Another Response from Senator McCaskill

Please see my initial correspondence to the senator, and her initial response, and then her most recent reply below:

November 9, 2009

Dear Mr. Emmerling,

Thank you for contacting me regarding Medicare physician payment cuts. I appreciate your comments and welcome the opportunity to respond.

As you may know, in the Balanced Budget Act of 1997, Congress introduced the sustainable growth rate (SGR) which is the mechanism currently used to determine payment to physicians in the Medicare program. The SGR compares yearly changes in payments made to physicians providing care to Medicare beneficiaries to the growth of the overall economy. If the data shows that reimbursement rates are too high, they are then set to be reduced in accordance with the SGR formula. However, as health care costs have skyrocketed, the formula has produced skewed results and left physicians facing significant Medicare payment cuts at the same time they are experiencing increased costs. Physicians are, in fact, facing a staggering 21.5 percent cut in reimbursement starting in January, 2010. Congress has consistently acted to prevent any cuts to physician payments. I have supported these efforts because I recognize that the SGR formula is flawed. I support efforts to simplify the Medicare payment system and to address the SGR formula problem in a more principled fashion.

Furthermore, I am concerned that these recurring Medicare cuts to physicians could put patient access to their doctors in jeopardy by preventing physicians from accepting new Medicare patients. On October 13th, Senator Stabenow (D-MI) introduced the Medicare Physician Fairness Act of 2009 (S. 1776). The bill would permanently repeal the SGR formula. In addition to S. 1776, there are proposals within the Senate and House versions of the health reform bill that would improve physicians' payment schedules.

I agree that it is essential for Congress to replace the flawed physician payment system with one that reflects the cost of treating our Medicare patients. However, I also believe that we must do so in a fiscally sustainable and responsible manner. I will be closely reviewing what the best method is to address the problems associated with the SGR formula, but agree that a fix must be made.

Again, thank you for writing. Please do not hesitate contacting me in the future regarding other matters of interest or concern to you.

Sincerely,

Claire McCaskill
United States Senator

P.S. If you would like more information about resources that can help Missourians, or what I am doing in the Senate on your behalf, please sign up for my email newsletter at www.mccaskill.senate.gov.

--------------------

What more can I say?  "Clearly", she has addressed "all" of my concerns.

BE

Response from Senator Claire McCaskill

Below is the response from Senator
Claire McCaskill:

November 3, 2009
Dear Mr. Emmerling,

Thank you for contacting me regarding Medicare and Congressional proposals for health care reform. I appreciate your comments and apologize for the delay in my response.

Medicare has been the foundation of health insurance for our nation's seniors since 1965 and has provided a crucial health care safety net for nearly 45 million elderly Americans. I know how important Medicare is for seniors living on a fixed income, and I assure you that I am committed to strengthening this vital benefit program.

There is, however, no denying that our health care system is in need of reform. The soaring cost of medical care is crippling our economy, bankrupting our nation's families, and becoming an unsustainable financial burden for American employers. Federal entitlement programs, such as Medicare, will face financial insolvency if burgeoning health care costs are not addressed. In fact, it's estimated that Medicare will begin to run a deficit by 2017 and there is growing concern that the federal government will not be able to keep pace with the aging baby-boomer demand for medical services. It is clear that reforms must be made to our health care system so that we can maintain seniors' access to medical treatment in a fiscally sustainable manner.

As you may know, the President's budget includes a number of proposals which will generate an estimated savings of $92.3 billion over five years in the Medicare program. Congress is also exploring other ways to bring down health care costs and to produce savings in Medicare. Some of the proposals being debated include adjusting Medicare drug coverage premiums for the wealthy; bundling hospital Medicare payments to incentivize better follow-up care and decrease hospital readmission rates; and improving Medicare payment accuracy to prevent waste, fraud, and abuse.

Many of the potential savings for Medicare are expected to come from establishing a competitive bidding system for Medicare Advantage (MA) plans. Currently, the federal government is paying private insurers up to 12 percent more than it costs to treat comparable beneficiaries through traditional Medicare. In fact, a recent GAO report revealed that MA insurance companies made $3.36 billion in profits in 2006, with some companies making profits in excess of $1 billion more than they had projected. These overpayments are making sustaining Medicare more difficult. The proposed savings plan would require private insurance companies to competitively bid to cover Medicare beneficiaries in a certain geographic area and be paid the average of the bids. Generating competition within the private insurance market will lower overall prices and would save Medicare nearly $177 billion over 10 years.

Options like these will not only provide higher quality and value of care to patients, but also produce the savings we so desperately need to ensure that future generations can receive this benefit. Congress, as it considers health care reform, must work toward creating a Medicare program that serves the interests of seniors rather than private insurance companies.

Although there is not a final version of the health reform bill in the Senate, I understand that there has been a lot of confusion surrounding certain provisions in the various versions of this legislation. There is also misinformation being propagated, especially with regard to seniors. You may be interested to know that the Special Committee on Aging, of which I am a member, has prepared a document entitled "Health Care Reform, Fact vs. Fiction". I encourage you to visit the website http://www.aging.senate.gov/issues/healthcare/factvsfiction.pdf to gather factual information regarding some of these rumors.

As health reform legislation comes to the Senate floor, please be assured I remain committed to making sure all of our nation's seniors have access to affordable quality coverage.

Again, I appreciate your letter. Please do not hesitate to contact me in the future about other matters of interest or concern to you.

Sincerely,

Claire McCaskill
United States Senator

P.S. If you would like more information about resources that can help Missourians, or what I am doing in the Senate on your behalf, please sign up for my email newsletter at www.mccaskill.senate.gov.

----

BE

An Open Letter to My Congressmen

RE: the Healthcare Package

Dear Congressman,

Please understand that voting for the Healthcare Package before Congress is an act of TREASON!

Allow me to explain why:

1. No bill should be passed UNREAD BY YOU PERSONALLY. If you cannot read it, VOTE NO. At ~2000 pages, you cannot possibly have read AND analyzed the document. You were not sent to Washington, D.C. to be a "Yes Man".
2. Any bill of this nature is clearly UNCONSTITUTIONAL. I expect you feel otherwise, if so please indicate which sections and paragraphs of the US Constitution apply.
3. This bill is over reaching and clearly an attempt at socialism/communism. Our Founding Fathers, those who fought WWII, Korea and Veitnam laid down their lives for against such things, and we are willing to do the same. (Yes, I know I am labeled by our government as a Right Wing Domestic Terrorist simply for SAYING this.)

You have attacked my 1st Amendment right of free speech and freedom of religion. This alone is an act of TREASON, for which you should be recalled, replaced and tried in the courts of Missouri.

I expect those who represent me to represent my values, and to stand for what is truly right, regardless of opposition.

Vote No on healthcare reform as it is presented.

Feeling VERY unrepresented,

William & Sharri Emmerling

P.S. Please note, I will post this on my blog, http://the-word-on-the-street.blogspot.com/, along with your response.

cc: 
Representative Ike Skelton (D-MO 4th)
Senator Claire McCaskill (D-MO)
Senator Christopher S. Bond (R-MO) [His letter was modified as he voted against the 'Hate Crimes' Law.]