The Free Press, Mankato, MN


July 31, 2013

Change Medicare, and pricing

Why it matters: A bipartisan plan to bring more sense to Medicare price could save billions


So far, the bipartisan bill would replace the annual need for the doc fix with a more reasonable 0.5 percent increase in physician payments each year. The bill is sponsored by Rep. Fred Upton (R-Mich.), Rep. Joe Pitts (R-Penn.), Michael Burgess (R-Texas), Frank Pallone Jr., (D-N.J.), Henry Waxman (D-Calif.) and John Dingell (D-Mich.)

Rep. Jim McDermott, (D-Wash.), a physician himself, has authored a separate bill to set up a more independent advisory committee to recommend Medicare pricing. Long a critic of the current procedure, McDermott told the Post: “I’m not anti-doctor, but there has to be some reality here.”

We would also recommend that Medicare consumers have full access to the prices paid for the services they receive. Medicare and the medical establishment has long resisted opening up their books to consumers and taxpayers.

Without realistic Medicare pricing, there is no way to measure the overall cost and value to taxpayers. Unfortunately, for years, the pricing has been a kind of quid pro quo, it appears for the medical community. We have no doubt there are physician services and hospitals that are underpaid for the services they provide and that Medicare prices don’t always cover costs.

At the same time, medical service pricing is extremely complicated. Medicare assesses over 10,000 procedures. All can be done in places were doctor and hospital costs vary widely.

But we are coming into a Medicare tsunami. The people coming into the system will grow exponentially in the years ahead. The entitlement of Medicare is not likely to go away soon given its political popularity, so the reforms are badly needed.

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