How could a new Medicare reform bill soon to be considered by the House affect Central Coast doctors?
The new Medicare payment reform bill that is working its way through Congress could have a huge impact on the Central Coast. Right now, there is a formula that is used to determine how a doctor is paid for seeing Medicare patients. That formula is based on an old classification of either “rural” or “urban” for all of the counties in California. To give you an idea of how outdated this formula is, San Diego is still considered rural. Unfortunately, so are most of the counties on the Central Coast, including Santa Cruz.
The problem is this formula does not take into account things like the high cost of living or the cost for doctors to practice on the Central Coast. The formula assumes that supposedly those costs are low in rural counties and so doctors here are paid less to see Medicare patients than doctors in neighboring counties.
This creates many problems. Doctors will choose to open a practice in a county with higher payment rates rather than coming to the Central Coast. It also means the doctors who do practice here are less likely to see Medicare patients since they won’t be fairly compensated for their time. The end result is too few doctors on the Central Coast and even fewer willing to take on Medicare patients, leaving many folks without access to quality healthcare.
I was able to get a provision inserted in the new bill that would fix this. Instead of using the old formula, doctors would instead get paid by Medicare under a formula already used to reimburse hospitals. It tweaks something called the Geographic Practice Cost Index. It sounds complicated but really it just focuses more on the urban factors that drive the cost of medical services and doesn’t just rely on outdated classifications for counties to determine them.
If we can get this provision through the House and the Senate, this will be a big win for many areas of California. More doctors will want to come to places like Santa Cruz to practice medicine knowing they will get fair pay for treating Medicare patients. And more doctors means better access to healthcare for all Central Coast residents.
Looking out at 2014, what do you expect to be the biggest battles in Congress?
I think the biggest battle we are going to face in this year is one that has been building for decades now: What do we do about growing income disparities in the United States?
Fifty years ago, President Lyndon B. Johnson declared an “unconditional War on Poverty in America.” This wasn’t just a slogan but a real effort to reduce the number of people living in poverty. I had just returned from the Peace Corps where I experienced the cycle of poverty first hand. I learned that if people had access to healthcare, food, a safe place to sleep and an education, they have all the tools to make it in this world.
President Johnson knew that, too, and his War on Poverty focused on those issues. His programs cut the poverty rate in half and lifted up millions. But it wasn’t just the poor who benefited. Our focus on a bottom-up economy allowed the middle class to expand and flourish. It was a rising tide that lifted all boats. Unfortunately, our country has turned its back on those proven policies. Failed ideas like trickle-down economics have left us a divided country of “haves” and “have nots.” Rather than investing in America, we have developed a cut, squeeze and trim mentality to governing in Washington.
As we come out of the recession, folks outside of the beltway are rediscovering that the best way to create jobs is through smart investments in our country. We need programs that ensure everyone has access to those tools necessary to break the cycle of poverty. In the next year, Democrats will fight to reduce the growing income gap in America. We will push for a real jobs bill, a livable wage, tax policies that benefit the middle class and programs that expand access to necessities like affordable housing, a quality education and healthcare.
With Republicans still controlling the House, this won’t be an easy fight, but it’s one the American people demand.