tv Washington Journal Betsy Mc Caughey Discusses the Future of Health Care CSPAN June 30, 2017 3:52am-4:32am EDT
of years, pretty much proved himself invaluable. he was the one that actually kept it going. the owner was rather distracted to politics to the point he owed henry a lot of back wages. so in 1860 his employer zieed to give the paper to pettech. he was eventually able to build a house as grand as this one. >> watch saturday at noon eastern on c-span's book tv. working with our cable affiliates and visiting cities across the country. next former new york lieutenant governor betsy mccaughey discusses health care reform efforts. this is 35 minutes.
>> betsy mccaughey, thanks for joining us. we want to start with the senate legislation that's being rewritten at this point. but as it was originally written, was it something that you could have supported or do you think that the senate members who did not get onboard kept this from coming to the floor, were right in doing so? >> well, i support the senate bill especially the medicaid reform. medicaid reform is urgently needed in this country, and the senate bill was a very solid start towards that. >> what sort of changes do you think should be considered at this point as a rewrite is happening. we're hearing efforts to get to the congressional budget office by the end of the week for a new scoring. >> well, i hope they won't change the medicaid reform. because medicaid was a tipping
point. medicaid was founded as a safety net program, but now enrollment is so large and the cost of it is so great it's threatening the very existence of the safety net. it's threatening access to care for the poorest and neediest and most disabled who should be guaranteed under medicaid. >> do you think democrats should be brought into this process? with something that's such a big issue for you, should that something that should be negotiated? >> well, what i've heard so far suggests the democrats aren't even willing to hear this issue. i'm shocked when i hear like senator chuck shooumer calling this -- even hillary clinton
calling it the death party. that's not the way to work together. and i asked democrats when they attack this reform, well, how many people should be on medicaid, what's your thought? how many? give us a number. >> and we'd love to hear from viewers as well as on this topb as we're talking with betsy mccaughey this morning. >> let me point out that right now one of every two women who gives birth in this country has medicaid pay for it. half. that's not a safety net when half the people in the country are using it. and 75 million people are currently enrolled in medicaid. and accord to the budget report that number will soar to over 86
million people in the next decade. and it's really endangering medicaid for people who need it the most. and here's why. medicaid pays hospitals and doctors only about 86 cents for every care delivered. it short changes the hospitals and the doctors. and hospitals, for example, are able to keep their doors open because they shift those unmet costs over to people who have commercial like blue cross, one of those companies. well, that shifting can only go on when there's a certain number of medicaid enrollees and a larger number in commercial insurance. well, what's happening is medicaid is getting so big that the costs that aren't met are getting too large. already the average family that has commercial insurance pays about $2,000 of their premium just to meet medicaid. it doesn't really go for the
wrong care at all. the more people in medicaid, the more the premiums are soaring. and the mayo clinic for example announced in march they're not going to take so many medicaid patients. they're going to put them in the back of the line because of this problem, medicaid has reached a tipping point. too many people enrolled and the costs aren't being met. and that's a bad sign when we hear the premier institution of our country saying they can't take medicaid anymore or cut back on the number of patients they take, it's time to reexamine medicaid enrollment so we protect it for those who really need it. >> you brought up earlier chuck schumer calling this bill mean. he called it meaner earlier this week as a press conference.
based on reported comments from president trump about the house legislation, that president trump had called the house bill mean. did you think the house bill was mean -- >> i don't think either of these bills is mean. i think if you look very carefully at what's happening to medicaid, if you want to protect this social safety net, health care has been the issue my entire life. if you want to protect medicaid, you must curb the rapid increase in enrollment. because a safety net isn't a safety net when over half the people are signing up for it. and that's what's happening now. medicaid enrollment has skyrocketed under obamacare. and here's what else they did. the obamacare law said to state governors you enroll as many people as you can in medicaid and the and the fal government, uncle sam will pick up the first
of the tab, 90% and then some transfer. they often spent the money very unwisely. for example, a new congressional budget office report shows that 10% of medicaid payments are mistaken. they're in error. how you run a business where 10% of the money going out the door is a mistake, right? so it's very important that medicaid spending me monitored and be smarter. don't waste taxpayer dollars especially when people need care. and the medicaid reform in both the house and the senate block grant the money to states and say spend it wisely. we're talking with betsy mccaughey, the former lieutenant governor of illinois and also about her book.
she's with us probably about the next 30, 40 minutes or so this morning taking your calls. we will go up to at that point at some point here. we're expected to be joined by senator john wicker of mississippi, a couple of centers stopping by our program today. so we'll go to that in a bit, but we'll take some calls. steven you're up first for betsy mccaughey. >> good morning. >> good morning. >> i listened to you and i heard just two long time. i'm not going to sit there and degrade you. >> exot specifically doesn't make sense to you? >> caller: sorry? >> what specifically doesn't make sense? what issue or what part? >> caller: she's saying the losses, everybody is getting into it. and they're talking about the losses.
pharmaceuticals and hospitals. you go there, you walk in the hospital doors, it's $2,000 for a band-aid. it's overpricing, and this lady is talking about everybody getting in there is the problem. i'm sorry, i'm not very good at this talking stuff. >> thanks for calling. >> go ahead. >> thanks for calling. i think there are instances obviously where hospital bills bills patients or insurance companies or the federal government way too much. you're absolutely right about that. that's a separate issue and one we must fix. on the one hand, we have to make sure that medicaid spending is smart. on the other hand, we have to make sure that medicaid enrollment is also smart. and when i ask many people who are opposing this reform, how many people ought to be on medicaid, they don't have an answer. they're so prepared to just object to medicaid reform
without actually analyzing how many people should have access to a safety net before it doesn't become a safety net anymore. >> peter is in valley cottage, new york. line for republicans. peter, go ahead. >> caller: thank you, john. i appreciate you letting me make a few comments. betsy, i have seen you many times on fox and also on "washington journal." i'm amazed by your knowledge on this particular subject. >> thank you. >> caller: you should be working for president trump. but that being said, i believe the republicans are making a big mistake by going with reconciliation. if the republicans refuse to fix obamacare and the democrats kill that battle off, they're not going to work with the republicans, the only way that they can pass a bill is through reconciliation. under reconciliation, they cannot eliminate all of
obamacare, and senator rand paul is correct. this is -- this is the aca light or obama light. >> i would like to jump in and answer that comment or return the favor. because i heard senator rand paul's comments, and i like him very much. but let me point out, this is -- this bill, the senate bill that repeals the individual mandate, very important for freedom. it repeals the job killing employer mandate. i have a list right here of hundreds of employers around the country who push their workforce down, demoted them to part-time status, to avoid the employer mandate. so many people in this country are trying to cobble together a living with two or three part-time jobs because obamac e obamacare's employer mandate discouraged full-time hiring. >> caller: you're right. >> let me continue. thirdly, the medicaid reform i discussed a moment ago is
absolutely essential to this country. medicaid is the biggest item in most states' budgets. it's breaking the bank. it is diverting funds that are urgently needed, for example, for school aid. i'll give you an example. john kasich's own state, ohio, total fund spending in ohio, 40% from medicaid. only 14% for school aid. what kind of a priority system is that? when you deny children their education? >> betsy, you're absolutely correct. the problem is, is they can't get it through the senate. what they should have done, if mitch mcconnell was not willing to eliminate the filibuster -- >> i think he should eliminate it. >> caller: they should eliminate it. but i'm saying, the republicans should have passed the best health care bill, for instance, they can't do it across state lines under reconciliation. >> right. >> caller: what they should have
done is pass, is put out the best possible bill to repeal and replace, and let it die in the senate. and put it on the democrats that they refuse to vote for it. >> well, that's an interesting idea. >> and betsy, finish your thought, because we have somebody with insight into this. >> there are other ways they could do it as well. i agree with you about the filibuster. the filibuster is a senate rule for those watching who aren't familiar, a senate rule. it is not spapart of the constitution. the united states constitution requires only a simple majority in the senate to pass a law. but over time, politicians have devised a, quote, filibuster rule that requires a super majority. 60 votes it happens to be. a super majority to pass legislation. well, this was devised by career politicians who know that some years they're going to be in the majority and other years they're going to be in the minority, and
looking ahead, they want to make sure that when they're in the minority, they still have clout in the united states senate. but it does not serve the public. and right now, it is holding up vitally needed legislation. but let me point out, even if mitch mcconnell isn't willing to give up on the filibuster rule, the senate parliamentarians who make decisions about what would be allowed in a reconciliation bill, a bill that only requires 51 votes to get through, is not elected by anybody. and in fact, mitch mcconnell has the authority to overrule the parliamentarian, so if you wanted to put something in the senate bill, for example, allowing insurance to be sold across state lines, a good idea, or anything else, you could do it and simply overrule the parliamentarians. >> betsy, we'll come back to this in a little bit. we have one of those key votes joining us from the senate
office building. roger wicker, republican from mississippi. appreciate your time this morning. we have been having this discussion all morning about the health care legislation. can you just give us the latest status update? we're hearing about a rewrite of the senate bill, possibly trying to get it to the congressional budget office by friday. where is this as far as you know? >> i have to say, first of all, i hate to break into this great discussion. and governor mccaughey, thank you for making a very strong case for doing something that's going to help millions and millions of americans. so i'm eager to make my point and get back to listening to this great discussion. i think there's been some movement. clearly, there's some people in the ohio valley who feel real strongly about we need around $45 billion more in medicaid to fight the opioid epidemic. it's very serious. i think it's something we can do around the edges there that's
not going to affect the outcome in future decades. and maybe get people with it, and i was encouraged to hear there might be some movement toward allowing people to buy their own insurance out of health savings accounts, and that should make those of us on the right happier about the bill. so i think there's movement in the right direction. there was a willingness yesterday, and among everybody, to work to get together. there were people, intransgents on the issues in the past who were driving. i feel good about it. i'm optimistic. i don't know if we'll get there today or tomorrow, but i think we're moving towards an opportunity for a real honest to goodness medicaid reform that works better for people and
makes this program attainable for future decades. >> also yesterday, president trump suggested a big surprise was in store for the senate bill. can you give us any insight as to what that might be? was he referring to what you were just talking about possibly? >> perhaps he was. further than that, i don't know. i guess the surprise would be the bill that people like susan collins could have a big hug about. >> what sort of role do you see the president playing in this process as this debate continues? >> a very important role. and part of that, of course, is mike pence, who served with a lot of us. i was a colleague of his in the house of representatives before we went on to different offices. reince priebus, the chief of staff is very helpful. the chief health person in the
administration has been very, very active. but i think the president getting us together a couple days ago in the white house, sitting around the room and getting down into the weeds on the issues i think was helpful. and i think he continues to be helpful. >> the president tweeted yesterday about his level of engagement on this topic, about his level of knowledge on this health care. do you consider the president a wonk on health care? is he doing that in specific issues? where do you see his expertise? >> well, i don't consider donald trump or senator roger wicker to be a policy wonk. but i think we understand the basics of this issue. i was quite impressed with the president's command of the issues. particularly, the stabilization
fu fund, able to write huge, huge checks for continuously to prop up the system that is failing. i think the president understands what we're up against. we are up against a system that is failing. the markets are collapsing. and we can't be writing these huge multi-billion checks to stabilize the market forever. when we can do something a lot better, and make the system last for a long time, and also give people like people in my state an opportunity to have a refundable tax credit to buy real insurance. a better type of coverage than medicaid. you have a choice of getting on blue cross blue shield or anthem or geico or whatever rather than staying on medicaid, you want to get on real insurance. >> senator wicker, i know you have to go in about a minute or so, but i did want to ask you. we asked our viewers at the
beginning of the program, should republicans negotiate with democrats when it comes to the health care issue. i want to get your view on that. we spent an hour talking to our viewers about that. >> i do join with the president in wondering if they're serious about this. let me just say, from the outset, former president obama said don't put your fingerprints on this bill. let the republicans own it. senator schumer changed his tune yesterday, but he all along since january has been saying this is for the republicans to do, and we're not going to have any part of it. i think maybe yesterday senator schumer realized we might -- we republicans might be getting close to getting to 50, and suddenly he wants all 100 senators to have a meeting with the president at the white house. i think we're close to getting something very helpful and very
meaningful done in terms of entitlement reform. and i think that's the path to a good result right now. >> senator wicker, appreciate your time on a busy day. thanks so much. >> thank you. >> returning to our conversation with betsy mccaughey. we appreciate you holding on. you were listening to that conversation. i want to get your takeaway from what senator wicker had to say. >> i thought your question was very interesting about the president's engagement. i want to tell you, he is engaged. in fact, i was sitting at my computer writing one of my columns earlier this year, after the president was elected and had taken office. i got a call from him. and he said the first sentence out of his mouth was, after saying hello, of course, was, you know, i'm really concerned about pre-existing conditions. i made a promise to keep, to protect people with pre-existing conditions and i have to keep my promise. so he is very engaged in the actual policy issue, and i think it makes a difference.
not only that, but he has made it very clear to this congress that they must act because the choice isn't between obamacare and some future republican bill. obamacare is dead. it is in a death spiral in many, many counties across the u.s. now. there's only one insurer left. in a few counties, they have all back eed out. how can we say the choices between obamacare and some republican alternative when insurance companies now refuse to participate in obamacare? it is no longer an option. >> we have about 15 minutes left with betsy mccaughey this morning. the former lieutenant governor of new york. former adviser to the trump campaign. we'll get to as many calls as we can in the time we have. chris, arlington heights, illinois. line for democrats. you're up. >> caller: hi, john. hi, betsy. you know, it's been six years that the republicans took the house and the senate. and over those six years, we
have yet to see any logical proposal being set forth. you introduce this bill, and we can't even get it to committee to have a bipartisan discussion about what should be in and what should be out. to me, that's just un-american. >> that's the distortion of what factually happened. >> chris, hold on a second. let betsy respond. >> that's a distortion of what's actually happened. when the republicans first started discussing their repeal and replace bill this spring, senator schumer and others made it known that they would not participate. they would not participate in committee hearings. they would not participate in any meetings about it. they would not, as senator wicker just said, let their fingerprints be on this in any way. so that is why it has been a one-party initiative since the beginning of this year. not because the republicans didn't welcome them, but because the democrats in what i would
call a very un-american pose, refused to participate, and i just want to set this in some historical perspective because we have had a two-party system in this country almost since the beginning. really only after 1800. and from almost all of that time, the party that is out of power has understood that its job is to participate in governing. to support the success of the government even though it lacks the majority. so when i hear this time around words like sabotage, obstruct, prevent any kind of success at all, prevent even any kind of participation, that is un-american. it is not in the great tradition of our two-party system. >> let's head to wisconsin. denise is waiting. line for independents in nucusa, wisconsin. did i get that right? >> caller: yes, you did.
>> make sure to turn your television down and speak through your phone. >> caller: yes. i have it muted. i'm calling for several reasons. number one, i work over 30 years in my life while raising my family. i am now a recipient on medicaid. without it, i would be in much worse health than i am. and i would be bankrupt for the medical care that i require. which is mostly debilitating. i never thought that this is where i would be at. but without medicaid, i will die. >> well, i'm glad you're getting it. now, tell me. tell me a little bit more about
your medicaid eligibility. were you eligible for medicaid before obamacare? >> caller: no. because i was working. and i had insurance through my employer. okay. >> what i'm saying is -- >> caller: i'm disabled. >> so you are on medicaid because of your disability. >> caller: and then i was -- >> you won't lose your medicaid under this reform. you're not going to lose medicaid. >> caller: because the medicaid, i was then able to have screen work done and found out that my cancer that i've had 15 years ago was back with a vengeance, and that through another surgery and have had multiple medical complications since that time. anyway, the reason i'm calling
about this medicaid thing, one of the comments that you made several times is relative to the number of people who are faced with being covered under medicaid. one of the issues is that the cost of living, the cost of health care, the cost of health insurance, everything is going up. except the wages. nobody does anything about the cost of health care. nobody's doing anything that needs to be done about the pharmaceutical costs. you know, you need to look at the entire picture instead of only what percentage of folks require the medicaid. they're requiring it because their incomes don't allow them
to participate in a private insurance plan. when we were trying to obtain the insurance under the aca, for my husband, who had retired, he was of retirement age but not old enough for the medicare yet, and he had to wait for the medicare to be available, so we tried to buy his policy under the aca. but because our income wasn't taxable enough, he wasn't even eligible for the supposed supplemental payment from the government to help with that aca policy. >> thanks for sharing your story. betsy mccaughey. >> well, i'm very glad this caller called in. first of all, it's very important to reassure people that the medicaid reform is not eliminating medicaid for people with disabilities. so this caller who has been
through a lot, i can hear it in her voice, she's not going to lose her medicaid. what the medicaid reform does is this. it looks at future enrollment patterns and says, well, let's make sure that medicaid is there for the people who are seriously ill. and this lady appears to be one of them. if we don't control future growth through medicaid, and no one who is currently on medicaid, by the way, is going to lose it. they're grandfathered in under both of these reforms, the house reform and the senate reform. anyone currently on medicaid is grandfathered in. i hope you're listening because you're not going to lose your medicaid. if you're on medicaid, you're grandfathered in. that means you can't lose it. but to control, to curb, the slow the future growth in medicaid enrollment is vital so that a woman like this one who called with serious health problems including cancer has
accesses to places like i mentioned before, the mayo clinic, johns hopkins, places that have already said we have to take a look at how many medicaid recipients we're treating because the cost of care is so much greater than what the government is paying us for these folks and we can only take so many. and that's exactly the issue. let's reform medicaid so that it's there for the people who need it the most, including this caller. >> let's head to brooklyn park, minnesota. michelle is waiting. line for republicans. good morning. >> caller: betsy, you're wonderful and so logical. i was going to talk about medicaid and the shame that -- and it's so shameful how 50% of the babies in this country are born under medicaid. what is going on with this country? but you talked about medicaid. you explained it well. and the changes. let me talk about the cost of drugs. i think the government has to negotiate the cost of drugs for
medicare and medicaid. the insurance companies keep -- i mean, the pharmaceutical companies keep on saying that if they do, that will hurt development. there was a gentleman on c-span the other day who said that pharmaceutical companies are spending more on marketing on the airways than they are in development. if we negotiate the price of drugs, the pharmaceutical companies aren't going to stop developing drugs. they're going to have to go to the rest of the world and say you guys have to start paying your fair share for the price of drugs. >> it is unfair that american consumers go through the entire burden of research and development for these drugs and people in other countries pay much lower prices for them. i totally agree with you on that. as we're talking about cost, i would like to raise another issue. it is totally neglected and one of the biggest costs, human and financial costs in our health care system. it happens to be very close to my heart. hospital acquired infections. going to the hospital and then
you get an infection. these infections are adding almost $50 billion a year in direct treatment costs our health care spending. and worse than that, they're killing tens of thousands of patients a year. the centers for disease control and prevention says 75,000 patients a year are dying in hospitals from these infections. but in fact, the number is quite a bit higher because in every state now, the doctors don't put hospital infection on the death certificate. they're not required to. there's not even a box for it on the death certificate. so often, the hospitals that killed the patient isn't listed as the cause of death. in fact, instead, it's, for example, a heart attack. something that brought the patient into the hospital to begin with. we can prevent these infections. the single biggest cause of these hospital acquired infections is poor hygiene in the hospital.
the number one predictor of who gets a hospital infection, not your age, it's not the diagnosis that brought you into the hospital to begin with, not your health problem. no. it's what room you're assigned to. if you are assigned to a room in the hospital and a preceding patient in that room even two weeks or three months before had an infection, your risk of getting an infection goes way up. that's how bad the cleaning is. that preceding patient was discharged but his germs were left behind on the bedrail, the over the bed table, the curtains, the call button, the television monitor. all of those things, laden in invisible germs. this is something we can prevent through rigorous cleaning of hospitals. >> just a couple minutes left. lots of calls. john in greenwood, indiana. independent. go ahead, john. >> caller: okay. how to solve health care in four easy steps. number one, medicare for all. people can buy into medicare.
number two, the insurance companies do away with it. they charge 30% to our billing. they don't give us nothing. all prices should be posted in all health care facilities. and the final thing, we need politicians to go on, the first question you should ask them, do you have support from insurance companies for your campaign? >> well, i'll answer that right now. i don't take any money from insurance companies. and i would like to address the other issue you raised. i think price transparency is absolutely essential. it's only fair. but i do not advocate single-payer health care. that is medicare for all. and here's why. if you look at the countries that have gone to that system like the uk and canada, they have very low cancer survival rates. cancer survival rates, it's one of the fairest, best indicators of the quality of the health care system.
two examples. a woman diagnosed with breast cancer in the united states has over a 90% chance of surviving it. but in europe, her chances of surviving it are less than 80%. you do the arithmetic. she's twice as likely to die from it. prostate cancer, a man diagnosed with prostate cancer in the united states, it's not a death sentence here. but nearly 1 out of every 4 men diagnosed with prostate cancer in europe dies from it. and among the european countries, the united kingdom has the lowest cancer survival rate in western europe. their single payer system is not doing well for people who have serious illnesses. >> see if we can get in richard in marion, ohio, republican. go ahead. >> caller: really great discussion about infections and everything. >> before you start, i just want to refer our viewers to the website for infections. hospitalinfection.org. we have a brochure to help you,
15 steps you can take to reduce your risk of hospital infection if you're going into the hospital. and another one if you're in a nursing home or long-term facility for your family. go ahead, i'm sorry. >> caller: i think there's some machines that help to radiate better, things like robots walk through the room. >> oh, yes. there's now one that can operate 24/7 while patients are in the room continuously disinfecting. there's absolutely no excuse for the hospital infections. and i must say the federal government has been really behind the curve on addressing this condition. i'm hoping that president trump will take this on as a major effort. >> richard, we have a minute left. >> okay, sure. the problem that we have is that we put everyone in, we do housing, just about blew up the financial system. everyone don't have to do anything, just get the house and whatever, nothing down. now we have a health care program that we have pre-existing conditions.
well, we're not just talking about pre-existing conditions in the united states. we aren't asking people to come into our country 90 days to see what pre-existing conditions were loaded up and we're going to blow it up. it's going to be a big magnet around the world, bringing everyone into our country without any way to control it. that doesn't mean we solve all the disease in the world. we're carrying the load. >> got your point. betsy mccaughey in the last 40 seconds or so. >> well, first of all, i would like to say this. i don't want americans to be so scared by the headlines about health reform because in fact this medicaid reform is urgently needed. the message, the information that i tried to convey in our last half hour together is medicaid reform is essential to insure that the safety net is there for those who need it the most. and if you actually look at the numbers, medicaid reform will be a good thing for people who have serious health problems and need
uncle sam and the taxpayers behind uncle sam to help them out. so make sure that safety net is there in the future. we have to reform medicaid. and secondly, if you need help with hospital infections, if you're going into the hospital and want to protect yourself from this terrible risk, please come to hospitalinfection.org. we only have one goal at hospitalinfection.org, and that's to save lives. >> betsy mccaughey, appreciate your time as always. come back again. >> thank you. c-span's "washington journal," live every day with news and policy issues that impact you. coming up friday morning, role call's neal brzezinski and gabby mor morengelo debate health care, and also usa today contributor and ethics expert alicia shepherd discuss the rising tension between the media and
the trump white house. be sure to watch c-span's "washington journal" live on friday at 7:00 a.m. eastern. join the discussion. >> next, former acting medicare and medicaid administrator andy slavitt on the potential impact of the senate's health care bill. from the "washington journal," this is 40 minutes. >> and we turn now to continue this discussion on health care, to andy slavitt. he's the former acting administrator of the centers for medicaid and medicare services. joins us now. betsy mccaughey just then was talking about don't be scared by the headlines. one of the headlines in yesterday's "usa today" in their op-ed section was your story, health care bill breaks senate promises. i want you to explain what promises are broken. >> thanks for having me on. generally speaking, if you talk to democrats, you'll hear a