WASHINGTON, DC – With Medicare facing insolvency and health care costs continuing to spiral, two members of the House GOP Doctors Caucus spoke to The Ripon Society this past Wednesday morning where they outlined specific reforms needed to address fraud and reduce government interference in medical practice.
The Members were Congressman Greg Murphy, M.D. (NC-03), who serves as Co-Chair of the caucus, and freshman legislator Congressman Mike Kennedy, M.D. (UT-03).
Murphy, a urologist by trade and the only practicing surgeon in Congress, opened the discussion by highlighting the weak points susceptible to fraud in American health care.
“Medicare Advantage is supposed to be something that helps keep people out of the hospital and sees what things are going on that could make them sicker.”
“Yesterday in Ways and Means we had several companies testify before us, all of whom actually do a very good job at it,” the Tar Heel legislator continued. “But sadly enough, as oftentimes occurs with programs, we have some bad apples.”
“That system has been manipulated; it has been exploited. We have several companies that now will go in and make a person appear much sicker than they are. If they're sicker than they are, then they get to charge Medicare a lot more. … We are losing hundreds of billions of dollars fraudulently – that's medical malpractice, period.”
Kennedy, who is both a physician and attorney, considered another source draining public medical coffers and driving up healthcare costs: graduate medical education.
“Guess what system is paying for graduate medical education? It's Medicare,” Kennedy said. “Why is the government so involved in this healthcare delivery process? Medicare was not created to fund graduate medical education, but we stuck it on somewhere in the past, and now the system's going insolvent.”
“One of the things that I bring to the table, and I'm very interested in long-term government reform is, ‘Why is it that the legal profession is the way that it is, but the medical profession is so constrained and controlled by the government?’
“Part of our problem is we've really gotten our fingers into a noble profession, that we could actually back out of on some level, and ultimately help it to flourish instead of flounder. There are a few proposals that I have, but I'm really focused on how we can make the system healthier so that it's working 50 years from now in a better way than it currently is.”
The pair of doctors also took a number of questions, with one pertaining to congressional priorities following reconciliation.
“We have to have PBM reform,” Dr. Murphy answered. “A good government system tries to control costs, but middlemen have destroyed it. It is probably the number one reason we have medications that are so expensive here in the United States.”
The caucus chair then touched on the need for Medicare Advantage and physician fee schedule reform, among his many other medical and legislative priorities. “This is an area ripe for good bipartisan work,” he added.
Dr. Kennedy echoed Chairman Murphy’s remarks.
“PBM reform – it's really interesting to think about drug costs and why are they so expensive. It's a very constrained and controlled environment. Government has got its fingers in a lot of this.”
“It's all money-driven, and PBMs have a lot to do with that. I'm pretty irritated by all that stuff. Wherever I can reform on that, I'm certainly focused on it.”
To view the remarks of Murphy and Kennedy before The Ripon Society last Wednesday morning, please click the link below:
