House Republicans are in the process of drafting an alternative budget proposal. Nothing has been finalized but the representative who will write the proposal, Representative Paul Ryan of Wisconsin, has a draft that includes the end of Medicare as we know it, replacing it with a system of vouchers for seniors to buy private insurance. Also included is a plan to privatize social security, turning your savings over to the wall street speculators who caused the recent financial collapse.

It is urgent that you contact Peter Roskam today and tell him to reject any plan that would take away your Medicare and Social Security.

You can contact Peter Roskam in Washington at (202) 225-4561 or in Bloomingdale at (630) 893-9670.

Earlier today, Republican Congressman Peter Roskam voted to cut Medicare payments to physicians, putting at risk access to care and choice of physician for the nations senior citizens, for disabled persons served by Medicare, and for families of U.S. military personnel receiving care through TRICARE, the health care program serving active duty service members, National Guard and Reserve members, retirees, and their families and survivors. It was just Peter Roskam’s way of saying thank you to the nation’s elders and soldiers for their hard work and sacrifices for their country, and thank you to the nation’s physicians as well for their efforts on behalf of their patients.

The vote was on H.R.3961 – Medicare Physician Payment Reform Act of 2009. Congressional action was required on this bill to prevent physicians caring for seniors and military families from receiving a 21% pay cut in 2010. Such a drastic cut in physician reimbursement would force many physicians caring for seniors and for military families to stop accepting such patients or dratically cut back on the number of physicians. This would result in many patients losing access to their physician of choice and perhaps losing access to care altogether. Roskam himself described the access problem in a letter attacking similar impending cuts back in 2008:

“Despite the rising costs of living, Congress is unwisely poised to cut Medicare payments for physicians, severely limiting access to medical care for an ever growing senior population,” said Roskam. “If such cuts are enacted, Illinois will lose $510 million for the care of elderly and disabled patients over the next year, and $10 billion over eight years. It is my sincere hope the bipartisan support from many of my fellow colleagues will help restore this funding, insuring that Medicare patients can find physicians in their community with the financial ability to treat them.”

Medicare seniors look to their doctor as the key professional in charge of their care. Every aspect of our health care system from hospitals to rural health clinics relies upon the skills and services of physicians. A stable payment structure for physician services is critical. The impending cuts will only destabilize the Medicare program and jeopardize all patients’ access to care if not addressed in a thoughtful manner. It is critical that we work together in a bipartisan fashion to enact legislation early in this year to stop the Medicare cuts.

So  Roskam’s support of pay cuts to doctors this time around is based in his obstructive partisanship rather than good policy and he is willing to let everyone suffer for it.  DuPage County Seniors, families of servicemen, and physicians should take note of this vote and remember it next fall.

Fortunately, Peter Roskam did not get his way. H.R. 3961 passed by a vote of 243-183. Only a single Republican voted for the bill: Rep. Michael Burgess of Texas. We see once again that all the Republican protestations about supporting the troops are really just so much hot air.

House Speaker Nancy Pelosi issued the following statement on the passage of H.R. 3961:

“Strengthening Medicare for generations to come is essential to our efforts to reforming health care for all Americans. This legislation will permanently improve the way Medicare pays physicians and in doing so, guarantee that America’s seniors will continue to have access to excellent care through Medicare.

“This legislation is a top priority for seniors and was endorsed by the AARP and the American Medical Association because it protects seniors’ access to their doctor, promotes primary care, and offers incentives for doctors to provide patients with higher quality and more efficient care. Today’s vote by the House keeps our promise to strengthen Medicare, never weaken it.

“As this legislation heads to the Senate, the statutory ‘pay as you go’ budget bill will be added to ensure that we put our nation back on a path of fiscal responsibility and begin to bring down the deep deficits that face our nation.”

Summer has been busy and I haven’t had time to write as much as I’d like. Some important votes have slipped by without comment. One that I think is of particular interest is the vote on June 24 on H.R. 6331: Medicare Improvement for Patients and Providers Act of 2008. Medicare recipients and the physicians who care for them should take special note.

On July 1st 2008, physicians participating in the Medicare program were scheduled to receive a 10 percent cut in reimbursement. An additional 5 percent cut was to take place in 2009. These cuts, if enacted, could have been devastating to both physicians, who are struggling to maintain the solvency of their practices in the face of reimbursement reductions by state, federal and private payers, and to Medicare recipients, who are faced with increasing difficulty in finding physicans willing to treat Medicare patients. According to the American Medical Association, as many as 60% of physicians would have been forced to limit their services to Medicare recipients under the proposed cuts.

In an effort to prevent these cuts from taking place, Democrats in the House, led by Rep. Charles Rangel, introduced H.R. 6331. In addition to to stopping the physician pay cuts, the bill provided for a number of modest improvements to the Medicare program to aid beneficiaries including:

  • Coverage of additional preventive services
  • Elimination of late enrollment penalties for the part D drug benefit
  • Coverage of pulmonary and cardiac rehabilitation
  • Elimination of higher co-payments for mental health services

Prior to the vote, President Bush threatened to veto the bill because it would have reduced payments to Medicare Advantage plans – private health insurance plans that offer alternatives to traditional Medicare under contract with CMS. Such plans currently receive, on average, about 12% more than the cost of services for recipients in traditional Medicare. Outside the Administration, there is widespread feeling that these plans, which are supposed to reduce costs through careful medical management, should be receiving reimbursements at a level lower than the costs of traditional Medicare, although insurance companies argue that the cuts will increase out-of-pocket costs and decrease options for Medicare Advantage recipients.

When the bill came to a vote on June 24, Peter Roskam voted no, siding with the Bush administration in its desire to allow the pay cuts to take effect. The bill passed but was vetoed by the President on July 15. That veto was quickly overridden by the House and Senate and has become law.

Physicians and Medicare recipients in the 6th district should ask Peter Roskam why he voted to support pay cuts for Medicare physicians. Roskam can be reached at his Washington office at (202) 225-4561 or in Bloomingdale at (630) 893-9670.