Since returning to Washington, Congress and the White House have focused some attention to health care and Medicare reform, both issues in which end-of-life advocates can play a part in pushing for change and improvement. Chief among health care issues are patient rights bills, caring for the uninsured, continuing benefits for the unemployed, and overhauling Medicare to include a prescription drug benefit. Action is likely to be circumscribed by a grim CBO budget forecast predicting deficits of $21 billion in FY02 and $14 billion in FY03. Julie Shroyer, vice president of Wheat Government Relations and ABCD policy analyst, points to the following issues as being critical to our work this legislative session.
Medicare reform. It remains to be seen how or if Congress will address the many issues confronting the Medicare program this year. These issues include how to create a prescription drug benefit, to save Medicare from long-term solvency and to handle impending payment cuts for providers and hospitals. President Bush’s budget includes no money for increased payments but many health care providers particularly doctors are looking to Congress for help.
President Bush proposes spending $190 billion over 10 years to reform Medicare and to establish a prescription drug benefit for seniors. The House is likely to send a Medicare reform bill to the Senate by early June, but the outlook in the Senate is unclear. The Senate Democratic Leadership opposes the President’s Medicare reform proposal. Congress set aside $300 billion for a prescription drug benefit in its fiscal 2002 budget resolution. Democrats and Republicans are far apart on how much money is needed and how to implement a benefit. Many anticipate a year full of debate but little action on Medicare legislation.
Patients’ rights. Some analysts predict that Congress and the White House might reach an agreement on patients’ rights legislation. Although a House-Senate conference committee has not yet been appointed, Senator Ted Kennedy (D-MA) and President Bush have spoken informally in attempts to resolve differences between the House and Senate bills (S. 1052, HR 2563). Crucial differences remain between the two versions of the bill. Differences revolve around setting standards that managed care organizations (MCOs) would have to meet and on whether lawsuits against MCOs will be heard in state or federal courts. President Bush continues to publicly express his interest in signing a patients’ rights bill this year. Although the President and Senator Kennedy still disagree about the terms that should remain in the final bill, both are committed to ongoing discussions. ABCD has worked with congressional offices to ensure that all versions of patient rights' bills define people with serious and complex illness as a group to be protected under the law. Provisions for continuity of care are important to improving care for people near the end of life.
Several policy initiatives would position the country to meet the needs of the increasing number of Americans who face serious, eventually fatal chronic illness.
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