The Friday - The Cost of Doing Nothing and the Courage to Offer Solutions

Op-Ed

By Representative James Lankford

I am well aware that Medicare is often called the "third-rail" of American politics and those who propose changes to it do so at their own peril. This paradigm has allowed politicians to stand around and do nothing while Medicare slowly hemorrhages and the nation sinks deep into debt. Anyone who says that Medicare can just keep going is ignoring the fact that the emperor has no clothes. The Medicare trustees have informed Congress and the President that the program will be insolvent by 2024 (five years faster since the passage of the Affordable Care Act). That "rosy" future can only occur if doctor reimbursement rates are also cut another 30 percent next year (no "Doc Fix"). With more and more doctors refusing to take additional Medicare patients because of the current low reimbursement rates, just imagine how many physician options will exist when they are cut another 30 percent.

It is time for the nation to hear the truth. The politics of the past have squandered Medicare and used senior citizens for political gain. In the next decade we will see Medicare go insolvent, leading to higher taxes and reduced benefits. One thing is certain, ten years from now we will not have today's status quo. It is not sustainable.

There are currently two plans on the table: central control and competition. The President has proposed absolute central control by cutting Medicare $250 billion over the next ten years by lowering the reimbursement rates for doctors and hospitals. The "savings" will be determined by the new Independent Payment Advisory Board (IPAB), a new bureaucracy created in the Affordable Care Act. IPAB is a fifteen member board in Washington that will have the absolute authority to determine the cost of every medical procedure and device in America. They will also have the authority to determine which medical procedures cost too much and which are affordable. It may sound like the model of efficiency, but it is actually the greatest example of central control ever conceived in American life.

The House of Representatives plan, submitted by Congressman Paul Ryan and the Budget Committee (of which I am a member), is the competition model. The Republican plan applies what we have learned from competition in Medicare Part D, and means testing in Medicare Part B, to all of Medicare. It is NOT a voucher plan because Medicare is still in charge, patients are still guaranteed coverage, pre-existing conditions are still waived, and the seniors who need the most financial help will get the most help.

This is not a "radical" plan as many have called it; it is common sense. During the vote in Washington, I called my own mother (who is a current Medicare recipient) and let her know that when I came home for Thanksgiving, I would not throw her off a cliff -- as Democrats have accused us of doing. The radical rhetoric is obscene, and it masks the looming insolvency of Medicare. The time for playing politics is past; now it is time to solve the problem.

To be certain, the cost of doing nothing should not be acceptable to anyone who wants to honor our commitment to our seniors. Our inaction will condemn our nation into an endless struggle to find adequate medical care and bury our nation in debt. I am not ready to accept a future where our nation faces a decline because we are afraid to make hard decisions today. House Republicans are challenging that premise this year. We passed a budget that pays off our debt over time by cutting trillions of dollars in spending and preserving Medicare for years to come by giving seniors more control of their health decisions. Make no doubt about it; these are significant and meaningful to the federal budget and entitlement programs. But we need the courage to offer solutions; we have long passed the time where simple tweaks will do.

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