[Congressional Record (Bound Edition), Volume 152 (2006), Part 13]
[House]
[Pages 17191-17192]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     H.R. 5866, A MEDICARE SOLUTION

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent to go out of order.
  The SPEAKER pro tempore. Without objection, the gentleman from Texas 
is recognized for 5 minutes.
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I come to the floor tonight to talk about 
the way that this Congress and the Center for Medicaid and Medicare 
Services pays for patient access in the Medicare system and how they 
reimburse physicians.
  Under the current formula, America's doctors participating in 
Medicare can expect an annual pay cut of approximately 5 percent over 
the next decade. That translates to between a 30 and a 36 percent pay 
reduction for physicians in this country over the next 10 years. Now, 
Mr. Speaker, I do not know of many small businesses where the 
expectation of their overhead payments is going to fall by a third over 
the next 10 years. Indeed, it will be very hard for many of these 
individuals to remain in business if this issue is not fixed. Not 
addressing this impending crisis would be negligent at best and put 
frail and elderly Medicare beneficiaries at risk of losing their 
physician.
  The current Medicare physician payment methodology is fundamentally 
flawed, and it must be reformed. It is not going to be fixed by the 
application of a Band-Aid. This requires major surgery. A recent bill 
introduced, 5856, the Medicare Physician Payment Reform and Quality 
Improvement Act of 2006, will attempt to accomplish this and two 
additional goals.
  The three purposes of this bill are, one, ensure that physicians 
receive fair payment for the services that they provide; number two, 
create quality performance measures and improve the quality improvement 
organizations that exist to improve the quality of care available to 
Medicare patients; and, three, identify reasonable offsets to give 
Medicare physicians a more regular and predictable payment update year 
to year.
  Without intervention, payment for physician services will be cut more 
than 5 percent next year. H.R. 5866 ends the application of what is 
known as the sustainable growth rate on January 1, 2007, and institutes 
a single conversion factor, the Medicare economic index minus 1 
percent. This creates a more market-based approach to physician payment 
by placing more value on the actual costs of inputs and not on 
arbitrary volume of service targets each year.
  In other words, doctors would be paid the same as hospitals are paid, 
the same as nursing homes are paid, the same as long-term care 
hospitals are paid, based upon the market cost of inputs for providing 
that care.
  The bill also establishes a system of quality performance measures so 
that

[[Page 17192]]

physicians can voluntarily, and let me stress the word voluntarily, 
report data to the Center for Medicare and Medicaid Services. Patients 
can then assess the level of quality of their prospective doctors, the 
level those doctors are achieving, and decide which doctor they would 
prefer to use. These measures will be developed in collaboration with 
physician specialty organizations for core medical services to make 
certain that these measures are relevant and meaningful to that 
particular practice of that branch of medicine.
  As an incentive to participate in reporting for performance measures, 
participating physicians will be permitted to balance bill certain 
high-income Medicare beneficiaries. Redirecting the stabilization fund 
from the Medicare Modernization Act provides an additional $10 billion 
for offsets. Eliminating the double payment from Medicare for indirect 
costs of medical education is another source of offsetting these costs.
  Mr. Speaker, this August, the American Medical Association, in its 
publication the American Medical News, talked about this bill, 5866. 
Quoting now, it said that ``the bill would ensure positive annual 
updates by tying rates to the Medicare economic index. This index is an 
indicator of how much doctors' cost of caring for patients is 
increasing. If lawmakers and the White House can approve the measure 
before Congress adjourns for the year, physicians would start receiving 
yearly updates equal to an approximately 1.5 percent increase in 
Medicare rates.''
  The bill drew endorsements, of course, from the American Medical 
Association. But also the American College of Obstetricians and 
Gynecologists and the American College of Clinical Endocrinologists are 
a few of the specialty organizations that have endorsed the concept of 
this legislation.
  We need help to make real changes in this system. We need help from 
every Member on both sides of the aisle. We need to create solutions 
and stop simply talking about the Medicare problem. I am asking my 
colleagues to join me in cosponsoring H.R. 5866.

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