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The 5.1 percent reduction in Medicare payments scheduled to begin in January 2007 could lead many physicians to stop accepting new Medicare patients, to defer investments in new equipment and technol­ogy, or both. These problems are merely symptoms of a deeper pathology within Medicare and highlight the need for Congress to adopt comprehensive Medicare reform. Without congressional action to reform this profoundly flawed system, America's seniors could face a decline in access to high-quality health care.

America's emergency rooms are in crisis. Emergency medicine encompasses the care of patients with traumatic injuries or serious signs and symptoms of disease. Quick evaluation and rapid treatment of these patients obviously cannot be done on an "elective" basis. These services are invariably provided under the auspices of a hospital and are available to patients 24 hours a day, seven days a week.

Medicaid is expensive and rapidly becoming unaffordable in many states, while the quality of care it delivers is often substandard.