Coburn: more government is not the answer
U.S. Sen. Tom Coburn, a physician, was the spokesman for cost containment for the Republicans at the recent summit on health care with Democrats and President Obama.
“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,” Coburn said. “And that is that we get stuck in the idea of treating the symptom rather than treating the disease.”
Coburn said it is a fact that one out of every three dollars spent on health care in America doesn’t help anybody get well or prevent illness.
Secondly, most of the drag on delivering cost-effective health care comes from government rules and regulations, Coburn said. 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,” Coburn said. “It hadn’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.”
Coburn said America is good at treating illness but falls short on prevention.
“If you look at what Malcolm Sparrow from Harvard says, he says 20 percent of the cost of federal government health care is fraud,” Coburn said. “That’s his number.
“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 know, 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.”
Coburn said doctors run a large portion of tests for doctors, not for patients, because of the risk of frivolous lawsuits.
“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,” Coburn said. “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.”
Coburn said an immediate help would be to give incentives for prevention.
“We don’t pay rewards for great management of chronic disease,” Coburn said. “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.”
Coburn said the food stamp program and school lunch programs are opportunities to prevent disease.
“We actually create more diabetes through the food stamp program and the school lunch program than probably any other thing, because we’re not incentivizing a great response,” Coburn said.
Fraud is another easy target.
“When you compare the private sector fraud rates, it’s 1 percent compared to Medicare and Medicaid,” Coburn said. “You know, there’s estimates that there’s $15 billion worth of fraud in Medicaid a year in New York City alone.
“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 $1 in $3 doesn’t help somebody get well and doesn’t prevent it, then we ought to be going for that $1 in $3.
“And we ought to do it by not 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.”
“Tom, I appreciate what you said,” Obama said. “… I just want to make this quick point: Every good idea that we’ve heard about reducing fraud and abuse in the Medicare and Medicaid system, we’ve adopted in our legislation.”
House Minority Leader John Boehner said, “For 30 years we have had a federal law that says that we’re not going to have taxpayer funding of abortions.
This bill, that we have before us, for the first time in 30 years allows for the taxpayer funding of abortions.”
Obama did not respond directly to the question.
“This became a very ideological battle,” Obama said. “It became a very partisan battle and politics I think ended up trumping practical common sense.”