In 1997, as part of a bipartisan bill to balance the budget, Congress attempted to control Medicare’s skyrocketing growth through a payment formula known as the sustainable growth rate [SGR]. It has been difficult for Congress to adhere to the resulting reductions in physicians’ payments. In fact, since 2002, Congress has stepped in to delay these cuts from taking place, providing an annual “patch,” which has made the problem worse. In January, absent a change in law, Medicare physician payments will be reduced by more than 20 percent.
Members of Congress, on both sides of the aisle, agree this problem needs to be addressed. But the Senate is set to consider legislation ignoring the structural problems in Medicare that drive the reimbursement issue. Instead, the legislation sweeps this problem under the rug and adds $247 billion to our national debt. This is the height of fiscal irresponsibility. It does nothing to address the problem facing physicians; it continues the age-old congressional practice of kicking the can down the road; and it saddles future generations, already facing $62 trillion in unfunded liabilities, with another $247 billion in debt, plus interest.
To consider this as somehow “independent” from health care reform is baffling. The House health care bill includes roughly $400 billion in Medicare spending reductions, and $245 billion to fix the Medicare physician payment problem. To pull the so-called “doc fix” from the bill, add it to the debt, and then claim health care is paid for, is a gimmick.