MedCity Influencers

Time to Break the Cycle and Fix Medicare for Good

Sometimes life does unfortunately imitate art. In 1993, the movie “Groundhog Day” hit the big screen. The plot of the movie, starring Bill Murray, centered on Murray’s character being forced to live the same day over and over again until he managed to get it right. Four years later, Congress created a completely flawed formula […]

Sometimes life does unfortunately imitate art. In 1993, the movie “Groundhog Day” hit the big screen. The plot of the movie, starring Bill Murray, centered on Murray’s character being forced to live the same day over and over again until he managed to get it right.

Four years later, Congress created a completely flawed formula surrounding the funding of the Medicare program. Since that time, the nation’s seniors, military families and the physicians who care for them have been living their own version of “Groundhog Day.” Funding for the Medicare program has faced catastrophic cuts year after year, only to have Congress continue to fail to get it right. Instead, they continue to apply a short-term intervention to temporarily prevent these cuts. This continued failure by Congress has forced those who rely on Medicare and the physicians who care for them to live the same painful scenario over and over again.

Unlike the movie, this real-world scenario is more of a tragedy than a comedy as Congress has continued to apply short-term patches to this issue rather than fix it once and for all. Congress has stepped in 12 times in eight years to temporarily prevent large Medicare physician payment cuts mandated by the broken government formula created in 1997.

Repeated short-term interventions failed to repeal the broken formula, compounding the cost for taxpayers and mandating steeper cuts in physician payments every year. On January 1, the prospect of the largest Medicare fee cut ever scheduled looms. The drastic cut of more than 27 percent would threaten access to care for our nation’s Medicare and TRICARE patients.

While preserving access to care for seniors and military families should be more than enough reason to repeal the Medicare Sustainable Growth Rate (SGR) formula responsible for this pending cut, continued failure to act by Congress has increased the cost of fixing this mistake. As recently as 2005, the cost of permanently repealing the broken payment formula would have been $48 billion. If Congress continues its temporary interventions, the cost will escalate to $600 billion in only five years.

As we know all too well here in Ohio, our nation is in the midst of challenging economic times, which are compounded by strained budgets at every level of government. Another temporary patch is fiscally irresponsible. There is no question that the formula needs to be repealed and the cost of repeal will never be less than it is today. Acting now to repeal the formula is the only prudent option for preserving the security and stability of health care for Medicare and TRICARE patients.

The Ohio State Medical Association (OSMA), along with the American Medical Association (AMA), believes that the Joint Congressional Committee on Deficit Reduction has a unique opportunity to finally permanently fix this flawed Medicare SGR. The OSMA and the AMA are strongly urging the congressional deficit committee to repeal the broken Medicare payment formula once and for all.

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Sen. Rob Portman (R-OH) is one of twelve members of this deficit committee. The OSMA has communicated to Sen. Portman and his staff about the opportunity to include a permanent fix to the SGR in the committee’s recommendations due Nov. 23.

However, we need your help. If you believe that Ohio’s seniors, baby boomers, veterans and military families should be able to continue to have access to medical care, please click here to send a letter to Sen. Portman and your member of Congress calling for a repeal of the flawed Medicare payment formula.

The movie “Groundhog Day” had a happy ending. With your help, we can make the real-life version have one as well.

Charles J. Hickey, MD
President
Ohio State Medical Association