Politics & Policy

Fixing the ‘Doc Fix’ for Good

Today’s Medicare vote is an important step toward reining in costs while protecting patients.

President Obama’s debt is hurting our prosperity today and imperiling the American Dream for our children and grandchildren. On his watch, America’s national debt has increased by $7.5 trillion, to more than $18.1 trillion. Virtually everyone agrees: This simply can’t go on forever.

Entrusted with a majority in the House of Representatives since the start of 2011, Republicans have worked hard to reduce out-of-control Washington spending. Despite staunch opposition from the White House and Senate Democrats, we have made 99 percent of the Bush tax cuts permanent and we are on track to save taxpayers nearly $2.1 trillion. And every year, we’ve proposed budgets that would balance and set us on a path to pay off our debt.

Obviously, we haven’t achieved everything we wanted. The federal government still spends more than it takes in, largely because of mandatory entitlements like Medicare, Medicaid, and Social Security, which account for more than half of the entire budget. These important programs are still scheduled to go bankrupt in just a few years. It will take more work to save them, not to mention a president willing to do the right thing.

We can’t put off progress until 2017, though. Our debt grows by the day, robbing our kids and grandkids of promised benefits that they are unlikely ever to see. Social Security Disability Insurance runs out of money next year. And due to what’s called Medicare’s Sustainable Growth Rate (SGR) formula, doctors will be hit with an automatic 21 percent cut to the payments they receive for treating patients on Medicare — unless Congress acts.

We’ve faced this cliff before, nearly 20 times over the past dozen years. And every time, instead of actually addressing the problem with real reforms, Congress has punted with a temporary “doc fix.” But this time can be different.

Later today, the House will vote on legislation that will make real progress in strengthening Medicare — a bill that will provide better health care for seniors and real savings for taxpayers. We know that more and more seniors have been losing access to their doctors because of Medicare rules. If enacted, this bill will permanently replace one of Washington’s most infamous budget gimmicks, SGR, with a more stable system that rewards quality and innovation. In doing so, not only will we reassure seniors that they can count on Medicare and continue to see their own doctor, but we will also put in place a stronger Medicare program for Americans who are trying to care for elderly parents.

#related#For the first time ever, Democrats in Congress have dropped their demands for tax increases and accepted two structural reforms that will strengthen Medicare and put the program on a more sound financial footing. The first means-testing reform would ask higher-income seniors to pay a little more for their premiums for Parts B and D. The second reform would limit the availability of first-dollar coverage (i.e., having insurance pay the deductible) for certain Medigap plans, to encourage beneficiaries to think more like consumers when it comes to their health care — a concept we know is the right approach to reducing health costs.

These reforms must be phased in over time, so they won’t “pay for” the total cost of this bill over the ten-year Congressional Budget Office (CBO) window. But over the long term, the next 20, 30, and 40 years down the road, these reforms will produce hundreds and hundreds of billions in durable savings for taxpayers — not just the illusion of savings from the gimmicks in SGR. CBO has confirmed that the bill will result in a net deficit reduction for taxpayers by the end of the second decade — and far more after that. Moreover, Douglas Holtz-Eakin from the American Action Forum estimates that these two Medicare reforms will save $230 billion in the second decade alone.

This would be the first real entitlement reform in nearly two decades, and that’s a big win for conservatives. Just as important, these commonsense changes — in combination with the “doc fix” reforms — will bring more competition to Medicare and set the stage for further reforms in the future to help seniors and taxpayers.

Make no mistake — this bill is not perfect. But it is an opportunity to solve a problem permanently and improve Medicare in the process. We should seize that opportunity and do some good for the American people.

— John Boehner (R., Ohio) is speaker of the House of Representatives.


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