MEDICARE REFORM: Senators Oppose Hospital Payment Changes
A bipartisan group of 55 senators, including California's Barbara Boxer (D) and Dianne Feinstein (D), last week sent a letter to the National Bipartisan Commission on the Future of Medicare opposing proposed changes to the system which gives extra payments to urban and teaching hospitals. The proposal would move the payments "out of Medicare and into the overall appropriations process" (Convey/Gatlin, Boston Herald, 2/16). The hospitals oppose the change, because it would force them "to fight for the payments each year instead of receiving them automatically." The group of senators, led by Sens. Daniel Patrick Moynihan (D-NY) and Edward Kennedy (D-MA), expressed their views in a letter to commission co-chair Sen. John Breaux (D-LA). Currently, Medicare pays hospitals "additional money to those that handle large numbers of poor or inner-city patients, who often cannot pay for services. Special payments also go to hospitals that train doctors, on the argument that those hospitals incur extra expenses" (Zitner, Boston Globe, 2/16).
The senators wrote: "We urge you to maintain Medicare's commitment to funding [Graduate Medical Education] and [Disproportionate Share]. Since two-thirds of DSH funding goes to teaching hospitals, the two programs are closely related. ... They represent Medicare's fair share of the cost of caring for senior citizens in these hospitals. They are just as appropriate an expense under Medicare as the higher Medicare payments made to hospitals in areas with higher wage costs" (Kennedy letter, 2/12). Besty Stengel, executive director of the Conference of Boston Teaching Hospitals, said, "The senators took the step of telling the commission, 'We know what you're looking at, and we're telling you right now that we oppose it.'" She added that the letter sends "the message that teaching hospitals are an important resource, and meddling with the reimbursement system is not something to be taken lightly" (Globe, 2/16). Richard Hollander, president of the Massachusetts Hospital Association, said, "Maybe this letter will start to turn the tide around from budget-driven health policy, and renew our national commitment to training the next generation of caregivers" (Herald, 2/16).