THE BLOG

Why Seniors Should Say 'No' to Paying for the Medicare Doctor-Fix

09/19/2013 02:50 pm ET | Updated Nov 19, 2013

Congress is floating a proposal that would require people covered by Medicare to fork over more of their money to the health care industry.

Older Americans already spend, on average, 23 percent of their Social Security checks on Medicare Part B and D premiums and cost sharing, a figure that jumps to a whopping 32 percent in 20 years.

On July 31, the House Energy and Commerce Committee unanimously approved a bipartisan bill to change how Medicare pays doctors. The Congressional Budget Office estimates a $175 billion price tag over 10 years.

Medicare's way of paying doctors surely needs to change. Conscientious doctors who perform a valuable public service should not face a personal fiscal cliff every year -- this year it's a 26.5 percent cut in reimbursement rates. Congress has always come to the rescue to avert a cut. It is time to stop the band-aids and render a cure.

To pay for the doctor-fix, a draft proposal from the Health Subcommittee of the House Ways and Means Committee would require seniors to dig deeper into their pockets. Part B and D premiums for certain Medicare beneficiaries and the Part B deductible will increase. A new $100 co-payment for home health care visits in selected cases will kick in.

While it might appear reasonable to ask users to pay more, it's a bad idea. Too much of the money that older Americans and all taxpayers already give for Medicare is misused and abused.

When ProPublica analyzed Medicare Part D prescription drug data earlier this year, it found that large quantities of potentially harmful drugs are prescribed to older Americans. Congress and Medicare officials have done little to stop the wayward prescribers and patient harm. The incalculable cost in human and monetary terms mounts in perpetuity.

The Wall Street Journal examined Medicare Part B records in 2010 and identified jaw-dropping billing abuses. Congress and Medicare get an "F" for failing to apply rudimentary principles of good governance.

The result? The mantra in the health care industry has become "bill, baby, bill"-- taking a page from the oil industry's chant, "drill, baby, drill."

Medicare has become an entitlement for Fortune 100 companies, private equity firms, and venture capitalists, as revealed in "Medicare Meltdown: How Wall Street and Washington Are Ruining Medicare and How to Fix It."

The Leadership Council of Aging Organizations (LCAO), a coalition of non-profits that serve older adults, rightly urges the Ways and Means Health Subcommittee to refrain from cost shifting to older Americans. "They can't afford to pay more," says Stacy Sanders, federal policy director at the Medicare Rights Center and member of the LCAO.

The Medicare Drug Savings Act of 2013 introduced by Sen. Jay Rockefeller (D-W.V.) would save Medicare money on prescription drugs by requiring drug manufacturers to provide rebates for low-income Medicare beneficiaries and those eligible for both Medicare and Medicaid. The rebates existed before Medicare Part D was first implemented in 2006 and the bill would reinstate them.

"With rebates, lower drug prices will save money, even more than if Medicare negotiated drug prices," says David Lipschutz, policy attorney at the Center for Medicare Advocacy, also an LCAO member. The rebates would save $140 billion over 10 years, nearly enough to pay for the doctor-fix.

Before Congress requires older Americans to pay more for Medicare, it needs to recycle the waste and excessive spending. There's plenty of it.