Medicare quagmire

Reform of the complex Medicare reimbursement formula must be a part of the final health care package approved by Congress.

The 45-year-old system for reimbursing hospital and doctors who care for Medicare patients has shortchanged Washington state for years because, compared with other states, Washington has a high-quality, low-cost Medicare system that costs less per patient than the national average. The Medicare reimbursement system in place rewards health care providers who rack up additional costs through unnecessary medical tests and services.

A shift away from the fee-for- service based formula to one that recognizes efficiencies and quality of medical care could save the Medicare program, which is responsible for $1 of every $5 spent on health in this nation, about $100 billion a year. That’s savings that would drive down the nation’s overall medical bill.

Senior citizens in this state are paying a huge price for the disparity in Medicare reimbursement. Nearly 30 percent of the state’s 6,200 physicians refuse to accept new Medicare patients or have decided to drop ones they have.

A survey last year by the Washington State Medical Association suggested that number could grow to 51 percent, barring changes in the reimbursement formula.

Sen. Maria Cantwell, D-Wash., is working hard in the Senate to make sure Medicare reimbursement is part of the health care reform package. In the House, Democratic Congressmen Jay Inslee and Norm Dicks are carrying the torch on this vital issue.

“We are trying to do health care reform rather than insurance company reform,” Inslee noted.

All three lawmakers have made it clear that their support for the health care package hinges on meaningful changes in the Medicare reimbursement program.

Their voices need to be heard. Changes in the Medicare reimbursement plan is so important to the 780,000 seniors in this state who rely on Medicare for all or a portion of their health care coverage.