Health Care Reform: A System that Works for Patients and Providers
The health care reform measures that I helped passed in the House — the landmark Affordable Health Care for America Act (HR 3962), along with the Medicare Physician Payment Reform Act (HR 3961) — will dramatically improve our health care system for patients and providers.
The primary concern of all doctors is treating the sick and healing the wounded. Health care reform will expand access to lifesaving care for millions of Americans who lack insurance. It will also improve care for everyone by ending denial of coverage for pre-existing conditions and eliminating caps on coverage. Doctors understand that an existing health condition is all the more reason to help a patient, not deny them treatment. No longer will insurance industry bureaucrats make life-and-death decisions and interfere in the sacred bond between doctors and their patients.
The public health insurance option included in the insurance exchange will provide many Americans with real choice, increased access, and will lower average insurance premiums — but it is an option for consumers just as it is for doctors. Physicians will not be required to participate in the public option, though I believe many will, as providers’ rates will be fairly established through negotiation.
The important issue of Medicare reimbursement is addressed in the accompanying bill, HR 3961, which will permanently replace the outdated Sustained Growth Rate (SGR) for determining doctors’ payments through Medicare and military TRICARE. When the SGR was implemented, projections failed to anticipate the steeper rise in health costs relative to growth in per capita Gross Domestic Product (GDP). As a result of a flawed formula, every year physicians face cuts to their reimbursement. For six years Congress has kicked the can down the road, preventing cuts one year at a time but failing to address a problem that continues to grow. The result is a looming 21% cut in 2010 that threatens doctors’ practices and could force them to limit their services to seniors and military families. This bill will finally address the problem by rebasing expenditure targets on a rolling five year average to prevent the kind of cuts we’ve witnessed since the plan was first implemented.
This reimbursement fix is important to strengthening our health care workforce, something that is also addressed in our reform measures so that our health system is ready to provide for those who gain access to care. The reform bill includes over a billion dollars in additional funding for the National Health Service Corps, strengthened scholarship and repayment programs for providers in areas of need, and enhanced grant programs to training institutions to encourage expanded primary care programs.
Fundamentally, these reforms will allow doctors to perform their craft and fulfill their mission of helping those in need. That’s why our plan has been endorsed by the AMA and at least 13 other major physicians’ organizations. We finally have a plan that provides America’s doctors and patients the health system they deserve.
Congressman Joe Sestak, PA-07, serves on health care subcommittees in the Education & Labor and Small Business Committees and is a candidate for the U.S. Senate in Pennsylvania.