The Free Press, Mankato, MN


April 2, 2014

Our View: Medicare reform fails again

Why it matters: Medicare continues as an entitlement costing taxpayers billions but lawmakers have done little to create incentives for providers to be more efficient

Congress again appears fearful to reform Medicare spending as it authorized for the 17th time a bill to temporarily extend funding at a cost of $21 billion to taxpayers.

Congress has been trying to reform the out of control costs of Medicare since 1997.

This one prevents a 24 percent cut in Medicare payments to doctors.

The bill only staves off the cuts for one year, meaning Congress will be back to the table in 12 months.

The temporary fix passed the House last week on a voice vote and the Senate voted 64-35 on Monday to approve the measure. President Obama is expected to sign the bill.

The Associated Press reports that there is bipartisan support for Medicare spending reform that would increase fees to doctors by about 0.5 percent per year and provide incentives for doctors to provide less costly, more effective care. Physicians groups like the American Medical Association also favored long-term reform.

The reform bill has been held up because lawmakers can’t agree on how to pay for the $140 billion cost.

But even the short-term fix has an iffy method of payment, according to the Associated Press report. The law proposes paying for the cost by cuts to health care providers, half of which won’t go into effect for 10 years.

The $17 billion cost for the temporary measure over the next three years includes payments to doctors but also provisions for higher reimbursement rates for rural hospitals and rural ambulance services.

On the positive side, the bill does allocate about $1 billion over four years to new mental health grant programs to improve care and access to mental health services in states. Another $60 million will go to improve outpatient services for people with serious mental illness.

But with savings in other Medicare programs and payment reform, the funding for mental health programs, still vastly underfunded, could be improved.

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