Iowans pay the same Medicare payroll tax rate as everyone else in America. But for years Iowans haven’t gotten the same rate of return. A flawed federal payment formula shortchanges Iowa and 29 other states.
Iowa communities must compete for the best and brightest health care professionals with cities across the United States. Yet Iowa isn’t able to offer the same competitive salaries and benefits to help attract and retain health care workers because of the Medicare payment inequity.
Iowa physicians, hospitals, home health agencies, renal dialysis facilities and ambulance service providers render life-saving care and medical attention to Iowans, including a half-million-plus Medicare population. Just like their counterparts in urban America, health care professionals in rural America fill a critical role in the communities in which they live and work.
The value of a health care professional’s ability to save lives, treat illnesses and provide emergency health care services shouldn’t be determined by the zip code in which he or she practices medicine. Whether they work in Florida or Iowa, Medicare shouldn’t pick favorites.
The good news is Congress is closer than ever before to implement the most dramatic reforms ever to improve health care in rural America. The unfair federal payment formulas for too long have been held hostage by powerful committee chairman representing big city interests.
As chairman of the influential Senate Finance Committee, which bears primary legislative and oversight authority over Medicare, I dug in my heels during intensive negotiations on Capitol Hill to address the penalty against rural providers.
Backed up by the White House and a bipartisan coalition in the Senate, I led the effort to secure rural equity in the comprehensive Medicare reform bill. Iowa hospitals would gain $278 million and Iowa physicians would gain at least $160 million over the next ten years from the agreement. Moreover, those that serve a disproportionate share of Medicaid recipients and the uninsured would gain another $141 million over the next ten years from Medicaid.
That means the Medicare package moving through Congress would net Iowa another $579 million for our health care delivery system over the next decade. That’s a major boost that will help reinforce small town hospitals, revitalize community efforts to recruit and retain physicians, and maintain access to essential health care services for all residents making a home in rural America.
If Congress fails to act now, Iowa’s seniors also won't gain access to an affordable, first-ever prescription drug benefit available through Medicare by 2006. In the meantime, seniors would have access to a drug discount card available next year to help defray their prescription drug expenses. And obviously Iowa once again won't get the fair treatment it deserves under the Medicare payment system.
Congress has a golden opportunity to move Medicare into the 21st century. Iowa stands to gain significantly with the rural equity provisions I worked hard to secure in the final bill before Congress. In addition, I won a provision to make additional chiropractic services available through the Medicare program.
Let’s hope a majority of my colleagues can agree to set their sights on enacting good public policy and the people’s business instead of their party’s political ambitions in next year’s election.