Speeches & Floor Statements

Hearing Statement: Eliminating Excess Health Care Spending

Posted on July 17, 2018

Reducing Health Care Costs: Eliminating Excess Health Care Spending and Improving Quality and Value for Patients

Opening Statement

July 17, 2018

  • The Senate Committee on Health, Education, Labor and Pensions will please come to order.
  • Senator Murray and I will each have an opening statement, and then I will introduce the witnesses.
  • Then we will hear from the witnesses and senators will each have 5 minutes to ask questions.
  • A retired engineer in Tennessee who suffers from a number of health problems – diabetes, high blood pressure, depression, and chronic pancreatitis – visited Vanderbilt University Medical Center’s emergency room 11 times last year and had to be admitted to the hospital three times.
  • At Vanderbilt, a pattern like that is a flag for the Vanderbilt Familiar Faces program, started in 2017 to identify patients with chronic diseases who make frequent visits to the emergency room and clinics, often resulting in hospital stays.
  • Emergency room visits and hospital stays are expensive – for patients and the health care system as a whole.
  • So, the Familiar Faces Program works to help these patients reduce the amount of time they spend in the hospital by developing a plan to help patients better manage their chronic conditions by receiving regular care and treatment.
  • After participating in the Vanderbilt Familiar Faces program since September 2017, the retired engineer has been able to avoid the emergency room completely, instead only visiting an outpatient clinic twice.
  • This is the second in a series of hearings to look at how to reduce health care costs, as they continue to increase for families, taxpayers, and employers.
  • Our focus today is on reducing wasted health care spending, which is important given the estimated amount we spend on unnecessary services, like the visits to the Vanderbilt emergency room I just described, excessive administrative costs, fraud, and other problems is a great, big number – $750 billion in 2009, or as much as 30 percent of our total health care spending, according to the National Academies.
  • At today’s hearing, we will discuss two of these categories of wasteful spending:
  • This is spending that does not actually help patients get better or was spent on unnecessary medical tests, services, procedures, or medications; and
  • This results in spending money on health care services that could have been avoided if the patient had received care earlier.
  • Unnecessary spending is a burden on the health care system and on the patients who undergo tests and procedures that may not be medically necessary – and who are then stuck with the bill.
  • We need to find ways to improve care and maximize the quality of the health care patients do receive by looking at what medical tests, services, procedures, or medications are really necessary or if there are more cost effective alternatives.  
  • Here is an example of a more cost-effective alternative: If Sue has minor lower back pain, instead of her doctor ordering a CT scan or an MRI – which are expensive– Sue would likely be better off taking over the counter pain medicine, using heat, and exercising, according to the American Academy of Family Physicians.
  • Another example is educating a patient on the cost difference between a hip replacement surgery at a hospital, where the procedure will cost a lot more than if the patient had the same procedure, even with the same surgeon, at an outpatient clinic. 
  • Wasted health care spending also can come from not spending enough money on preventive care.
  • As the adage goes, “an ounce of prevention is worth a pound of cure.”
  • The Cleveland Clinic has said if you achieve at least four of six “normal” measures of good health and two “behaviors,” you will avoid chronic disease about 80 percent of the time.
  • These six indicators of good health are:
    • Blood pressure
    • Cholesterol level
    • Blood sugar
    • Body Mass Index (a measure of weight and height)
    • Smoking status, and
    • The ability to fulfill the physical requirements of your job.
  • The two behaviors are seeing your primary care physician regularly and keeping immunizations up to date.
  • This is important because we spend more than 84 percent of our health care costs or $2.6 trillion treating chronic diseases, according to Dr. Roizen at the Cleveland Clinic who testified before our committee last year.   
  • However, According to the Organization for Economic Cooperation and Development, the United States has the highest obesity rate in the world, at 38 percent.
  • So it seems Americans are not doing a very good job of taking care of ourselves. 
  • At this second hearing, I hope to learn from our witnesses specific recommendations on how to start investing more in preventive care and how to stop spending money on unnecessary medical tests, services, procedures, or medications.
  • We have four witnesses today who are implementing innovative strategies to encourage better care as opposed to just more care and to encourage patients to live healthier lives.
  • I look forward to hearing from our witnesses today.