During a House Ways and Means Committee hearing held before the congressional recess, Rep. Greg Murphy (R-NC) questioned witnesses about the effect of mandates on Federal healthcare access.
Fuel your success with Forbes. Gain unlimited access to premium journalism, including breaking news, groundbreaking in-depth reported stories, daily digests and more. Plus, members get a front-row seat at members-only events with leading thinkers and doers, access to premium video that can help you get ahead, an ad-light experience, early access to select products including NFT drops and more:
https://account.forbes.com/membership/?utm_source=youtube&utm_medium=display&utm_campaign=growth_non-sub_paid_subscribe_ytdescript
Stay Connected
Forbes on Facebook: http://fb.com/forbes
Forbes Video on Twitter: http://www.twitter.com/forbes
Forbes Video on Instagram: http://instagram.com/forbes
More From Forbes: http://forbes.com
Fuel your success with Forbes. Gain unlimited access to premium journalism, including breaking news, groundbreaking in-depth reported stories, daily digests and more. Plus, members get a front-row seat at members-only events with leading thinkers and doers, access to premium video that can help you get ahead, an ad-light experience, early access to select products including NFT drops and more:
https://account.forbes.com/membership/?utm_source=youtube&utm_medium=display&utm_campaign=growth_non-sub_paid_subscribe_ytdescript
Stay Connected
Forbes on Facebook: http://fb.com/forbes
Forbes Video on Twitter: http://www.twitter.com/forbes
Forbes Video on Instagram: http://instagram.com/forbes
More From Forbes: http://forbes.com
Category
🗞
NewsTranscript
00:00Thank You
00:01Representative Kelly, you know, I find it interesting on our some of our documents
00:05I've been in medicine now for 35 years and I'm looking at some of the documents here and I know this is absolute Greek to
00:12my fellow
00:13colleagues who don't know that who this what this is what a sniff is what a long-term care facility and truth be told it's a
00:19Little Greek to me because whenever I'm in a hospital and the most in my field urology we do mostly outpatient stuff
00:27but we still
00:28sometimes do long-term if we have to do cancer therapy somebody needs long-term care or we consult on somebody that needs long-term care and
00:35then if you look at the
00:38The tyranny of what our government has done in the rule after rule after law after law
00:46No wonder the medical system in the United States is screwed up. No wonder it is because if you have so many different
00:54Regulations when I was chief of staff of our Medical Center thousand bed level one trauma center
01:00We had during my three-year tenure
01:03three different rules about how an outpatient person would be
01:08Categorized whether they're overnight whether they have to stay two nights in a hospital whether they can go to a sniff or you literally have
01:15to keep them in a hospital an extra two days just so that they'll qualify for some of these things and this is where I am
01:22Beyond a static that we have a president and a government that is actually willing to step back and look at this nonsense
01:29Because frankly before I came to Congress when I once I got here
01:33I said I would go down to CMS which by the way
01:36Nobody's been in the parking lot for the last four years
01:38That I'd go down and fire a third of the people
01:41Because it is rule after rule after rule created so that they have something to enforce and I say this not only on the
01:48Hospital side, but I also say it on the physician side in our practice
01:51We have grown and grown and grown
01:54Individuals to try to put laws or to try to enforce
01:58Regulations that were put forth by the government you you look at all of these things
02:02There's no stability in this whatsoever. And if you look at the number of
02:07Folks who are now employed by the hospital
02:09There are administrators and you compare the growth of them versus the growth of actually the people who take care of this
02:16Why is this Delta occur? It is because of CMS. It is because of government and mr. Carlson. I'll go back
02:23You know you talked about the nursing home
02:27Mandate there's so many
02:29Disqualifiers if we could find the nurses in any corner of the country
02:34We'd be happy to do this
02:35But we have beds at our institution that are closed that are desperately needing to be open because we have folks sitting in our emergency
02:42Room for 36 hours waiting for beds because we don't have nurses. It's fine
02:46I'd want that higher level of care, but we literally number one can't find them and two can't afford them
02:52I'll go back to some of the
02:55You know other remarks that were made, you know in North Carolina
02:59from April to September of last year at least
03:04360 patients were medically cleared for discharge
03:07But did not have appropriate post-acute care placement, so what happens they sit in the hospital
03:14They sit in the hospital and what happens not only did they get nosocomial infections
03:18They get infections from other people ding ding ding it rings up the bill miss Graber
03:22I have a question for you in a second. You know look I think Medicare Advantage is making a steal on everything here
03:28I'll agree with mr. Blockett on the other side of the dais here Medicare Advantage will start with a great intention
03:34But it's absolutely
03:36Determined that they're going to steal the taxpayer dollar hand over fist and United Healthcare is the number one offender from what's happening
03:44From my vantage point and I think a lot of the federal agencies also the average wait time for the patients that I talked about
03:51Mr. Chairman can I continue okay average wait time for the patients was 73 days
03:5973 days for these 360 people
04:0251% of the patients waited over a month 25 per se did three months three months to two years
04:08Guys, I love the concept of home health because I think that's where care is done best if at all possible
04:16Miss Graber and I was astounded by the numbers that you gave about the profit margins of some of those
04:22And I look at the the problems here
04:24We're trying to actually get the physicians to not get cut more and more from pay that have happened over the last 20 years
04:3162% of medical beneficiaries Medicare beneficiaries were waiting for a skilled nursing facility placement
04:3844% had serious mental or substance use disorder
04:42So the system is broken for all those crying out that we can't do this to Medicaid
04:47We can't do this. This system is broken one to three years. We're going to have a financial insolvency of our country
04:55Medicaid desperately needs to be reformed all the cuts and all the scare tactics from the other side of the aisle
05:02Patients are still going to be cared for but if the by the administration
05:06Finally would let us audit the Medicare Medicaid rolls, which they didn't do for four years
05:11We would get people off the Medicaid rolls that don't deserve eligibility
05:15Our psychiatric hospitals in North Carolina had the longest wait times whatsoever
05:21197 excess days
05:23So we have a problem with getting people from the hospital to the care that they need
05:29For every three Medicare beneficiaries waiting in a hospital two
05:33Out of the three are involved involved in a Medicare Advantage plan
05:37the largest three ma apply plans denied prior authorization quest for post acute care level at
05:45higher levels
05:47Than did any other types of care? So yeah, maybe our
05:53Free-for-service Medicare needs to be fixed
05:55But good Lord our Medicare Advantage plan needs the the wrath of God to come down and fix that system
06:01Miss Graber in your view
06:03Let me ask you this if you're a hospital administrator if you're a physician if you're a nurse administrator
06:09What do we do to streamline both?
06:11discharges and prior authorization requirements
06:15because there's an entire cottage industry that we have to alert our
06:19Our nurse managers when we think that patient's going to be able to leave
06:24I mean heck as soon as I put scalpel down. It's like when is the patient leaving? So tell me how we streamline that process
06:30Thank you so much for the question. One of the things that you mentioned
06:34I believe you referenced the three-day stay requirement in an inpatient facility
06:39That's required before Medicare coverage into a skilled nursing facility. I think this is a perfect example of
06:46Something that is in statute that is really causing some of these issues on an inpatient basis
06:51So I I totally share your concern regarding this specific rule to repeal that rule could be very cost
06:59Prohibitive. So what you need to take what do you mean? Can you explain that?
07:04The the reason the rule is in place is because it prevents
07:09switching of benefits between Medicare and Medicaid and
07:13And
07:14So to control fee-for-service utilization that rule is in place to push down utilization
07:19We keep people in the hospital longer. Yes, so they're at more risk for DVT nosocomial infections, etc, etc
07:26that is the unintended consequence of the policy that's and that costs more money because it makes people sicker and get some guess what they
07:32Stay in the hospital. Yes, and your point is well taken the way that the Congressional Budget Office
07:37Unfortunately looks at that they're all right
07:39Don't even say CBO around here because I don't believe anything they say sorry about that
07:43The way that they sort of consider that they they probably would assign a pretty cost prohibitive score to repeal that rule
07:51Because that is their perspective on that particular policy
07:55You may want to also consider the revenue to go along with that to offset it
07:59And that's why I described things like the three-day stay as a regulatory relief
08:04You could possibly generate the revenue from a unified PAC PPI, but that's when people are given DRGs. They're paid for this diagnosis
08:11They're staying in the hospital. It could be three days. It could be 300 days. The hospital still gets stuck with that bill
08:17So, how do we cut down the regulation? How do we cut down the the burdensome administrative paperwork?
08:25We take up an axe to it and this is where CMS again
08:29This is what this government has done. And this is Republican and Democrat problem
08:33This is what's happened in every agency and this is why I'm so glad we're finally having a reset of our government is to look
08:40Back and say this is ridiculous because it's add-upon add-upon add-upon add-upon
08:45Things just don't make sense for patients or the people who care for them anymore
08:50I'm glad I appreciate everybody's
08:53Remarks today. I hope we get to the point where we're not just making remarks
08:57But we're actually fixing what is a badly badly broken American medical system. Thank you. Mr. Chairman. I yield back