Focusing on healthcare costs, not cuts

For years now, the budget debate in Washington has come to be defined by a myopic fixation with cutting Medicare and Social Security benefits that people have worked for and earned.
The common refrain we hear from Republicans in Washington is that the only path to cutting the deficit can be found in breaking our promise to today’s seniors and to the next generation who have earned the economic security these programs provide.

Over the last several years, the same folks who insist on cutting benefits have obsessively worked to repeal and defund the Affordable Care Act (ACA). This obsession has produced more than 40 repeal votes in Congress and led to a government shutdown that hampered economic growth and cost us 120,000 jobs in October.

The country has seen what the Tea Party brinkmanship has to offer, and it is looking for something different. The budget conference committee has provided us with an opportunity to find a bipartisan compromise that breaks this destructive pattern of drifting from one manufactured crisis to the next. It provides us with an opportunity for both parties to work together to pass a responsible budget that invests in the middle class, strengthens our economy and takes a balanced approach to reducing the deficit without shortchanging our future.

The budget that I supported, which passed the Senate last spring, builds on the $2.5 trillion in deficit reduction we’ve already accomplished in the last two years. This budget makes smart spending cuts and confronts wasteful tax expenditures and loopholes that are not creating economic growth. It also treats seniors and families fairly and includes significant healthcare savings, building on the $700 billion in Medicare savings included in the ACA — savings that extended the solvency of Medicare without cutting benefits.

The budget savings we have proposed don’t shift the burden to seniors, increasing their out-of-pocket costs. We have shown that there is, in fact, a path we can take where we can achieve healthcare costs savings without breaking our promises.
Unfortunately, a dialogue about how we continue down this responsible path of deficit reduction hasn’t gotten as much attention as it deserves in the current budget debate. Changes to our healthcare budget should focus not solely on where we spend healthcare dollars but on how we spend them. There is widespread agreement that significant savings can be achieved by reforming the way we deliver and pay for health services. Leading economists estimate that we can produce huge cost savings every year by enacting and building on smart, targeted reforms.

The ACA was the first step in transforming healthcare delivery. The law provides healthcare practitioners with incentives to better integrate care, increase quality and lower costs. These efforts are producing impressive results across the country, including a number of examples in my home state.

ThedaCare Healthcare Partners in Northeast Wisconsin has excelled with the ACA’s Pioneer Accountable Care Organization program, which gives healthcare providers incentives to better coordinate care. In its first year of participation, Bellin-ThedaCare earned more than $5 million in shared savings and lowered costs for its 20,000 Medicare patients by an average of nearly 4.6 percent. The Pharmacy Society of Wisconsin is using the ACA to better integrate pharmacists into clinical care teams. That initiative is set to save more than $20 million in three years. These parts of the law are empowering Wisconsin healthcare providers to provide higher-quality care at reduced costs. We must scale and build on these delivery reforms, which are already generating healthcare savings in our country.

Since the ACA’s passage in 2010, real per-capita healthcare spending has grown at the lowest rate on record for any three-year period. Healthcare price inflation has also reached its lowest rate in 50 years. Most healthcare economists agree that these slowdowns in healthcare spending have resulted in part from the important structural reforms enacted in the ACA. These reforms also have led to better quality, including a significant drop in hospital readmissions after Medicare began penalizing hospitals for causing them to occur.

I’m looking forward to the day when Congress moves beyond fighting old political battles. The years before the ACA, when healthcare costs were skyrocketing, people were denied coverage and families were forced into bankruptcy because our system was failing to provide healthcare security, should remain behind us. It’s time for both parties to work together to build a stronger future. There’s so much more to be done if we can form bipartisan consensus around enacting smart healthcare solutions.

That’s why I’m pleased to work with senators of both parties in pushing for transformative reforms that do not indiscriminately cut Medicare benefits or shift costs to seniors and states. A Delivery System Reform working group has been collaboratively endeavoring to study and build support for cost-saving measures, including reducing the burden of healthcare-associated infections. I’ve been heartened by the bipartisan, bicameral proposals that have been recently introduced to reform Medicare physician payments to reward the quality of care over the quantity of services delivered.

In November, I introduced commonsense, bipartisan legislation with Sen. John Thune (R-S.D.), The Quality Data, Quality Healthcare Act, which would increase the efficiency of healthcare by providing Medicare data to the decision-makers best able to use the information to improve healthcare quality and lower costs: physicians, healthcare systems, insurers, employers and research institutions.

I believe that we can find significant savings in our healthcare system and improve the quality of care without slashing benefits that seniors have worked for and earned. This path continues a more fundamental shift in healthcare delivery: coordinating care, rewarding the best results and the brightest innovations, empowering physicians and health systems to make informed choices, and generating savings through more meaningful, longer-lasting reforms.

A new path is before us, and the American people expect us to take it, together.


Baldwin is the junior senator from Wisconsin, serving from 2012. She sits on the Budget; Health, Education, Labor and Pensions; and Homeland Security and Governmental Affairs committees.