Re­boot it, don’t loot it

The Washington Times Weekly - - Commentary -

Do you have a prob­lem find­ing a doc­tor to see you? If you are a se­nior on Medi­care, like mil­lions of Amer­i­cans, the likely an­swer is yes.

As a physi­cian prac­tic­ing medicine in my home­town of Lafayette, La., I saw first­hand the dif­fi­culty Medi­care pa­tients en­dure. For years, de­clin­ing physi­cian re­im­burse­ments be­cause of cost-cut­ting mea­sures led to fewer doc­tors ac­cept­ing new Medi­care pa­tients. Those prob­lems could soon be­come much worse.

Se­niors could be forced to com­pete with a large new pool of Medi­care en­rollees for cov­eted doc­tor’s of­fice vis­its and ser­vices. As de­tails slowly emerge of a Se­nate Demo­crat “com­pro­mise” on a health care over­haul, a pro­posed ex­pan­sion of en­rollees in Medi­care to younger Amer­i­cans should deeply trou­ble cur­rent Medi­care pa­tients.

A re­cent Quin­nip­iac Uni­ver­sity poll found 62 per­cent of vot­ers al­ready think ex­pand­ing health care ac­cess will drive up their costs, and se­niors might have cause to worry more than most. Even an ed­i­to­rial in The Wash­ing­ton Post ad­mits that “the ex­panded Medi­care pro­gram would pay Medi­care rates to providers, rais­ing the ques­tion of the spillover ef­fects on a health- care sys­tem al­ready stressed.”

Medi­care al­ready faces a $37 tril­lion short­fall in the com­ing years as more and more baby boomers join the gov­ern­ment health care sys­tem. Ex­pand­ing Medi­care to mil­lions of new pa­tients, as Se­nate Democrats pro­pose, would fur­ther ham­per the pro­gram’s abil­ity to pro­vide qual­ity health care.

In ad­di­tion to the strain on Medi­care to be brought on by the new en­rollees, the Se­nate over­haul con­tains dras­tic fund­ing cuts that would fur­ther worsen the prob­lem. Un­der the cur­rent health care over­haul pro­posal, many se­niors, in­clud­ing more than 140,000 se­niors in Louisiana alone, could see their ben­e­fits re­duced or the pre­mi­ums in­creased.

Ac­cord­ing to the non­par­ti­san Con­gres­sional Bud­get Of­fice, the Se­nate bill would cut more than $135 bil­lion from hos­pi­tals serv­ing se­niors. It would elim­i­nate $40 bil­lion from home health agen­cies, $15 bil­lion from nurs­ing homes and nearly $8 bil­lion from hos­pices. Each of th­ese im­por­tant Medi­care ser­vices helps our se­niors dur­ing very dif­fi­cult times for them and their fam­i­lies, and th­ese cuts would hurt their care.

As a heart sur­geon, I know we can do bet­ter ad­dress­ing Medi­care’s loom­ing bud­get dis­as­ter in a re­spon­si­ble way that can­not be ac­com­plished with th­ese ar­bi­trary re­duc­tions. Rather, we need to work to­gether to strengthen Medi­care, putting it on sound fi­nan­cial foot­ing to en­sure that it will be there when se­niors and those near re­tire­ment need help with their health care costs.

Cur­rent pi­lot pro­grams demon­strate that high-qual­ity care can cost less. In Louisiana, a Medi­care pi­lot pro­gram is help­ing hos­pi­tal­ized se­niors avoid need­less re­hos­pi­tal­iza­tion and low­er­ing health care costs for th­ese pa­tients and Medi­care.

Cur­rently, 1 in 5 Medi­care pa­tients re­turns to the hospi­tal within one month of be­ing re­leased. Com­pli­cated post-release di­rec­tions or a lack of ac­cess to timely fol­low-up vis­its can cause th­ese avoid­able re­hos­pi­tal­iza­tions. The pi­lot pro­gram as­signs a coach to Medi­care pa­tients to en­sure that they can fol­low their dis­charge in­struc­tions, sched­ule ap­point­ments and ar­range care. Th­ese coaches help pa­tients avoid re­hos­pi­tal­iza­tion, im­prove the pa­tient’s qual­ity of life and re­duce costs.

The Se­nate health care over­haul fails to lower costs, makes ar­bi­trary cuts that would hurt se­niors’ ac­cess to doc­tors and add en­rollees to an al­ready stressed pro­gram. Un­for­tu­nately, many ad­vo­cacy groups, in­clud­ing AARP, that sup­port this health care over­haul do a dis­ser­vice to se­niors by back­ing a raid on Medi­care funds.

We should not sac­ri­fice qual­ity care to save cost. We can lower health care costs for se­niors and all Amer­i­cans by in­creas­ing com­pe­ti­tion in the in­sur­ance mar­ket, im­prov­ing pa­tients’ qual­ity of care, pro­mot­ing well­ness pro­grams and lim­it­ing friv­o­lous law­suits in medicine. It re­quires scrap­ping the cur­rent Demo­cratic pro­posal and work­ing to­gether.

How­ever, last week, House Speaker Nancy Pelosi, Cal­i­for­nia Demo­crat, said, “I think we would do al­most any­thing to pass a health care bill.”

With Demo­cratic lead­er­ship like that in Wash­ing­ton, se­niors are ask­ing, just what will that mean for me?

Rep. Charles Bous­tany Jr., a heart sur­geon, is a Louisiana Repub­li­can and a mem­ber of the House Ways and Means Com­mit­tee, which has ju­ris­dic­tion over Medi­care.

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