Hearing of the Health Subcommittee of the House Ways and Means Committee - MedPAC's June 2014 Report

Hearing

Thank you, Dr. Miller for coming in today to discuss MedPAC's most recent report. This is an important hearing, and I hope we can have a constructive conversation this morning that focuses on finding solutions to the challenges that Medicare faces in a way that protects beneficiaries.

Through its expertise and nonpartisan analysis, MedPAC helps members of Congress come together to discuss options for reform that improve the payment system, cut down on costs, and improve the quality of care that beneficiaries receive.

We may not always agree, but reports like the one we are discussing today often serve as a good starting point for important conversations.

Unlike previous reports that MedPAC has submitted to Congress, it's important to note that today's report does not contain any recommendations.

Instead, today's report presents a number of ideas that we can use as a framework for today's discussion.

We do not need to leap to any conclusions. We should listen, question, and analyze what we hear. After a careful review of these issues, we can then determine what proposals make sense and what won't work.

Whatever changes we decide to make, we need to focus on some key principles.

First, we need to make sure that beneficiaries are protected from having to bear an increased financial burden. Currently Medicare beneficiaries pay a greater share of their income for health services than the average American.

And yet, the Republicans often say they need more "skin in the game."

They paid taxes during their working years to earn eligibility, and they continue to shoulder a share of the load through premiums, co-pays or coinsurance and deductibles.

Second, we must work to get healthcare costs under control.

We did a lot of great things through the Affordable Care Act, particularly in protecting consumers and expanding access to affordable health coverage for millions of Americans.

The ACA improved Medicare's benefits by improving coverage of preventive care and increasing prescription drug coverage.

And the ACA helped constrain Medicare spending, such that we have had record low per capita spending growth -- below inflation -- in the years following enactment of health reform.

We must continue this work by focusing on controlling costs and improving outcomes.

Just this week, a report from the Commonwealth Fund found, yet again, that the United States spends more per capita than any other country on healthcare, yet we don't get the best results. We must fix this.

Third, we should make sure that payments are accurate and fair.

This involves a careful review of how Medicare pays doctors and hospitals, with an eye toward eliminating overpayments and fraud, waste, and abuse in the system.

This will allow us to strengthen the program without harming beneficiaries.

Finally, we should focus on saving money through innovative payment models.

The ACA introduced a number of promising reforms to Medicare, including Accountable Care Organizations and the Medicare Shared Savings Program, which will cut costs without harming beneficiaries.

We need to continue to remove barriers to setting up these innovative programs.

I'm concerned that my Republican colleagues will use today's hearing to suggest radical changes to Medicare.

Whether it's a proposal to eliminate the program's defined benefit through a voucher system or increased cost-sharing for seniors, I've heard a lot of bad ideas from the other side in the past.

MedPAC has not suggested we make any of these changes in its report, and I hope our conversation today doesn't use this hearing as cover for some bad ideas.

Source