Rep Wyden Offers US Medicare Reform Bill

US Representative Ron Wyden has offered details of his proposedMedicare Modernization and Patient Protection Act of 1997. He stressed the bill's fiscal responsibility; it sets annual spending limits on the Medicare targets set in the Administration proposal.

Unlike the Administration plan, his bill contains a fail-safe mechanism to enforce spending restraints within the program's principal social activity areas. It maintains Part B premiums at current levels and requires prospective payment systems for both home and skilled nursing care; these changes alone should save over $20 billion in five years, he said.

The bill changes the formula for paying capitated programs by de-coupling the Medicare payment system from rises in fee-for-service medicine and creating new constraints on spending in areas where the program has consistently overpaid health plans. It would make the Health Care Financing Administration require competitive bids from capitated programs in those high-pay areas and, where appropriate, in selection and purchase of durable medical equipment and related services.