What will Congress's latest Medicare bill mean for senior citizens and doctors?

Most importantly it will allow senior citizens to maintain access to physicians and enjoy the very high access and choice of doctors that Medicare beneficiaries have enjoyed since the start of the program. For physicians, it also means that they will get a very small bump up in fees rather than a 10 percent cut in fees, and that's, of course, important to them and their practices. It will also, it has some other pieces that add value for Medicare beneficiaries. It changes the cost-sharing for mental health services so that ultimately cost-sharing for mental health services and for physical health services will be the same. Historically, mental health services have had a co-payment at twice the level of other health services. And it provides greater protections, or it continues protections, for lower-income Medicare beneficiaries who need help paying their premiums.

What more can be done to improve the value of Medicare for seniors?

One thing Congress can do is to look at preventative services in Medicare—in both what services are covered in the Medicare benefit package to possibly make improvements there, but also to look at what financial services are for beneficiaries to receive preventive services in particular looking at the cost-sharing structure, possibly waving all cost-sharing for preventive services, and I think also looking not only at services like check-ups and health maintenance kind of activities, but also secondary prevention so that people with chronic illness—and the majority of Medicare beneficiaries have at least one chronic condition—are best able to manage those health care needs. I think another thing that can be done in Medicare that would help not only Medicare, but the entire health care system, is to look at what investments we can make in understanding what treatments, and drugs, and devices work best so that patients and their physicians can make the most informed, best health care choices for their medical conditions.

How can we improve Medicare's long-term financial health?

The most important thing that we can do to improve Medicare's financial health is to improve the health care system as a whole, and particularly to reform the health care system so that we have affordable coverage for everybody and we have better control of health care costs. Medicare is a health care program; it is subject to the same dynamics as the rest of the health care system, and when we see Medicare costs escalating, it's because health care costs as a whole are escalating.