No Hocus-Pocus Promises, Fix Medicare System (Editorial)

HEADLINE: No hocus-pocus promises: Fix Medicare system

BYLINE: Grassley Chuck, Readers

BODY:
By CHUCK GRASSLEY

Any regular reader of the Register's editorial pages is aware of the flawed Medicare funding formula that shortchanges Iowa. The reimbursement system punishes rural states such as ours that provide high-quality, cost-efficient health care. The inequity creates potentially far-reaching negative consequences beyond the pinched budgets of hometown hospitals, community health-care clinics and doctors' offices.

Medicare's low reimbursement rate for health-care services becomes a deterrent to attracting and retaining top-quality medical practitioners to Iowa. The underpayments put enormous pressure on Iowa hospitals to cover the gap between the reimbursement rates and the cost of providing services. Over time, the disparity could lead to a situation that puts an entire community at risk for no or limited access to routine, essential and emergency health-care services close to home.

On April 14, I will convene an official congressional field hearing in Des Moines to examine how Medicare's payment system mistreats Iowa. We will explore policy solutions to put Iowa on equal footing with other states.

I invited a nonpartisan panel of Medicare payment experts, Iowa health-care providers and business leaders to detail how the funding system shortchanges Iowa and to offer solutions to the problem. Two former Medicare administrators, one who served in a Republican administration and one who served in a Democratic administration, will lead the morning's testimony.

The advice, concerns and complaints I hear from folks during my annual road trip across the state help me do a better job in Washington. I like to tell my colleagues that Iowa common sense helps dispel a lot of Washington nonsense. That's why I'm particularly pleased to give Iowa health-care and business leaders the opportunity to put their ideas on record as the Finance Committee develops legislation this year to fix unfair Medicare reimbursement.

Iowans testifying April 14 will outline how Medicare's payment system negatively affects patient access to health care and business development. Witnesses include a hospital administrator, a physician, an employer and a representative of a major Iowa health insurer.

Getting a better deal for Iowa will take more than just the wave of a magic wand. People who pull political hocus-pocus on this issue aren't doing Iowa any favors. Ending Medicare's discrimination against rural states will require bipartisan policy-making in both houses of Congress.

For the last several years, I've worked to fix flaws in the Medicare payment system to make it fairer to Iowa. For example, Medicare needs to recognize that smaller, isolated providers incur special costs of doing business. If we get caught up in a discussion about who comes in first and who comes in last place on the payment scale, we'll end up like the dog chasing its tail. The issue comes down to ensuring fair payments and unfettered access to quality health care for all Iowans.

Last year, I wrote bipartisan legislation that, if passed, would have helped significantly every Iowa hospital. My legislation also would have corrected the negative payment adjustment our doctors receive by virtue of practicing in Iowa. We don't pay members of Congress or soldiers differently based on their home state. The doctors who provide medical care for seniors should be paid fairly and equitably, regardless of where they practice.

From my chairmanship position of the Senate Finance Committee, I will insist that any Medicare bill that moves this year must have a substantial component for states such as Iowa to fix the payment gap. But unless money starts growing on trees, any Medicare legislation must be responsible, balanced and fair to seniors and taxpayers. Making promises to the moon falls under hocus-pocus lawmaking. We're not trying to pull a rabbit out of a hat. This is a serious issue that needs serious discussion.

I look forward to rolling up my sleeves with Iowans on April 14 to flush out ideas to help improve Iowa's Medicare delivery system.

CHUCK GRASSLEY is a Republican senator from Iowa.