Congressman Jim Matheson said soaring health care costs have the U.S. economy careening toward a cliff, but he voted against a bill that would introduce sweeping reforms to the system.
Speaking at the Hinckley Institute of Politics on Monday, Matheson, a Democrat and member of the fiscally conservative “Blue Dog” caucus in the House of Representatives, outlined major problems facing our health care system and defended his vote against the House reform bill on the basis that it did too little to rein in costs in the long term.
“I’m here to tell you that when you have a cost structure where you’re growing several points over inflation every year, you can’t sustain that,” he said.
Matheson said runaway costs are only half of the health care problem, pointing to the more than 40 million Americans who lack insurance as the other major problem in need of attention. Although he said the bill passed by the House succeeded in addressing the coverage issue, a meeting with the head of the Congressional Budget Office convinced him that the measure would fall short of reducing costs, or “bend the cost curve” as it is now commonly known, and ultimately led him to oppose it.
He said President Barack Obama vowed that he would not sign a bill that fails to reduce growth in medical costs. Matheson also said he wondered why the House would nevertheless pass a bill that does just that.
“The Senate is about to engage in a very lengthy debate on its version of this bill, and I am hopeful that the issue of bending the cost curve and creating some stability in the system so everyone has access to quality, affordable health care in the long run, I hope they meet that criteria,” Matheson said.
He identified as two primary culprits for runaway costs that should be targeted for reform: bureaucratic waste, created by both the government and insurers; and excessive, unnecessary testing and the over-prescription of drugs referred to as “overutilization.” One step toward reducing costs would be for the medical industry to simply catch up with other industries by filing medical records electronically, eliminating the waste associated with copious paperwork.
“There is no question that various industries in this country have experienced remarkable increases in productivity over the last couple decades due to technology, and health care is absent from that list,” he said.
On the subject of overutilization of medical tests, procedures and prescriptions, Matheson pointed to Florida and New Jersey, where such services are administered through Medicare at a rate more than double of other states, such as Utah and Iowa, that have no proportionate improvement in quality outcomes. Moreover, Matheson said the current health care system creates a perverse incentive for doctors to overtreat patients, both to avoid lawsuits and to increase the amount of revenue they earn from these services.
“You and I in Utah say, “Well, that’s New Jersey’s problem,’ ” he said. “Well, it’s not. We’re all federal tax payers, we all pay into Medicare, so it’s all of our problem.”
The distortions of the system that have led to dangerous growth in costs are largely hidden from the public, because most people are content with their health care and don’t see the pressing need for reform, he said. For this reason, Matheson said people should consider the possibility that these problems could get so out of control that even those who are happy with their coverage could see it diminish or taken away altogether in the coming years as expenses get worse.
In addition to some of the major changes contained in the bill awaiting debate in the Senate, Matheson said smaller measures, such as mandating follow-up calls on recently released hospital patients, can spell the difference between a smooth recovery and a costly return trip to the emergency room.
“Those calls tend to catch problems before they become bigger problems,” he said.
As for the high costs associated with the treatment of critical diseases such as cancer, heart disease and diabetes, Matheson said much of the problem lies in behavioral habits, which can be changed to reduce the likelihood of developing these costly conditions. But he said aggressive public education campaigns, such as the one that has been waged against smoking for some 40 years, do not always produce results. Instead, he called for new ways to encourage patients to take the initiative in tackling these expensive conditions.