Videos & Speeches

Mr. President, I thank the Senator from Virginia for yielding to me. First of all, I would like to talk for a moment about the budget. I am pleased that the Senate is debating a budget. We are required by law to pass one by April 15. It has been a while since we have been able to accomplish that. I am hopeful that the budget will be reconciled with the House-passed budget, giving us the opportunity to develop 12 appropriations bills within this budgetary outline.

It is unfortunate that by the nature of a budget, it is a partisan endeavor. The expectation is that no Democrat will vote for the budget that ultimately will pass the Senate today. I hope that doesn't continue to be true in another issue that I am encouraging and am encouraged to know will be considered by the Senate, and that is the sustainable growth rate fix, the so-called SGR fix.

Back in 1997, a budget act was passed that created a formula by which physicians are reimbursed under Medicare. That formula has been very damaging to the practice of medicine--the ability to sustain a practice of medicine--particularly in areas of the country in which the population is elderly and patients are generally on Medicare and most of the physicians' income is then derived from reimbursement from the Medicare system.

The SGR has created a series of problems. At least annually, there has been a problem we have had to fix. Over a decade, we have spent millions of dollars--in fact, $150 billion in short-term so-called doc fixes.

What I hope happens after consideration of the budget today, tonight, in the morning, is that there will be unanimous consent and agreement that we take a vote on finally permanently fixing the problems created by this SGR, the formula.

In my state of Kansas, there are 127 community hospitals across our state that care for patients every day, every hour. Most of those hospitals have a significant volume of Medicare patients. The physicians who admit patients to those hospitals and see patients on an ongoing basis in those communities see a significant portion of their patients, and their bills are paid by Medicare.

In the last several years, the reduction in payment for a physician, that Medicare reimbursement, has been in the neighborhood of 20 percent to 30 percent. The reality, I think all of us know--in fact, it is evidenced by the fact that every year we do a patch, we fix this issue--what we know is that in the absence of fixing that formula either on a periodic basis or today potentially permanently, physicians will no longer be able to see Medicare patients. In many of the communities I represent, the physicians are employed by the hospital. So this becomes not just a physician issue, not just a hospital issue--the reality is, it is a patient issue. Will you have a doctor in your community who is willing to see, who is able to see a patient who is of the age at which Medicare is providing Medicare health care benefits?

The opportunity we have today is important. We can do so many things by permanently fixing the SGR. The outcome is that communities across our country and communities across my state of Kansas have a much brighter hope that their hospital doors remain open and physicians continue to practice medicine in their communities.

Our health care providers face tremendous challenges today related to the Affordable Care Act, related to the ever-increasing amount of regulatory burden placed upon hospitals and doctors, upon the costs associated with moving toward computerized medical records. Our health care providers in many instances are hanging on by a thread, and whether or not a community has a doctor, has a hospital determines whether that community has a future.

I know that in my own hometown of Plainville, the ability of my parents--who lived into their nineties--to remain in their hometown was determined by whether there was an active, quality medical community, quality physicians who cared about their patients and hospitals, who were there to admit their patients when that care was needed. Only because that existed in our hometown were my parents, into their nineties, able to continue to live in a community they called home.

The SGR fix is a significant component to make certain that no people have to move, no senior citizens have to move someplace closer to a doctor or a hospital because their hospital no longer is in existence or their physician no longer cares for folks who have Medicare.

The SGR, which I did not support when it was created, has caused a volatile and unsustainable system for both patients and health care providers. The uncertainty of knowing when and if Congress is going to fix by a patch creates problems in and of itself, in addition to the ultimate reimbursement rate that physician receives.

The time to act is now. We are as close to a permanent SGR fix as we have been in my time in Congress. It would be a very sad occurrence if we let this opportunity slip by, and one more time, in a few months, we will be back trying to figure out how to patch the SGR once again. We will spend more money. We will create greater uncertainty. We will hasten the day in which citizens of our country--Medicare recipients--are no longer able to see a physician of their choice or be admitted to the hospital in their community.

I am of the view that we ought not move on to other business. We ought not recess for this April period of time until we make sure that tonight or in the morning the SGR fix is permanently put in place.