On the recordMay 31, 2011
I thank the gentleman, my colleague, my fellow classmate, Dr. Roe from Tennessee. What I thought I would do is take just a moment and discuss the historical aspect of Medicare and how we got to where we are today. I began medical school only 7 years after Medicare began. In fact, my colleague, Dr. Roe, I think you're probably of similar age and station in life and also Dr. Gingrey who is here, and some of us may even remember before that. I watched Medicare grow, and the promise to physicians and patients at that time was that government, if this is passed, would not mess with anything. It would all be between doctors and patients. However, by the time we got to the '80s, we found that couldn't be true. The costs were exploding far beyond inflation, so the government--Congress, in fact--began to go through a number of calisthenics in order to make it work. One was RBRVS, which was a formula by which doctors would get paid rather than by what their costs were--then DRGs, diagnosis related groups, to tell hospitals exactly what they're going to be paid regardless of their costs, then CLIA, and then finally SGR, sustained growth rate, which we're struggling with now. It basically means, if we miss budget targets, doctors get across- the-board cuts, which would be up to 25 to 30 percent today.…
