Medicare Should Mean Equal Treatment
No Matter Where You Live

By Leonard Boswell, Member of Congress

Nationally, relatively few people are aware of the discriminatory and unfair way in which Medicare reimburses doctors, hospitals, and other health care professionals. These dedicated health care providers work endless hours to care for our friends and family members. Yet, health care providers in 35 states and many areas within other states receive discriminatory reimbursement formulas every day.

Most people assume the government pays the same rates for Medical services regardless of where those services are provided. However, as a result of complex and arcane formulas, many seniors and the health care professionals who care for them receive significantly less for these same services.

Despite the fact that everyone pays the same Medicare taxes, the outdated Medicare formulas do not reimburse for seniors , health care equally. This is simply unfair. And it must be fixed.

Medicare payments determine what services seniors receive. The current system results in seniors in some areas of the country receiving a wider range of services, such as coverage for eye glasses and prescription drugs, while seniors in other areas such as Iowa do NOT have access to these services. This is discrimination, plain and simple.

Medicare's formulas have created such a discrepancy that states where Medicare formulas provide a great deal of funding receive almost $2,000 more per Medicare enrollee than the national average and states where Medicare formulas are less generous receive more than $2,000 less than the national average. If the government paid twice as-much per individual for Social Security or Veterans benefits in one area as it did in another, the public would be Outraged, and rightly so. But it happens everyday under Medicare.

Iowa is not the only state facing discriminatory Medicare reimbursement rates. In fact, 35 states receive Medicare payments below the national average. Even within states where reimbursement rates are above the national average, health care providers in some areas receive reimbursements significantly below the average reimbursement.

Doctors, hospitals and health care providers are having to make unfair and unrealistic choices to limit services and health care options in many areas with discriminatory reimbursement rates. No one should ever face limited services because of outdated Medicare formulas. All seniors should be treated equitably regardless of where they live. Without major changes to the current Medicare reimbursement formulas, the discrimination many seniors and health care providers face will only become worse. This cannot be allowed to happen.

There are efforts to address this inequity in Congress. We are seeking to strengthen and build upon these bipartisan coalitions. However, we need national leadership, and the support of the President and his Administration is vital to ensure Medicare treats everyone fairly. As Congress continues to discuss Medicare payments, both as a part of adding prescription drug coverage to Medicare or as stand alone legislation, I am hopeful those of us representing individuals in discriminated areas will be able to reverse this trend.

Medicare inequities have an impact that stretches well beyond health care and seniors. There are large economic consequences to this discrimination. Workers and employers must pay higher health insurance premiums to make up for inadequate Medicare payments in discriminated areas and states. These areas have a more difficult time recruiting and keeping health care professionals. All of these factors have a negative impact on local economies. There is not a man, woman, or child in these areas facing discriminatory reimbursements who is not adversely effected by this issue.

To help build a national coalition to address this situation, I am calling on all health care providers, all seniors and all individuals in every state or region who receives less than the national average for Medicare reimbursement to urge their Representative and Senators to become actively involved in this fight. Only through public pressure on individual legislators and those who seek national office can we end this discrimination.

By building a broad coalition, we can send a strong message that all Medicare beneficiaries and those who provide health care must be treated equally. Together, through a united effort, we can end Medicare discrimination. All seniors should be treated fairly and equally. It goes to the heart of our American values.