As co-chairman of the GOP Doctors Caucus, I have spent the last three years working with my physician colleagues in Congress to address many issues in health care. Founded in 2009, the Caucus has allowed Republican doctors and nurses in Congress to collaborate in an unprecedented way. We’ve stood firm against the president’s health care law, promoted patient-centered solutions drafted by our members, and listened to concerned seniors across the country who are worried about the future of Medicare. My to-do list for fixing American health care is a long one, but at the very top is repealing Medicare’s flawed sustainable growth rate (SGR) payment mechanism.
The SGR dates back to the late 1990s, when Congress developed the formula in hopes of controlling Medicare’s physician spending. As health care spending continued to rise, so did the bill for Medicare—in 2002, physicians received a 4.8 percent decrease to reimbursements as a result of SGR. In 2003, with another round of cuts looming, Congress passed the first of many “doc fixes” to prevent cuts and preserve seniors’ access to medical care. All told, we’ve spent nearly $170 billion on short-term fixes and all without providing any certainty to physicians or patients.
In 2014, the Congressional Budget Office projected the cost of repealing SGR and replacing it with a sustainable payment formula would cost $138 billion, far less than the earlier estimates. Just last week, the American Action Forum released research that found repealing SGR and adopting structural reforms to Medicare would reduce spending by $295 billion by 2035. A lot of hard bipartisan, bicameral work in Congress has put us closer than ever before to permanently fixing a problem that has been a thorn in the side of physicians for well over a decade.
The process we have used to come up with a replacement for this flawed formula is in many ways a model for how policy can be crafted. The Ways and Means and Energy and Commerce Committees drafted a solution, and then asked for input from the Doctors Caucus, as well as doctors’ groups who the new policy will affect. The Doctors Caucus outlined the criteria we believed were necessary in any package in order to support a final product. We were proud to see these priorities – which included a transition period to a new system, a positive update for physicians, and the preservation of fee-for-service medicine as an option for physicians in Medicare – included in the SGR replacement bills introduced in the last Congress and in this one.
The time has come for both sides to come to the table and put a bill on the president’s desk. For doctors and their patients, this will end years of needless concern and frustration that care will be negatively impacted by arbitrary cuts. For policymakers, this will finally allow the American people to see Medicare’s true fiscal shape, and hopefully enable real reforms that will ensure the program can continue to serve future generations. For taxpayers, this will result in a huge amount of savings over time. Nobody loses if Congress gets this done.
We have a unique opportunity to bring much-needed stability to the Medicare program, and the time to act is now.
— Rep. Phil Roe, M.D.