Coburn at the health care summit
Sen. Tom Coburn, R-Muskogee, is at the table at the Blair House, just minutes before the much-hyped health care summit with President Barack Obama gets underway.
Coburn, a physician, is seated next to a fellow doctor, Sen. John Barrasso, a Wyoming Republican, on one side and Sen. Lamar Alexander, R-Tenn., on the other.
Update: Obama just arrived in the room and greeted the 30 or so lawmakers in there. He and Coburn had another brief embrace, though not as huggy as the one last year after Obama’s speech to Congress. In his opening comments, Obama also said that he had read Coburn’s health care reform plan.
Update 2: Coburn just spoke, making the argument that lawmakers focusing on the cost of health should go after waste and fraud in Medicaid and Medicare, the public health care programs. By one estimate, Coburn said, there is $15 billion of fraud in New York City’s Medicaid program alone. One-third of the money spent on health care, Coburn said, doesn’t go to treat or prevent disease. Coburn also made a pitch for medical malpractice reform, saying that “extortion” in the area forces doctors to order tests to protect themselves, rather than help patients. And he pushed for prevention and financial incentives for people to stay healthy.
Obama responded that his bill includes provisions for prevention and for combating fraud.
Senate Majority Leader Harry Reid, D-Nevada, interrupted Coburn and suggested he was filibustering the summit by speaking too long. Though Coburn and Obama are close, Coburn and Reid have had a testy relationship at best, largely because of the many “holds” Coburn has put on legislation that Reid wants to pass with the Senate’s fast-track process.
Here is a transcript of Coburn’s remarks:
SENATOR COBURN: Thank you. Well, Mr. President, thanks for having us do this. I think today is going to be enlightening. The first thing I would do is put out a caution to us, because what I see the Congress doing — and what I saw this last year — is us actually performing bad medicine. And that is that we get stuck in the idea of treating the symptom rather than treating the disease. And whether you go to Harvard or whether you go to Thomson Reuters, there are some facts we know about health care in America. And the facts we know is one out of every three dollars that gets spent doesn’t help anybody get well and doesn’t prevent anybody from getting sick.
The second thing we know is, from the Congressional Research Service, that most of the mal drivers today in health care come from government rules and regulations. The government now directs over 60 percent of the health care in this country. And if throwing money at it and creating new government programs could solve it, we wouldn’t be sitting here today because we’ve done all that, it hasn’t worked.
So what I thought we ought to do is maybe talk about why does it cost so much? Because the thing that keeps people from getting access to care in our country is cost. You mentioned Malia and Sasha. The fact is, is with young kids going to the ER, whether they have meningitis or asthma, they’re going to get treated in this country. But they may get labeled with a preexisting illness after that, and that’s another thing I’d be happy to talk about at a later time. But the fact is, is we know how to treat acute asthma. What we don’t do a good job of is preventing children from getting acute asthma. We don’t do the good job of prevention.
So when you break down the cost, what we know is 33 percent of the cost in health care shouldn’t be there. And how do we go about doing that, and what are the components of that cost? And when you look at, when it’s studied, and if you look at what Malcolm Sparrow from Harvard says — he says 20 percent of the cost of federal government health care is fraud. That’s his number.
So if you look at Thomson Reuters — when they look at all of this, they say at least 15 percent of government-run health care is fraud. Well, when you look at the total amount of health care that’s government-run, you’re talking $150 billion a year. So tomorrow, if we got together and fixed fraud, we could cut health care 7.5 percent tomorrow for people in this country. So what we ought to do is do the Willie Sutton thing; we ought to go for where the money is.
What’s the other area? What we do know — and I’m guilty of this; Dr. Barrasso is guilty of it; Dr. Boustany is guilty of it — is a large portion of the tests we order every day aren’t for patients, they’re for doctors. And the reason they’re there is because we are risk-averse to the tort system and extortion system that’s out there today in health care. And there are a lot of ways to fix that, but I just went through last night — if you add up what Thomson Reuters, which looked at all the studies that have been done and combined them in — they say between $625 billion and $850 billion a year of health care dollars are wasted.
So it seems to me if cost is the number one thing that’s keeping people from getting care, then the efforts of us as we go after cost ought to be to go to those areas where the cost is wasted. And there’s a philosophical difference in how we do that. One wants more government-centered approach to that; I would personally prefer a more patient-centered, market-oriented approach to that. But nevertheless, there’s where we can come together, just on those two areas, where we could cut costs 15 percent tomorrow. And that’s for everybody in the country.
What would happen to access in this country if tomorrow everybody’s health care costs went down 15 percent? Access would markedly increase.
So what I would hope we would do is that we would go back and concentrate on the areas that have the biggest pot of gold for us. And the biggest pot of gold is, is we don’t incentivize prevention. We don’t pay rewards for a great management of chronic disease. We have a system throughout the country where we’re encouraging lawsuits that aren’t productive for the country and what they actually do is cause the cost of health care to go through the roof.
We also know there’s some other real things that we ought to address. There are conflict of interests within the medical field. There’s nothing wrong with addressing those and taking those off. We know that we do not — we absolutely do not incentivize prevention. And I’m not talking about creating walking paths — I’m talking about paying people who actually do a good job to do prevention; talking about changing the school lunch programs where it meets the needs, nutritional needs, of Americans; changing the food stamp program where it incentivizes people to eat the right things, not the wrong things. We actually create more diabetes through the food stamp program and the school lunch program than probably any other thing because we’re not feeding — offering and incentivizing a great response.
So I think if — I think it’s great that we’re coming together, but the goal is in, where’s the cost excesses? And what I would hope we would do is we would look at that and say, how do we come together and actually achieve a reduction in the extortion that goes on in this country in terms of medical malpractice — and there’s lot of ways to do that without us mandating to the states. I know — and some — you have some of that in these new thoughts, in terms of incentivizing states to do that.
How do we do that in terms of creating an elimination of fraud? When you compare the private sector fraud rates, it’s 1 percent, compared to Medicare and Medicaid. There’s estimates that there’s $15 billion worth of fraud in Medicaid a year in New York City alone. And we haven’t attacked that. We haven’t gone where the money is.
And my hope would be that we would look at where the money is, and if truly it’s accurate — and I don’t know many people that will disagree that one in three dollars doesn’t help somebody get well and doesn’t prevent — then we ought to be going for that one in three dollars. And we ought to do it not by creating a whole bunch of new government programs, but by creating an incentive to reward people.
In your new bill, you have good fraud programs, but you lack the biggest thing to do. The biggest thing on fraud is to have undercover patients so that people know we’re checking on whether or not this is a legitimate bill. And you don’t know who’s an undercover patient and who’s not, and all of a sudden you start changing your attitude of whether or not you’re going to milk Medicare or you’re going to milk Medicaid.
SENATOR REID: Mr. President, if I could just say, I’m not an expert on much but I am filibusters and we’ve got 40 members of Congress here.
THE PRESIDENT: Tom, you made some powerful points. You want to just wrap up real quick?
SENATOR COBURN: No, I’ll just finish with that, is with one out of three dollars not helping everybody, we ought to go for where it is.
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Comments
Harry and Barry don’t really hear what should be addressed, spoken by someone who really knows. They just want more GOVERNMENT. They didn’t even listen to Sen. Coburn, they were watching the clock.
Thanks Senator Coburn for your input in the health care debate. We don’t need bigger government, we need more efficient government and people willing to stop wasting money or defauding the system.
The Healthcacre Summit/ Dog and Pony show was a huge travesty and a slap in the face of anybody who knows any better. The Dem’s didn’t listen to the Republicans and the GOP didn’t spend enough time presenting their own healthcare bill…
Agree with most Americans in that we need more efficient gov. and much less “big Government”
Good Job Senator Coburn. I’m glad your involved in the health care debate. Keep up the good work.