physician, I know that the best way to treat a chronic health care problem is to treat the cause of a disease, not just merely the symptoms. Unfortunately that is not the approach that Congress has taken with one of the biggest threats to the stability of the Medicare program over the past decade, the fatally flawed Sustainable Growth Rate (SGR) formula.
The SGR was created as a financial sleight of hand in the 1997 Balanced Budget Act when Congress needed to score budget savings. In order to balance the budget then, Congress enacted severe cuts to Medicare expenditures that would take effect in future years, thereby solving the current problem by creating a bigger one for tomorrow. The projected cuts were vastly too deep. They would have resulted in many physicians reducing care to Medicare patients; some would have been forced to quit treating Medicare patients altogether. As a result, the full cuts have never been implemented because of the negative impact on patient access to care.
The broken SGR formula keeps physicians subject to annual funding cuts and makes it harder for them to invest in care improvements that patients deserve. Instead of fixing the problem directly by repealing the SGR, Congress has applied 17 temporary patches since 2003 and put off the real cure, creating uncertainty for seniors in Medicare and military personnel in Tricare.
When patients put off treatment of needed health care services, delay often comes with a hefty price tag. The same is true for temporary SGR patches that now total more than $169.5 billion — which is more than the cost of a permanent cure!
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Now is the time to fix the problem once and for all. The U.S. House of Representatives recently passed HR 2, the “Medicare Access and CHIP Reauthorization Act” (MACRA), by an overwhelming vote of 392-37, showing big bipartisan support. This legislation represents years of bipartisan effort to eliminate the SGR, and implement new payment and delivery models that will promote high-quality care while reducing costs. The bill also reauthorizes the Children’s Health Insurance Program (CHIP) to provide health care coverage for low-income children. Idaho physicians are very grateful to Rep. Mike Simpson for his “yes” vote in support of HR 2.
However, now the U.S. Senate needs to act on a cure to SGR by passing HR 2 when Congress reconvenes on April 13. Repealing the SGR is a permanent solution that is more fiscally responsible than continuing the pattern of costly temporary patches that merely treat the symptoms and not the cause of the problem. HR 2 ensures access to physicians for our nation’s seniors and military personnel, addresses the health care needs of children and low-income citizens, and promotes the long-term sustainability of the Medicare program. It’s good medicine for Idaho and for our country!
Keith Davis, M.D., is president of the Idaho Medical Association.