Assessing Impact of Medicare Cuts

Floor Speech

Mr. Speaker, in 1965, a program called Medicare was incepted. It was offering health benefits to those over age 65.

At first, physicians were very suspicious of allowing so much government intervention in medicine. After a while, more and more physicians doing their duty to take care of patients accepted it.

The sad fact and the problem is that Medicare now is what they, in 1965, were very afraid of, that so much of government has gotten into medical issues.

This is the main problem. Medicare does not reimburse the cost of care for patients. This is a real access issue. We are not really talking about paying physicians. We are talking about access to care.

This year, CMS is proposing a 3.37 percent cut to the physician fee schedule. It would be about a 20 percent cut over the last 20 years.

Doctors want to see Medicare patients, but they simply won't be able to, and this is going to affect access to care.

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Mr. MURPHY. He has been a stalwart in the Chamber for 20-plus years as a physician, a retired OB-GYN.

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Mr. MURPHY. Mr. Speaker, it is about access. Physicians want to see Medicare patients, but if you do not pay the bills, they can't keep the doors open.

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Mr. MURPHY. Mr. Speaker, we are experiencing a doctor shortage, and it is going to get worse and worse, driving physicians out because they no longer are able to be paid for their services or forcing them into employment that destroys the historically great quality of medicine in America.

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Mr. MURPHY. Mr. Speaker, as you can see, this is obviously a bipartisan issue. We care about our constituents, but we also care about the health of our constituents.

Mr. Speaker, 10,000 Americans each day are added to the Medicare rolls. Again, with such a doctor shortage, you are adding more and more individuals where Medicare doesn't pay their bills, and it is harder and harder to take care of them.

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Mr. MURPHY. Mr. Speaker, the gentleman points out a perfect issue. We are depriving access to patients and developing more and more concierge medicine, which is wonderful for those who can afford it, but for those who can't afford to go and see one of these cash doctors, and you can't get into a doctor's office because they can't take more Medicare patients, guess what happens? They get driven to emergency departments where a more costly care goes on.

We have to stop this nonsense.

Schrier), a pediatrician.

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Mr. MURPHY. Mr. Speaker, if you owned a hardware store and sold hammers that cost $1 apiece but you had to sell them for 40 cents apiece, how long would you sell hammers?

You wouldn't sell them very long because it just doesn't make financial sense, and you literally can't just give money and walk money out the door.

Unfortunately, this is what is happening with Medicare patients. Physicians want to take care of their patients. They are caring individuals, but when the numbers don't matter, you just can't do it.

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Mr. MURPHY. Mr. Speaker, may I inquire how much time I have remaining?

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Mr. MURPHY. Mr. Speaker, I have seen Medicare patients for more than 30 years. I have had individuals come in my office after I have operated on and cared for them in the hospital and apologized, flat out apologized for the lack of payment that we received from Medicare.

I tell them I do it because I love operating and taking care of people, but there comes a point where you have to keep the lights on, you have to pay your nurses, and pay your mortgage.

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Mr. MURPHY. Mr. Speaker, we submitted a bill, H.R. 6683, a couple weeks ago, and while ENC was able to keep the cut at 1.25 percent, we are actually desiring to not allow the cut at all. We are taking money from the Medicare Improvement Fund, which is what the money is for, to solve problems within Medicare.

Unfortunately, as this was a wonderful bipartisan discussion this evening, we are oftentimes imprisoned, if you will, sometimes to the will of some of the leaders over in Senate, sometimes even here in the House.

Leaders over in the Senate didn't want anything for a doctor fix. The Democratic leader said, no, we want this huge wish list of things done, and we will trade that for the doctor fix.

Well, guys, you can't take poison pills to try to help physicians. This is where there should not be politics whatsoever. We saw both sides tonight, Democrats and Republicans, speak about the healthcare of patients in this country.

Mr. Speaker, at some point it is going to snap. At some point, whether it be what Obamacare was trying to do, absolutely starve private practice so that everybody would either be bought out by private equity or have to be assumed by hospital systems. Where, by the way, physicians don't work as efficiently, physicians cost more, and they see fewer patients. It is a closer ownership care of patients.

When I was practicing full-time, if another doctor called me and said, hey, can you see somebody? My response was always: Do you want me to see them today or tomorrow?

The sad fact is once physicians become employed, not only do they cost more to the system, but the work ethic is not as good. That is just point-blank what is seen.

What we need to understand is that private practice is the most efficient way of delivering healthcare in this country, but it is also the one where we care the most, and we follow up. We are always happy to see that next patient and make sure that we keep our doors open.

At this point, Mr. Speaker, we are going to approach a calamitous cliff, if you will, in the next 3 to 5 years with the number of surgeons that are available to take care of patients.

I am a urologist. I take care of disorders of the kidney, prostate, and bladder--those type of things. We are the most critically short specialty in the country.

Right now, the median age of individuals practicing urology is my age, the age of 60. If now we are not paying doctors enough to stay in business, they are going to quit. We are going to make a bad shortage even worse. We have to pay those who take care of patients what they need to be paid.

Mr. Speaker, I appreciate that this was a bipartisan discussion this evening, something that is easy for our leadership to fix. I ask that they do that.

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