July 16, 2008


By Senator Mike Crapo

Millions rely on Medicare to access our healthcare system. They should have exceptional care and cutting edge treatments available to them. Reimbursing doctors so that they can serve these patients is critical-for this reason, I have consistently advocated for timely and adequate physician compensation. Systemic reform is also crucial. The Medicare system needs the strengths inherent in the market-healthy competition that provides choice, flexibility and affordability The Medicare Modernization Act of 2003 introduced market forces into the system that have benefited millions of seniors since.

Unfortunately, in early July, the Senate voted to compromise positive gains we've made in instituting market-oriented reforms to Medicare over the past four years. The vote on H.R. 6331, the Medicare Improvements for Patients and Providers Act, wasn't about physician compensation. It was about whether or not this country would reject market-oriented reforms and move, instead, toward a strictly government-run healthcare system. As Paul Krugman, an editorial writer for the New York Times said in an article the day after the vote occurred: "Ostensibly, Wednesday's vote was about restoring cuts in Medicare payments to doctors. What it was really about, however, was the fight against creeping privatization...If the Democrats can win victories like this now, they should be able to put a definitive end to the privatization of Medicare next year. " Krugman concludes his article by stating, " A lot can still go wrong with this vision. But the odds of achieving universal health care, soon, look a lot higher than they did just a couple of weeks ago." Krugman has it exactly right. Contrary to Krugman, though, I don't support socialized medicine and don't view last week's vote on Medicare with jubilation.

There are those who want to move this country backward, toward failed healthcare policies that reduce choice, incentives for good service and access while increasing systemic and individual costs. They created a bill with controversial offsets, eroding provisions that have made Medicare more responsive to recipients. That's what the vote on H.R. 6331 was about, plain and simple. Physicians still would have received their unreduced Medicare compensation; there was virtually universal support for that fix and it will be made under every proposal on the table. But, linking the physician compensation fix to removing market-oriented reforms in Medicare was political manipulation in the extreme.

Those who want to reverse our move toward a more market-oriented Medicare system tried to turn my nay vote into an appalling misportrayal of my priorities. My priorities are and always have been patients, physicians and our entire health care system. Time and again, I've championed adequate and timely Medicare reimbursement for physicians. I've been a leader in the Finance Committee in fighting for this for years, as my voting record testifies.

Let me repeat:

• Support for stopping impending cuts in physician Medicare compensation is virtually universal and bipartisan; physicians would have received updated compensation, regardless of the outcome of H.R. 6331.
• This vote and legislative battle were not about physician's compensation. They were about rejecting market-oriented reforms and moving toward socialized medicine.
• I have been and will remain a leader in fighting for proper physician compensation. In fact, although I consistently support annual fixes, I continue to advocate for a permanent fix rather than the temporary fixes Congress continues to enact.

Please visit my website at http://crapo.senate.gov for links about the true nature of The Medicare Improvements for Patients and Providers Act. I regret that this particular bill passed Congress. What I regret even more is that physicians who treat Medicare patients were the unfortunate hostages in this ongoing crisis.