[Congressional Record Volume 155, Number 91 (Wednesday, June 17, 2009)]
[Extensions of Remarks]
[Pages E1477-E1478]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   STRATEGIC INVESTMENTS IN MEDICARE

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                          HON. EARL BLUMENAUER

                               of oregon

                    in the house of representatives

                        Wednesday, June 17, 2009

  Mr. BLUMENAUER. Madam Speaker, for too long, the federal government 
has enabled the inefficiencies of our health care system. This is not 
only wasteful, but inequitable to taxpayers in efficient, low-spending 
regions such as Oregon, Washington, Wisconsin, North Dakota and 
Minnesota who are subsidizing high-spending regions of the country.
  Medicare beneficiaries living in Miami, Las Vegas, New York and 
Houston receive approximately 60% more services than those living in 
low-spending regions. This higher spending has not produced higher 
quality of care or superior outcomes. In fact, research shows that 
health care outcomes and patient satisfaction are often greater in 
regions that spend less.
  We cannot afford to ignore this problem any longer. The June 2008 
Medicare Payment Advisory Commission (MedPAC) report stated

[[Page E1478]]

that ``. . . our health care system is not delivering value for its 
stakeholders . . . if current spending and utilization trends continue, 
the Medicare program is fiscally unsustainable.''
  Today I am introducing two bills to address this looming problem. The 
first would change the financial incentives in our health care system 
to reward low-spending Medicare regions through a 5% bonus payment. 
Currently, there is no financial incentive for high-spending regions to 
reign in spending. This would create that incentive and reward regions 
that have made a concerted effort to efficiently use health resources.
  The second would lay the foundation for better, more accurate 
research for Congress to use in analyzing Medicare policy 
recommendations. The legislation will change MedPAC's statutory mandate 
to include an annual report to examine each Medicare region, evaluating 
access to care, quality of care, increases or decreases in volume of 
services, and the potential effects of other policy recommendations 
under consideration. This new report will provide critical data and 
result in more accurate and targeted policy recommendations that take 
into effect geographic variations and recognize that distinctly 
different delivery systems should be treated differently.
  These strategic investments in Medicare will lay the groundwork for 
future improvements and refinements to the program as we promote 
efficiency and quality in all regions of the country.

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