[Congressional Record Volume 166, Number 19 (Wednesday, January 29, 2020)]
[House]
[Pages H642-H643]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               PAIN IS THE PRICE OF AMERICA'S HEALTHCARE

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Louisiana (Mr. Abraham) for 5 minutes.
  Mr. ABRAHAM. Mr. Speaker, the $3 trillion healthcare industry 
continues to crush the middle class. Americans are paying more than 
ever and getting ever less as they struggle to access care. The cost of 
care for both workers and employers is outpacing wage growth.
  What drives the cost of care in America today is lack of 
transparency, consolidation, and overregulation that is leading to 
administrative glut. The time is now to confront these cost drivers. 
President Trump has addressed these exact issues in recent months.

[[Page H643]]

  Obtaining coverage has allayed the fears as costs rise, yet coverage 
itself keeps costs hidden and high. Our opaque, third-party payment 
system has obscured the true cost of receiving care from patients and 
physicians alike.
  Prices are rising with no end in sight. We see examples of it every 
day, people who believe they are covered because they have insurance 
only to find out that, in some cases, they are just as vulnerable as 
those who are uninsured. The current system allows people who have 
insurance to end up paying more for a CT, for example, than if they had 
just paid cash.
  This process and complexity of billing can allow this to happen. This 
lack of transparency in our healthcare system is a culprit, and it 
harms patients, physicians, pharmacists, and others who rely on it.
  Consolidated hospital systems, the completely unregulated 
pharmaceutical middlemen, PBMs, and the insurance companies that are 
tied to both hospitals and PBMs have been increasingly profiting. These 
corporate giants have no motivation to offer transparency and 
discounts.
  Costs remain deliberately hidden until the patient receives a bill. 
The number of healthcare administrators has grown more than 4,000 
percent between 1970 and 2020. Consequently, spending on healthcare has 
increased 3,200 percent.
  Is there any other conclusion than to tie rising costs to 
administrative glut? No. Administrative glut is largely to manage the 
regulations that our government has put in place, regulations that make 
healthcare more complex than the tax code. It is past time to cut the 
glut.
  Medicine's malignant mergers, both vertical and horizontal, are 
creating behemoth healthcare systems like CVS, where insurance 
companies, PBM, pharmacy, and drive-by clinics are all together. This 
leads to patients being forced to go somewhere to receive their drugs 
and, in some cases, are told that they have to purchase brand-name 
drugs even when the generic equivalent is available. It is not about 
what is a better deal for the patient but what is a better deal for the 
PBMs and their ilk.
  Americans are paying more than ever for coverage that limits their 
choices and doesn't always provide them access to care. The bloated 
bureaucratic special interests must be unveiled and Americans must 
educate themselves on cost drivers to forge sustainable solutions.
  We need to focus on returning to a patient-centered healthcare 
system. Some people are starting to do this with things like direct 
primary care, which provides the patient with an array of services for 
a fixed cost that is actually transparent.

                              {time}  1030

  We need a system that allows patients to choose and fosters 
competition. The only way we are going to get a system like that is by 
shining a light on the shadows of our healthcare system. The answer is 
not more government, not more regulation but, rather, a concerted 
effort by Congress to bring our healthcare system out into the sunshine 
and to allow our sunshine to shine on these hidden practices; these 
practices are actually causing our prices to go up. No longer can we 
allow patients to bear the brunt of this complicated and very, very 
complex system.
  The time is now to follow healthcare's money trail, unwind existing 
laws, or enact new laws that demand cost transparency, cut 
administrative glut, stop consolidation, and bring regulatory relief. 
Your health depends on it.

                          ____________________