Close up image of a caretaker helping older woman walk

Regional differences in Medicare reimbursement rates are vast and must be fixed in order to achieve any sensible healthcare reform, one prominent senator argued Friday.

One way to control these costs would be to establish an independent Medicare commission, said Sen. Tom Harkin (D-IA). Harkin took over leadership of the Senate Health, Education, Labor and Pensions Committee upon the recent death of Sen. Ted Kennedy (D-MA). The Iowan noted that seniors’ cost of care is two-and-a-half times higher in Miami than Minneapolis, and that his home state of Iowa routinely ranks high for quality of care, but low in Medicare costs.

Speaking at a Families USA-sponsored teleconference, Harkin suggested the commission would be necessary for a similar reason that a congressional military base closing commission was needed. Lawmakers face intense political pressure to not cut Medicare spending, and are unlikely to vote to control those costs, he said. Medicare payments currently are a treasured source of reimbursement for long-term care providers because they typically are viewed as a necessary subsidy to counteract what is viewed as underfunding by the Medicaid program.