tv Washington Journal Sen. Tom Coburn CSPAN May 16, 2019 5:37pm-6:19pm EDT
was an important part of american history and part of american history schools. he wanted people to be able to have a eyewitness account, to see the dynamics of what lynching was. >> watch c-span's city tour of milwaukee, wisconsin. sunday at 2:00 p.m., american history tv on c-span three. working with our cable affiliates, as we explore the american story. >> former senator, that our desk, as we can continue our conversation. the former colleagues said that when it comes to healthcare, the gop message today is to preserve what works and fix what doesn't. start with that first part. what works right now? >> time, high-quality.
exceptionally high cost. access is not really a problem because we have intolerance in some of those other things. what we don't have is a control on the costs and when you have a cost likely have, we can spend 18%, almost 19% on healthcare. multiple studies are the last five or six yearss say close to 25% doesn't keep anybody from getting sick and doesn't help anybody get well. >> $800 billion a year. certainly we can come together on how to fix that. the third thing that is bad, you don't know what you will pay for when you go to buy. it's totally blank. one of the prince's printable, you need to know if you are going to pay for something before you buy it.
it's only 10% of healthcare that emergent or mental health. >> reef together on people controlling their costs. so what is in the government right now, in a way that you think congress can do that? >> it says you have to price transparency. if you participate in healthcare, consumer want to be able to know what it cost them before they get all these crazy bills and bankrupt there think account for then next four monts because they have a child go to an emergency room and have a laceration. >> what's happening is no transparency as a surprise. when there is no price discovery, there's no allocation of resource based on competition. will happen is, none of the capitalists in healthcare want price discovered. insurance companies don't want, hospitals don't want it.
outpatient centers don't want because they don't want you to know. they hook these deals and then they have closets with the interest companies they can't tell you what they are getting paid. >> you have insight into the white house plan? headline from the "wall street journal" today. disclosure of help a search. he relies on existing administrative tools. labor department powers under the law has minimum standards for private price industries. can you explain what that means? >> as for loss.fe twenty-first centuries act and the affordable care act. if you take the authority into the administration, they can mandate absolute price disclosure by everybody in healthcare. i hope they do it. once they do it, then what's going to happen is prices welcome down. this is seven 100% differential
in the price of an mri in oklahoma. from a freestanding mri center to a hospital. seven 100% more to get in at the hospital. most people don't know that. what you will see is what you see price transparency, you will see apps develop and they will have this procedure done. then once we start getting price transmitted, the differentiation will be outcomes. should we have a policy that says we want to have the best preventative medicine and the best outcomes at the best prices? we should. what you start seeing that differential go away, then you'll see a differential on outcome. the other core principle of to be every place that deals with healthcare publish their outcomes. you can know how many must up surgeries did this rain surgeon have? how many non- union fractures
did this orthopedics surgeon have? it doesn't matter what the number is, what matters is the difference between because we ought to be incentivizing excellence in healthcare. not mediocrity. >> the bottom of the hour this morning, if you want to join the conversation, the line is usual. you're currently working as a senior advisor with the convention project. what is that? >> a group across the country, for feeling strong. they're trying to organize an amendment invention that is under article five of our constitution. the reason we're doing that, the real problems, taking the can down the road in washington in spite of being fiscally responsible.
expanded scope and jurisdiction, voice going. turn limits. it's all three of those things. >> fifteen states have already passed. we will probably have 20 by this time last year. they had to be at 34 before that happens. >> the phone lines are open. democrat, good morning. >> good morning. my question is, who has been in hospice and why? that is a bad thing. >> why is it a bad thing? >> it murders people and you take your left want to the hospital to get the well and they don't. they give them medications that are bad. thenen the first thing, they wat to put them on hospice.
>> hospice has been other than being abused in medicare, by putting the rules on hospice, need to have a life expectancy of less than six months. it's been abused by a lot of hospitals. hospice is great carousel. it is care for those who are in the last months of their life. people dying from cancer or kidney disease or failure or other diseases. it's wonderful way to help the families deal with that. so i would disagree that hospice is that. i think it is really good. it's highly abused in the medicare program. >> you mentioned your service, or kind of doctor? >> 4000 babies delivered. i take care of months, grandpas, kids and women and men. i had almost 25 years doing that. >> why did you get out?
>> i thought somebody with real-world experience should come to washington. >> why did you go to washington? >> i had a term limit myself ani discovered we need to discuss these major problems. next from golden valley, arizona. good morning. >> good morning. my comment is we have a health ltpartment and i think the medical think is getting overkill. all my life, i went to the health department for $10, you can get a pap smear. emergency, you go to the hospital.it i think our focus should be on preventive and use what is already here, which is thewh health department, which is very good women clinics.
they check your cholesterol, diabetes, everything. i've never paid more than $20. the other thing, our men in our society are not being taught to restrain themselves. we have so many acts of violence against women and these incidents show that these boys do not know how to act. the choice for a man and a womat is not to have sex. once you have sex and you have a child, you cannot kill it. it is a human being. until we come together and start protecting the innocent our
country is going down. >> first of all, help the permit and a lot of states are very effective. as a title 19, also federal money that goes to those health permit as well as state department. women's care is very good. so i would agree with the color on that. prevention is the key. we waste a ton of money because we have not prevented that disease. >> would you make of the new law? >> i have looked at it yet. my theory is, if 50 states and all the territories in the absence, if death is defined by absent of heartbeat, then that has to be life in the opposite. >> good morning. >> good morning. my question is, i talked to a
lot of doctors and they say a lot of the costs their hospitals are charging for is administrative because of the administrative people dealing with non- streamline insurance information to fill out and if they don't do properly, the better do it again. to try to build. is there anything you would suggest that we can do to help mitigate that? >> one of the things i've done is go around then country in te hospital parking lots in the middle of the night. then look at them in the middle of the afternoon. what you see on average, six to eight times more cars there during the day. that means other than the surgery and maybe that, most of that is over. there are very few hospitals in this improvement. every other business in america coefficient uses all of this
other stuff and we just don't see it. what i would tell you the reason hospitals are fighting against this price disclosure, is because they are inefficient. one of the ways to make them better is to make it hard to make the process. 60% of hospitals and a lot of that portion is occurring in the last year of seniors. we ought to be looking at how we actually force competition in healthcare by transparent pricing and transparent outcomes. really, don't you want to get your next operation of the place cheapest?the best and $5900. that's not the average, that is the lowest average.
low plan. before you show off $5900, don't want to know this is the best price and best quality? incentivize good care rather than -- >> here's the question for your business.. widely pay the worst doctors the same as we pay the best doctors? why? crazy. we ought to have market forces allocating the scarcely sourced in transparency in the market so you can actually see what's out there. >> fifteen minutes left. freehold, new jersey. democrat. good morning. >> good morning. i have a question for you regarding our healthcare law. now that they are trying, well trump is you know, send it to this up in court, strike out the whole lot where millions of all of us are not going to have healthcare. i can't understand how people can support this man in about
this new abortion law they are doing, they care more about the child that hasn't even been born and they do the thousands of babies that are on the mexico order, laying there on the ground.. what is wrong with america? it's like we're turning into venezuela. >> i don't know how to respond. i haven't seen babies lying on the ground in mexico. decisions that should have been left to the state. that's why we are divided. if you take all these controversial subjects, in our country and say, we let individual states decide these and but oklahoma do it one wayya
and still in the law because the power of the government, everything else is to be left to the people in the states. i don'two think we see this division. i think abortion would be that big of a topic. i don't know what's going to happen to help you. i do know we spend too much, it cost too much, it's too high of a percentage of families budget and we can't see transparency. you ought to be able to know that. everything else you might in this country, you know what you get when you buy it. you have recourse if you don't. >> this is chuck on the floor senate earlier this week talking about the trump administration's effort when it comes to daca. >> 133 million americans under 65 years of age are living with a pre-existing condition of some kind. right now, because of the laws on the book, insurance companies
cannot charge those americans more or tonight them coverage simplyy because they have a pre-existing condition. that's a great thing. that's something americans long for. unfortunately, after all that changes in go away, against our healthcare while brought by republican attorney general and supported by the trump administration succeeds, it would deprive health coverage for tens of millions of americans. risk denial of coverage for a probative premiums for up to 3100 -- 130 million americans cre-existing commissions. that skill is so large, almost unimaginable, you won't get protections if god for bid you have an on this. and your insurance company were
to cut you off. yet, those of the practical consequences of the lawsuit the trump department of justice continues to support. >> to the acl a. >> i think they can do that, number one thing, i have a list of 13 things i think everybody can a agree about. if they would focus on back, then we would solve it. it wouldn't be a divisive issue. it's going to be a four-page document coming up next month. we all are degree, nobody loses their home because they have an illness. in this country. they lose their life savings because of an illness. we ought to agree that we ought to cover everybody whether or not they have pre-existing conditions or not.
if it is true, there all the way from mckenzie to the institute of medicine have said, somewhere between 400 billion and a trillion to is wasted every here in healthcare. that pays for everybody's condition. and everybody's premiums. why wouldn't we go that? instead of making healthcare controversial political issue, but we find the things we can agree on and like the legislation based on what we agree on? >> american wage growth is oppressed because of our axis to healthcare costs. we don't have real insurance, we have prepaid expense that goes up anytime we use it.all of a sd
me uveindt nobody should have to pay for that. we're just climbing out of that. they're talking about again. i can't believe anybody would want them to touch itt again after what they did. there are kids who went without christmas, people couldn't pay their bills because of the mandate. that was ridiculous. that would bring in conversation, prices would come down, also make sure they can get pre-existing conditions
insurance. they may have to pay more, that makes sense and they will have to pay. but it should be offered. they're always charging more for th procedures, you can ask what the cash price procedure is, i know, i've done it. versus a competent insurance. decide if you want to use your insurance or pay cash work. competition is good. lines for people to call in on fraud that are getting bills. there is so much money in fraud that can be collected. i don't get why we don't put money into that instead of all of this other insurance crab and medicare coverage, you can't do it. what about the people who paid inu it to it their whole life? >> a lot of topics this morning. a tremendous amount of money that doesn't help anybody.
you don't -- we created a false market with the affordable care act. it's a false market. you have to dignify across everybody. that aside, you're never going to be able to share a risk until you have ties price transparency. there's an app that tells you where you can get there cheapest ct or cheapest outpatient procedure done. that's all available now and people are starting to use it in costs are going down. just based on technology. in the future, you will be able to know, especially if the trump and ministration project guidelines, mandating price price transparency. everybody knows what theirco deductible is, they know their percentage of co-pay, if we tell
them is what this code cost coming from us, you can decide had of time whether he want to pay it or not. you can shop it. there's no shopping. >> she ended about talking about medicare for all. robots? >> i thank you see medicare for all, you see healthcare system. ...fo ... . >> do you have to buy homeowners insurance on your house if you own it? know you don't. only if you have a mortgage.
so where do we get off telling people we have to - - they have to do it? should they have car insurance quick. >> sure. that's a state law that is decided at the state level so if oklahoma was to mandate everybody to do that, that is fine that is within the confines but what i am saying is we're fixing the wrong problem.is these are symptoms if health care cost too much there is no transparency and you can evaluate what you are buying and once you change that we will see hundreds of billions of dollars in savings per year and then the cost will go down not up. >> we have time for a few more calls from pennsylvania independent lying good morning.
>> thank you for taking my call but with government and business with two world wars and the cold war and wars in the middle east, i think it's safe to say it's okay to start rewarding americans now. that idf medicare for all is not sustainable and i don't believe that expanding medicare is socialism. here is my idea. fifty-five stay alive at 55 years old you should get basic health insurance medicare and basic social security. many people when they reach 62 that i can get health insurance by the time they reach 65 so now the hospitals are filled with americans that shouldn't have these in the first place so it will pay for
itself and here's why for every american 55 and older there are two workers filling the vacuum because they are making twice as much as that young workers so two workers fill that void and then at 55 you can retire and get the rv and enjoy your life because you have worked hard. that's it. that's my idea. >> not a bad idea but the economics of what we have today not even close to cover the promises that were made. a we are less than ten years away from social security social security disability is already kaput. i think the idea of having
synchronization of medicare is dead on. i think he is right we need to convince people to retire earlier but work longer because their health is better when they are not retired. >> so before obama care we had a competitive health care market. >> we didn't what was competitive? your insurance premium products that wasn't competitive you have no idea what they were payingg you had no idea. we had nonprofit blue cross blue shield. so we had nonprofit and profit insurance companies i do think the nonprofit hospitals made tens of billions of dollars profit last year and that's
the same method that the for-profit hospitals made and they don't pay taxes on that what are they doing in the community with that excess money? so there is a lot of things so the market forces and everything else we buy allocate scarce resources we don't have competitive pricing there is always a catch if you are getting a better deal from this insurance company than this one. the swiss system has everybody insured, you have to participate and then they look at the loss ranges of the individual companies and transfer money around to make sure they all carry the load. so it creates an absence of nadverse selection. because real insurance is the
indemnification and they tried not they want the healthy people for more money so the point ought to be how we get the best health care in the most efficient way with health care in the best outcomes. >> good morning democratically. >> i f do have a few quick comments i am disappointed with the idea of making that competitive to know the price of the procedures there is a standard of care there are things that you could do somewhere else in another hospital across the country if you say it cost eight dollars
here then people will walk away and say i cannot afford this. that i feel that is what we should have for those insurance companies to drive up the cost i think it is too risky to ruin the whole system but also you made some comments about hospice being abused and as a former social worker with hospice i have seen a lot of people come into the emergency room to have their care and they have never had insurance or preventative care there whole life and now they are immediately referred to hospice mto. that is unethical and it is criminal. so if you are working for an
insurancee company and that was detrimental to the health care. >> out of work for anybody with a health care business or an insurance company i thank you are misguided so what are the outcomes? and it was far better than to make a decision hospice is needed i never said it is not but i have just seen a lot of abuse as a practicing physician but being used when it was not appropriate. . >> people who don't have
insurance should have to pay for hospital services why should the taxpayer have to pay for those who don't contribute? know insurance then no free medical services. do youou agree quick. >> i think we should incentivizee people to do good things. if you say here is my family budget i spend $800 a month on health care we don't have enough money to pay everythingve else and we are healthy basically then if they have an event yes they should be responsible for that and that is called accountability but to have the government say no matter your health care you will get a penalty or a tax or a fine if you don't buy health insuranc insurance, i think that is antifreedom with the ability to make the decision and with that comes a responsibility you have to
come up with that so how do you police that? you can so the next best thing is to have a transparent where people can actually purchase with there dollars with ac is the best value not the best advertising slogan from the biggest hospital in town. and people will do that. once you have price transparency on price and outcomes associated with it , don't buy a used volkswagen from 1952 and think it's going to be a cadillac and they won't do that on health care either. here is the underlying assumption that americans are not smart enough to buy health care. i reject that flat out 50 percent of my practice was medicaid they are plenty smart they know how to manipulate that program to their ownpe benefit and people will do that to the benefit of their
health and their pocketbook. we don't allow that that opportunity they don't get the opportunity to decide they have a mandated budget from an insurance company so tell me anybody that can explain the io be to the average person so you have to know that ahead of time not after the bill comes. >> republican line good morning. >>caller: i have a comment about the health care and then abortion. on health care i completely agree with the doctor about the pay structure of health care in the united states. this take $6000 a year from omaha mutual to have a health care plan.
so what happens if you don't have $6000 a year? that's another issue. and now with the abortion issu issue, there are 61 million children aborted since 1973. at least two generations of americans railroad workers cabdrivers, maybe even scientist that could have cured cancer. in alabama i think the alabama people see that but what do you think about the 61 million children that were aborted? or the doctor that did it but to me, i always felt human
life was a sacred thing. that was a sacred trust. do you think about that quick.s >> quick. >> as a physician i have done abortions for women who are going to lose their life because of the pregnancy i have delivered babies that were 15 weeks that were trying to breathe you could hold in your hand. i delivered them all the way up to full term. over 4000. my conviction is life begins at conception. that is not a majority viewpoint anymore. but i also believe we should have the logic to say that if this is death than the opposite is life and that ought to be our guideline for
go unless we change our definition of death, than the opposite should be the definition ofpo life. but i' would make the point, here is the other point. if we had 60 million more people that we wouldn't have social security and a medicare problems funding we would of generated revenues but the fact is we don't. it is a heartache to see the country so divided on so many issues. and again i put that on the supreme court the should be decided at state level and you wouldn't see this with a harshness that we see inse our country. >> what is dividing right now is impeachment. back in 2013 there was ack story about the case for impeaching president then obama calling him a personal friend but at the time he was getting paris
loosely close to impeach ability so what are your thoughts now calling for president trump quick. >> i try noto to pay attention to washington because i find it so polarizing. both sides. again at 71 years of age, i don't want to hear it. tired of hearing it i think the average american is tired of hearing this out ofon washington. i think they are turning it off. i don't know the details because i'm not following it. i don't want to follow it. my friend barack obama did what he thought was right in his mind and in his heart but that doesn't mean he wouldn't be close to consider but that
doesn't mean you should be impeached but what we should do is say where we going with this? how do we work through that? this is such an angry place anymore i'm so happy i'm not here as far as a member of thehe senate because i don't thank you can get anything done. >> new mexico independent line. >>caller: you may be happy to be out of the senate but we out here misss you. >> thank you. >>caller: it seems that government through unintended consequences you made a couple points on that but to my understanding when medicare was approved years ago and i have an medicare everything was covered. no cost control at all by the government but i believe medicaid was the same thing
and until it got out of hand now we try to bring it back but the fact that they allowed that to get out of control this one point. number two. the politicians use the companies yeah there is problems and cost that should not be there but it's only ten or 15 percent of health care butt yet everybody points their finger and then finally discussing problems with medicare and social security. i understand if the government didn't borrow the money from those costs for those services
there wouldn't be a problem where the government would pay that back. and again, we miss you. thank you for your service. >> your understanding of that is wrong $144 trillion of unfunded liabilitiesud that include social security medicare/medicaid and government employee retirement pensions.on that is due in the next 50 years so we transfer that to the next generation. that actually works out for the average millennial of $30000 per year over the next 50 years. the average income is $64000. if a millennial marries a millennial what happens? they will be undermined in terms of their future. the tragic thing nobody wants to fix medicare. who do you see working on medicare fixing social uscurity? nobody because getting reelected is much more important than fixing the real problem. that is how this place has degenerated it's always the
next election then we will do something it's been that way ten or 15 years and that's one of the reasons i left. the reason i'm doing this convention of space because the only real solution for the problem we have is article five conventionon for amendments of forces the government to make decisions that puts term limits and limits the scope of the jurisdiction of the federal government and puts those back to the state. >> that cms project you can find them there senator coburn. >> life here on c-span2 a george mason university life town hall with candidate