Bill Cassidy Calls Out Hospitals Over Medical Debt Crisis: ‘They’re Not Doing The Right Thing’

3 months ago

Earlier this month Sen. Bill Cassidy (R-LA) questioned witnesses on medical debt and non-profit hospitals during a Senate Health, Education, Labor and Pensions Committee hearing.

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Transcript

00:00that's what we're going to

00:07miss. We're just out of

00:08curiosity, which hospital where

00:11your children treated.

00:12They've been treated in

00:13several. We were living in

00:15Dallas and children are born

00:16and the Nick you the Nick you

00:17bill sounds like it was the

00:18most which which hospital is

00:21a They were both at Baylor in

00:22Dallas and then also children's

00:25Medical Center. Sounds good.

00:26But I assume the patient you

00:29were talking about was at

00:32Rhode Island. So there's 340

00:35B in the hospital. All 3 are

00:36mechanisms by which it's

00:37supposed to help those who

00:39cannot pay their bills. The

00:40alleviated from the burden. Do

00:43you know if Brigham ever

00:43reached out to those patients

00:47to help decrease their cost.

00:49I should be clear. The patient

00:50I was talking about Rhode

00:53Island where I did my

00:53residency training. So not in

00:54the Brigham Rhode Island. It's

00:55an academic center. Typically

00:58it's a hospital. And by the

00:59way, did that hospital as far

01:02as you know, have a program or

01:03does bring him. Let me ask

01:04about Brigham. Do they have a

01:06program where somebody comes in

01:07uninsured are poorly insured or

01:10with a high deductible to help

01:11offset the cost of that bill.

01:13Yes. Mass General Brigham does

01:15have that policy. It's up to

01:16150% of the federal poverty

01:17level gets free care up to 300%

01:19gets discounted care. All

01:20hospitals have to have in a

01:22sense that mechanism has been

01:23working that, you know, what a

01:24motivating what a motivation

01:27for you. But what a terrible

01:28story for us about your

01:29husband. Sloan Kettering. Again

01:31it's a nonprofit 340 B and

01:34disproportionate share big

01:35speaks big discourse share

01:37state. Does Sloan Kettering have

01:40a program where they pass the

01:41340 B discount to the patient?

01:44We are not a 340 B program at

01:46Memorial Sloan Kettering. I

01:47looked it up and I think I saw

01:48that you are. Okay. That is

01:50news to me. I apologize. But I

01:52will say that our charity care

01:53program is actually quite

01:55robust. We actually. But do

01:56they pass it because you

01:57mentioned specifically the cost

01:59of drugs. Do they pass that

02:00340 B discount to cover up to

02:02500% of FPL for our charity

02:05care program, which is far more

02:07than we need to. Is that for

02:09the is that for the uninsured

02:10or would that include the

02:11people with a less generous

02:14insurance policy up to 500% of

02:16FPL? Yes. So so in that sense,

02:18the programs we have with it

02:19would address that that portion

02:20of medical death that would be

02:21at hospitals. That's important.

02:23It's important. But you also

02:24have to realize that in New

02:25York City, even up to 500% of

02:27FPL is not necessarily a

02:30livable wage. And I know that

02:31sounds insane. And when you

02:34think about charity care, come,

02:35for example, for my husband, he

02:37was underinsured, but he was

02:38also a college professor. So we

02:40did not need any actual charity

02:42care program. And yet we still

02:44fell into massive debt. He

02:46would have been below 500% of

02:48FPL if he was he was not treated

02:50at Memorials on countering in

02:53the hospital where he was

02:53treated. Was that a 340 B

02:55nonprofit? I apologize. I do

02:56not know that, sir. Okay. Do

02:58you know the name of the

02:59hospital? He was treated at the

03:00University of Michigan. That

03:02would have been a three. Yeah,

03:03that would have been a 340 B

03:04nonprofit. Dr. Bai, what we

03:06have here, at least in a couple

03:07of cases, maybe cases where a

03:08340 B nonprofit receiving

03:10disproportionate chair dollars

03:12is not helping people with

03:14their medical expense. Is that

03:18a and I and as it turns out, my

03:23staff just tells me that Baylor

03:25is also a 340 B hospital

03:27nonprofit. So theoretically we

03:29have hospitals which are

03:30supposed to be doing the right

03:32thing and they're not doing the

03:33right thing. What I guess is

03:35not a market failure, but it's

03:37certainly a failure of a

03:37hospital to act in a way which

03:39would be consistent with that

03:41was intended by the by the

03:42policymaker. Any comment on

03:43that? I think that's good. I

03:45believe that's exactly what the

03:47policymakers are trying to do.

03:49All these policies are in favor

03:51of large players, in my

03:52opinion, is trying to build a

03:53coalition between the

03:55policymakers and the large

03:57players. So large players will

03:59just ignore what the patient

04:00needs and focus their effort on

04:03this influencing, capturing the

04:05regulatory process and

04:06legislative process. So I think

04:08at the best benefit, like more

04:09340 B, right? More site-based

04:12payment. They would act for

04:14more subsidy, but yet we have

04:15clear instances of that

04:17subsidy not being passed to the

04:18patient. Two things about your

04:21testimony. You said only 14% of

04:23people have a medical debt over

04:2510K. In my statement, I

04:27mentioned that 50% of medical

04:29debt is related to hospital

04:30expense. So really, if these

04:32policies were actually

04:33implemented as intended, it

04:35would have a very positive

04:37impact. Dr. Ippolito, real

04:39quickly, I'm almost out of time.

04:40The No Surprises Act was

04:42supposed to eliminate surprise

04:43medical billing, and that was a

04:45major cause of medical debt.

04:47Has there been an analysis of

04:49the accrual of medical debt

04:50subsequent to the passage of the

04:52No Surprises Act? Not that I'm

04:54aware of, but in theory, it

04:55should have helped. Yeah,

04:57certainly the testimony we

04:58received at the time was a lot

04:59of medical debt was related to

05:00I thought you were in network,

05:01turns out you weren't. And now

05:03No Surprises addresses that.

05:05Maybe that will be a policy

05:06that actually works. Mr. Chair,

05:08I may have a second round, but

05:09I'll yield right now.

Bill Cassidy Calls Out Hospitals Over Medical Debt Crisis: ‘They’re Not Doing The Right Thing’

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Transcript

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