Earlier this month, Sen. Bernie Sanders (I-VT) questioned witnesses on the lasting effects of healthcare costs during a Senate Health Education Labor and Pensions Committee hearing.
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NewsTranscript
00:00We are waiting for another senator. In the meantime, I think Senator Cassidy and I had
00:06a few questions we'd like to ask. You know, this has been a very interesting hearing,
00:13and I think everybody, regardless of where you come from, understands that the root cause
00:18of the crisis of medical debt is the high cost of health care in America. And the interesting
00:23discussion is why we are spending twice as much per capita on health care as any other
00:28nation, and our outcomes are often not as good. I would mention to folks, there was
00:36a study recently at the Peterson Foundation, which talked about administrative costs. Now,
00:43I would hope that most of us agree that if we spend a dollar on health care, we want
00:47to go to a doctor or a nurse or some medicine. We don't want to go to some bureaucrat hounding
00:52this ward, or some bill collector hounding this ward, or Dr. Chino who is worried about
00:57family members. It's not a very good investment in health care dollars. Just for the record,
01:03in Japan, they spend about $70 a year per person on administrative costs. Sweden, $70.
01:10Italy, $74. Australia, $148. France, $306. Switzerland, expensive, $528. In the United
01:18States, we spend $925 per person, not on doctors, nurses, but on bureaucracy.
01:25All right? Brief answer. Now, I'm going to give you my view. You tell me what you think
01:32about it. And this really raises an interesting question with Senator Cassidy. We may want
01:36to do another hearing, really. I think that the function of a rational, humane health
01:42care system is to guarantee health care to all people, regardless of income, as a human
01:48right. I think it's wrong if somebody says to Bill Cassidy, Bill, sorry, you have cancer.
01:54Too bad you're going to die because you can't afford the treatment. I don't think that that's
01:58what a civilized society should have. That is what exists right now.
02:02Dr. Sayed, and I'll go right down the line to everybody. What should be the function
02:08of a sane, humane, cost-effective health care system?
02:12Doctor? I'd say it's to prevent the illnesses that can be prevented, treat the illnesses
02:18that can be treated, and to prevent the adverse consequences of getting sick in the first
02:23place.
02:24Dr. Messack?
02:25To look out for patients. That's the oath I take, and that should be the function of
02:29our health care system.
02:31Regardless of income.
02:32Amen. Yes, absolutely.
02:33Ms. Ward?
02:34To help all families and children thrive in any way that they can, the best way that they
02:38can.
02:39Dr. Chino?
02:40I think our health insurance system, our health care system, should invest in the American
02:44people, because when you invest in the American people, it will always pay out for you.
02:48Dr. Bai?
02:49I believe it should make all the stakeholders able to benefit themselves, and eventually
02:56that will benefit society as a whole. Everybody want to be rich. Through competition, then
03:01people innovate, and eventually drag down price and improve quality, benefiting all
03:05Americans.
03:06Dr. Polito?
03:07I think the goal should be to balance cost and the innovation that generates lots of
03:11health that we enjoy.
03:13I just read statistics. I think there is no denying, or somebody can deny it if you want,
03:20that our system is not only the most expensive, it is the most complicated, the most bureaucratic.
03:27Everybody in America spends half their lives filling out forms, arguing with insurance
03:32companies, all of which cost an enormous amount of money.
03:36Dr. El-Sayed, what is the solution for creating a simple, cost-effective health care system?
03:48We've heard a lot about providers and payers, and it's important for us to differentiate
03:52between those two.
03:53Health care providers are the doctors, the hospitals, the folks you see to get care.
03:57That should stay private. It encourages competition, and competition is good.
04:01But there is no innovation. There is no improvement on the insurance side. This is an industry
04:06that sits as a middleman between individuals.
04:09What is the function of the insurance industry?
04:11In theory, they're supposed to protect you from the financial consequences of getting
04:15sick.
04:16In reality?
04:17In reality, it's to make a lot of money for CEOs of large health insurance corporations.
04:20Dr. Misak?
04:22I agree. We have to cut out the middlemen in health care. There's way too much money
04:26floating around between patients and the health care providers that's never benefiting patients
04:31at all.
04:32Why is it, anybody jump in, that we are spending less than half as much per capita on primary
04:41health care than virtually every other major country?
04:45I think we all understand the function of a good health care system is to keep people
04:49healthy.
04:50What role do the insurance companies play? Do the insurance companies make any money
04:53by keeping you healthy?
04:54Dr. Chino?
04:55No, sir, they do not.
04:58Dr. El-Sayed?
04:59Yeah, I'll say as a public health official, this is a place of mass frustration because
05:06in theory we should, but we've made Medicare the insurer of last resort rather than the
05:10insurer that should cover you your whole life.
05:12And so what happens is any investment that they make in prevention early on is going
05:15to redound to Medicare's benefit. So there's really no incentive for them to invest upfront
05:19in keeping you healthy, but rather we have a situation where they're being subsidized
05:24over the long term, and so that prevention is not happening.