Sen. Maria Cantwell is on the right track with her push to reform Medicare.
The Washington Democrat has played a key role in keeping the issue in play, despite all the contention over health care.
It'll be a shame if the anger and division that currently define the health care debate end up killing this sorely needed fix in the way Medicare payments are calculated.
The devil is in the details, and it's possible that the precise language that survives the legislative process will fail to produce the desired results.
But Congress is closer than ever to repairing decades-old flaws in the Medicare reimbursement system that punish doctors and hospitals for making good decisions about the use of public money.
Even worse, the existing system encourages waste.
The trouble is a fee-for-services formula that pays health care providers based on raw numbers rather than results or even medical need.
See more patients, order more tests, perform more surgeries -- and get a bigger government check.
After the New Yorker magazine published a detailed look this summer at the way Medicare dollars are spent in McAllen, Texas, that town became the poster child for the problems inherent in the system.
In 2006, Medicare spent $15,000 per enrollee in McAllen, almost twice the national average.
"The income per capita is $12,000, the magazine reported. "In other words, Medicare spends $3,000 more per person here than the average person earns."
And yet the physician who wrote and researched the article, Harvard professor Atul Gawande, couldn't find any evidence that patients in McAllen got better care than their counterparts in other cities.
They saw more specialists, had more medical tests and underwent more operations, but it's clear that when it comes to health care, more isn't better.
You can't blame doctors and hospitals for reacting to the financial incentives built into Medicare's reimbursement formulas, but you can change the system.
Where the focus is on the quality of care rather than the number of medical procedures -- the result isn't only lower Medicare costs, it's also better outcomes for patients.
That's not conjecture. Plenty of models exist that prove the concept. The most famous is probably the Mayo Clinic in Rochester, Minn.
Physicians at the nonprofit hospital are paid a salary. There is no financial incentive to order an additional CAT scan or to take out more gall bladders.
Health care professionals there focus on what's best for the patient, Medicare costs average thousands of dollars less per patient than in McAllen, and the quality of care is among the best in the world.
In Washington and other states, where hospitals and doctors operate on a model closer to the Mayo Clinic than McAllen, Texas, Medicare reimbursements are seen as a hardship, not a profit center.
Some doctors in the Tri-Cities refuse to see Medicare patients altogether, and others set a limit on the number they'll allow in their practices.
There's a growing push for reform in Congress. More than a quarter of the Senate -- 28 members -- wrote President Obama, urging for Medicare reform to be included in any health care legislation.
The system is broken, and billions of dollars are wasted because of excessive Medicare reimbursements.
If the battle over health care does nothing else, it needs to fix the Medicare problem.
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Some rural Mid-Columbia hospitals at risk from state, federal cuts
Some rural Mid-Columbia hospitals at risk from state, federal cuts
What looks on the surface like relatively small state and federal budget cuts to hospitals could mean the loss of the Tri-Cities' largest mental health services provider.
The cuts specifically affect hospitals with the "Critical Access Hospital" designation, and in the Mid-Columbia include small public hospitals in Prosser, Othello, Sunnyside and Dayton.
Lourdes Medical Center in Pasco also is designated as a Critical Access Hospital, and officials there say the combination of state and federal cuts will drive Lourdes Health Network's operating budget several million dollars into the red, causing the network to re-evaluate its spectrum of services.
Lourdes Medical Center in Pasco lays off 19
Lourdes Medical Center in Pasco lays off 19
Lourdes Medical Center in Pasco announced Wednesday that 19 people have been laid off as part of what officials described as an "organizational restructure."
Hospital officials attributed the layoffs to the rising number of uninsured people and federal and state budget cuts that are cutting into the hospital's bottom line.
"After much deliberation, prayer, discernment and consultation with our Sisters, board and leadership at Ascension Health, we have decided to reduce our work force to just over 2 percent," Lourdes CEO John Serle said in a statement.
Look at health care through experience
Look at health care through experience
The Washington State Insurance Commissioner recently reported that more than 1 million Washington residents do not have health insurance.
As a consequence, Tri-City hospitals provided $53.1 million in unpaid health care in 2010. Despite this situation, all Republican presidential candidates have vowed the repeal of the Affordable Care Act, derisively referred to as Obamacare, primarily due to its mandate for all citizens to carry health insurance.
It is widely accepted that the cost of health care in general, and Medicare and Medicaid in particular, are rising at an unsustainable rate, but there is strong opposition to any change in these popular programs.
Mid-Columbia home to many uninsured residents
Mid-Columbia home to many uninsured residents
A new report from the state Insurance Commissioner shows several counties in the Mid-Columbia have the highest rates of uninsured residents in the state.
And that leads to area hospitals losing more and more of their bottom line to charity care and bad debt -- and costs being shifted to people who are insured.
Franklin, Adams, Grant and Yakima counties made up four of the five counties with the highest percentage of uninsured residents in the report released Tuesday by Insurance Commissioner Mike Kreidler's office.
PMH, Kadlec Medical Center announce 'strategic alliance'
PMH, Kadlec Medical Center announce 'strategic alliance'
PROSSER -- Health care in Prosser is changing -- subtly right now and more noticeably in the coming year.
PMH Medical Center and Kadlec Regional Medical Center in Richland on Monday announced a "strategic alliance" between the two hospitals. The increased collaboration already is making referrals to Kadlec specialists easier for physicians at the Prosser hospital.
Next year, the increased partnership will make medical specialists from the Tri-Cities available in Prosser and bring PMH online with Kadlec's new electronic patient-record system, officials said during a news conference Monday.
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