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Medicare Fix Remains Elusive

Margaret Dick Tocknell, for HealthLeaders Media, August 1, 2012

Medicare turns 47 this week. Here's to another 47…maybe.

What began as a program designed to help seniors and disabled persons with the cost of healthcare has exploded into what some would describe as a costly, complicated, ineffective magnet for fraud—an example of bureaucracy at its worse.

As the pace of healthcare reform quickens under the Patient Protect and Affordable Care Act, one thing is constant,  the inability of Congress to fix Medicare.

How to fix the entitlement program overseen by the Centers for Medicare & Medicaid Services has been the subject of intense debate among stakeholders and policymakers who have been searching for the elusive secret of how to balance Medicare funding against the growing demand for healthcare services and the need for providers to be sufficiently reimbursed for those services.

Congressional hearings on Medicare come and go. In recent months most have focused on the sustainable growth rate formula. The SGR, which was part of the Balanced Budget Act of 1997, was designed to help control Medicare costs by setting annual spending targets. That worked for a couple of years until it became apparent that significant cuts in physician reimbursements would be required to help reduce spending.

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