• 4 months ago
During a Senate Health, Education, Labor & Pensions committee hearing prior to the Congressional recess, Sen. Bill Cassidy (R-LA) gave opening remarks about the medical debt crisis and healthcare costs.

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Transcript
00:00Hey, thank you all for joining us today. Incredibly important topic. Really appreciate it. I'm
00:05a physician. I worked in a hospital for the uninsured for 20 or 30 years. I've been at
00:10the bedside where I've had to tell someone they've got a terrible disease, in which they
00:16may have hope, but nonetheless it's going to be tough, or maybe in some cases the diagnosis
00:21is more likely than not fatal. The last thing you want them to be concerned about is medical
00:26debt. That is a burden which they need not have. So we've got to address medical debt,
00:35but in medicine we have a saying, don't just do something, think. We have to think about
00:40what is causing this. As you think about it, the medical debt is a symptom of a larger
00:47problem, the high cost of health care. What is driving that? If we address that, then
00:55we will kind of, along the way, address the issue of medical debt. Not entirely, substantially.
01:02Right now Americans pay more for health insurance than ever before. On the Affordable Care Act
01:08exchanges, the average monthly unsubsidized insurance premium on a silver tier plan is
01:15$483 for a 40-year-old. For a family of four, the average unsubsidized is $1,600 per month,
01:23and the average deductible is $5,000. So this is the amount that the patient is paying before
01:28they benefit from the plan. So this kind of coverage is oftentimes unaffordable, and this
01:34is what can lead to medical debt. We have to examine where patients are taking on this
01:39debt. Data shows that hospitals are responsible for more than half of medical debt. That's
01:46important. Congress has long provided additional resources and support to hospitals to help
01:52cover the cost of a patient who may otherwise be unable to pay. Many federal grant programs
01:59are available to hospitals in financial distress to ensure that they continue, they should
02:05be able to continue to be helpful to those who are unable to pay. One example of this
02:11is the 340B program, where hospitals are able to bill a full rate for a drug which they
02:18acquire at a sharply discounted amount, and the idea is that they would use that delta,
02:23that profit, if you will, to help the patient. But there's other examples, too. The Disproportionate
02:29Share Program, or sometimes the Upper Payment Limit Program, as well as a non-profit and
02:34tax-exempt status for many hospitals. There are a lot of resources out there for that
02:3950% of the medical debt, which is contributing to the problems that Cher just spoke to. Speaking
02:46specifically about 340B, hospitals participating in 340B get substantial discounts on prescription
02:54and oncology drugs, but it is unclear if these discounts are actually being passed to patients.
03:02Since last year, I've led an investigation in how different health care entities are
03:06using this 340B revenue. The Chair has declined to participate, but it's an important topic
03:12to consider if we're going to address both a root cause of medical debt, and two, why
03:18are the things that we're putting out there that may potentially address this not addressing
03:22it? If we just put in one more program which is poorly implemented, we're going to be back
03:27in this hearing five years from now. We've got to see how the ones we've already done
03:31are actually working. Don't just do something, think.
03:35So I'll also point out that it's been proposed that we just cancel all medical debt. My colleague,
03:42on the other side of the aisle, suggested that. But to be clear, a one-time cancellation
03:46of medical debt is not a solution. It is a Band-Aid approach for a one-time problem
03:53that's going to come back. Don't just do something, think.
03:58It also shifts the debt upon taxpayers and upon those who, like, you know, we think it's
04:04free. It's not free. If people haven't noticed, we've got this incredible debt and deficit
04:08in our country, and that's going to weigh upon our children and our grandchildren, upon
04:12these young interns who are here. What about our obligation to them? Don't just do something,
04:17think.
04:18We may hear today about Medicare for All. It's been mentioned. But I'll also say that
04:24a health care system in which you think it's free because the taxpayer is footing the bill,
04:30you've never seen how expensive something can be until you perceive that it is free.
04:40This committee has a long history of engaging in real bipartisan efforts to ensure that
04:45our health care system works better for patients. Just last year, the committee passed the PBM
04:49Reform Act to address misaligned incentives affecting PBMs and the price patients pay
04:57for their prescriptions. We need that signed into law. That would be a way to begin to
05:02lower the cost for patients.
05:04There's other examples, too. I look forward to exploring them. I thank you all for being
05:08here. You represent a spectrum, but this country is a spectrum. And so, ideally, we're
05:14going to learn from you the kind of width and breadth and depth of that which we can
05:20do as a government to help reduce medical debt for all Americans.

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