​Even the most experienced lawmakers in Washington realize these are not easy times for making political decisions on how to reduce spending while at the same time preserve the Medicare and Medicaid programs that most Americans view as a sacred trust between the people and government.

For newcomer Nan Hayworth, MD, the freshman Republican representative from upstate New York’s 19th district, these past months have only solidified her belief that solutions exist for maintaining obligations to seniors and at the same time rein in out-of-control government spending.

Indeed, even as a first-termer, she became a leader in this summer’s debt ceiling debate in the House, speaking to the need for solving problems in this current era of charged political rhetoric.

“I didn’t come here with any preconceived notions. I have just concentrated very hard on the job and have been inspired by the fact so many men and women [in the House and Senate] are dedicated to doing the right thing. We have to do what is best for our country as a whole,” Hayworth says, noting the ceiling had to be raised to prevent serious economic consequences, but not paid for by raising taxes.

She voted for her party’s budget proposal last spring, which did not get anywhere in the Senate, to tighten government spending, partly by converting the Medicare program to a premium support format. Under this model, the current Medicare program would be replaced by a system of competing public and private health plans, with the federal government contributing a set amount toward the purchase of Medicare coverage, based on the premiums charged by the different plans.

“The House majority plan preserves Medicare in ways the Accountable Care Act [health reform law] does not,” Hayworth says, noting that the current system puts limits on what providers can be reimbursed for, hurting the ability of doctors to do their jobs while remaining in the program. Medicare losing doctors and making access for seniors difficult is a growing problem, she notes.

An opthamologist by profession, Hayworth is in tune with the health care debate in Congress more than most legislators. She has first-hand experience with caregiving; navigating federal and state reimbursement systems; and dealing with a myriad of medical, labor, and legal issues tied to modern doctoring. “A lot of my patients received Medicare,” she says.

She has definite opinions on the reform law, saying she supported repeal when the House approved such action in January, while at the same time suggesting the goals of the reform effort are worthwhile. “It’s just bad mechanisms” within the president’s plan that make it way too costly, she says, adding, “it costs far more than it will benefit us.”

In her congressional district, health care, and care for the elderly are big issues. She says it is inevitable with the aging of the population as a whole that long term care is a priority issue in Washington.

The daughter of World War II veterans, both father and mother, Hayworth says it is true that the generation that survived the Great Depression and won the war requires proper care in their old age, through programs like Medicare and Medicaid.