‘Band-Aid Approach’: Bill Cassidy Advocates Against One-Time Cancellation Of Medical Debt

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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.

‘Band-Aid Approach’: Bill Cassidy Advocates Against One-Time Cancellation Of Medical Debt

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