[Congressional Record Volume 151, Number 152 (Wednesday, November 16, 2005)]
[House]
[Page H10367]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         BABY BOOMER GENERATION

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent to go out of order 
and address the House for 5 minutes.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Texas (Mr. Burgess) is recognized for 5 minutes.
  Mr. BURGESS. Mr. Speaker, this morning at a breakfast, Chairman Alan 
Greenspan was talking to a group of us, and he made mention of the fact 
that one of his concerns about those of us who were members of the baby 
boomer generation, despite the fact that we may have lavish pensions or 
Medicare, Social Security awaiting us upon retirement, that we may 
suffer because there are not enough of those in the generation coming 
after us to provide the things that we may want; and of course one of 
those things we may want will be physicians to take care of us in our 
old age on Medicare and Social Security.
  Well, there is an event happening at the end of this year that I 
think is particularly pernicious to the upcoming crop of young medical 
students and physicians, and that is a planned 4.4 percent negative 
update, that is, a pay cut for doctors who provide care for Medicare 
patients. As a Member of Congress, and as a physician, I can strongly 
empathize with the medical community, particularly the younger medical 
community as they face an impending 26 percent cut in reimbursement 
over the next 6 years, law already in place, cuts already programmed to 
happen unless this Congress takes action.
  Medicare payments are already lower than the cost of delivering the 
care. Medicare payments do not pay the freight for overhead in a 
doctor's office. According to a survey conducted by the American 
Medical Association, a tremendous number of physicians, 38 percent, 
responded that they would be forced to reduce the number of Medicare 
patients that they accept, based on the 4.4 percent reduction that they 
face just for this coming year.

                              {time}  1845

  This data is reflective of the first installment of a series of cuts. 
This is of great concern to me, as access to health care is crucial for 
the Medicare population. We have seen the roll-out yesterday of the 
availability to the part D Medicare prescription drug benefit; and many 
of us, myself included, have argued on the floor of this House that the 
Medicare prescription drug benefit is crucial to providing 21st-century 
medicine to our seniors. But if we have no doctors present to write the 
prescriptions, then all of the prescription drug benefit in the world 
will be of no benefit to tomorrow's seniors.
  It is not just that we have doctors dropping out. We have doctors 
restricting the types of services that they might offer to Medicare 
patients, and we have doctors restricting where they might go into 
practice.
  Well, in addition, based on these reduced reimbursement rates, 
doctors will be less able to invest in things that we are asking them 
to do, things like information technology and necessary and up-to-date 
medical equipment. All of these combined factors will negatively impact 
the quality of care that our seniors receive. Simply put, we are 
driving doctors out of the Medicare system, and we can no longer afford 
to do that.
  Now, one of the proposed solutions deals with what is called Pay For 
Performance; and true, we should explore the concept of Pay For 
Performance by addressing whether this system is an improvement over 
the current one. It is important to establish the true quality 
indicators, and this is best done in conjunction with the specialty 
societies themselves, with the doctors themselves who will be 
delivering the care.
  What are the goals of Pay For Performance? Well, the number one goal 
is better clinical outcomes. In partnership with that, we want improved 
patient satisfaction, and that goes hand in hand with improved 
physician satisfaction.
  The fact is, Mr. Speaker, that doctors will support a concept like 
Pay For Performance if they believe in what it is trying to accomplish; 
but if it is just simply empty rhetoric, doctors will be among the 
first to recognize that and will abandon any attempts by Congress to 
drive a concept like Pay For Performance.
  Ultimately, if Pay For Performance is structured appropriately and 
the cost of delivering care comes down, well, that is good. We save 
some dollars in the Medicare part B system, but that money cannot be 
used to offset other debt. It has to be put back into the system and 
reward those doctors who have improved quality and lowered costs.
  Well, Mr. Speaker, fortunately, in my committee, in the Committee on 
Energy and Commerce, we are going to hold a hearing on physician 
reimbursement tomorrow, and it is timely. I am grateful to the 
chairmen, both the full committee chairman (Mr. Barton) and the 
subcommittee chairman (Mr. Deal of Georgia), for having this hearing. 
We are going to have good panels of witnesses present to receive our 
questions, and I think it is timely that my committee be involved in 
that discussion because, after all, that is the jurisdiction where this 
particular argument resides.

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