In Iowa and nationwide, Medicare dollars support hospitals, nursing homes, home health care services, pharmacies, medical equipment suppliers, and the private insurance industry, which offers supplemental coverage to beneficiaries who want additional protection. Since its passage nearly a half-century ago, the public health insurer reaches the lion’s share of American society. Workers and employers are subject to the payroll tax that helps finance Medicare. Retired and disabled Americans rely on Medicare for health care coverage. Tens of millions of Americans have jobs that are directly or indirectly supported by Medicare spending.

Medicare’s looming fiscal crisis matters greatly to retirees and those who are approaching retirement. It matters to the health care professionals who serve aging Americans. And it matters to the taxpaying public facing a currently unsustainable program as an unprecedented demographic shift takes place between the ratio of workers to beneficiaries.

When policymakers in Washington debate solutions to address Medicare’s looming insolvency, it’s proven tempting for partisans to demagogue proposals to score political points. In an era of ballooning deficits and exploding health care costs, it’s more important than ever to reach consensus on reasonable structural reforms that will help strengthen Medicare’s finances for current and future generations of Americans.

From my position on the Senate Finance Committee, I have worked to modernize Medicare and have gone the extra mile to champion rural health care providers who are shortchanged by a flawed federal reimbursement formula. Adopting necessary policies to put Medicare on sound, sustainable financial footing is critical, especially in rural areas of America where access to health care services close to home is so important to an aging population. In many communities, the local hospital also serves as a primary employer and anchor to the local economy.

Keeping Medicare financially sound also requires meticulous oversight to protect the integrity of the program. For a long time, I’ve led efforts to root out the waste, fraud and abuse that afflicts the federal bureaucracy. Swindlers look for every opportunity to milk what they see as Uncle Sam’s cash cow, regardless of its impact on the taxpaying public.

Consider a recent congressional investigation by the Senate Finance Committee. It revealed improper tactics by for-profit home health companies to double down on their Medicare business and game the reimbursement policy to make as much money as possible.

For more than a year, our bipartisan investigation reviewed practices by four large for-profit home health companies. The review revealed improper practices by which therapists were encouraged to target the most profitable number of therapy visits, prioritizing bonus payments above the necessity for treatment.

As home health care emerges as an even bigger provider in the U.S. health care delivery system, Washington needs to nip such unacceptable practices in the bud. Medicare pays out an estimated $19 billion annually for home health care. That figure is projected to climb as an increase in the number of aging Americans will require more home health care services.

The federal government needs to fix the policy that allows Medicare money to flow down the drain. Companies that manipulate Medicare reimbursement rates to put profits before patient care are thumbing their noses at taxpayers and the most vulnerable citizens among us.

As Washington works to whittle down deficit spending and responsibly address the long-term solvency issues facing Medicare, I will keep working to protect Medicare beneficiaries and taxpayers. That includes turning up the heat on those who bilk the Medicare system for their own gain and making sure consumers have access to the information they need to make informed decisions about the medicine they take and the doctors who provide their care.

Specifically, I’m working to make sure my bipartisan Physician Payment Sunshine Act is put into practice exactly as intended. The new law requires public disclosure of the financial relationships between physicians and the pharmaceutical, medical device and biologics industries to address concerns about potential negative effects on patient care and efforts to rein in health care spending. Transparency does a lot of good in establishing accountability.