[Congressional Record (Bound Edition), Volume 159 (2013), Part 3]
[House]
[Page 4003]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     REFORM OUR HEALTH CARE SYSTEM

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Illinois (Mr. Quigley) for 5 minutes.
  Mr. QUIGLEY. Mr. Speaker, I rise today to call for continued reforms 
to our health care system. The Affordable Care Act was a huge step in 
the right direction, but we can do more because the path we are on is 
unsustainable.
  The U.S. spends approximately 18 percent of its GDP on health--close 
to twice as much as other developed Nations--and yet we don't have 
better health care outcomes. Health care costs are rising faster than 
inflation and wages, meaning they are eating a larger portion of 
Americans' paychecks and the government's budget.
  If we continue on our current path, the Medicare trust fund will be 
insolvent by 2024. And Medicare and Medicaid will grow from 24 percent 
of the Federal budget to almost 30 percent, crowding out other needed 
investments.
  We have to reduce health care costs in both the private sector and 
the public sector in order to ensure America remains competitive in the 
global market. But there is a right way to reform our health care 
system and there is a wrong way. With all due respect, Mr. Ryan's plan 
is the wrong way.
  Mr. Ryan's plan for Medicare and Medicaid misses the point. His 
solution simply shifts the costs from the government to patients, 
rather than reducing health care costs. Under the Ryan budget, seniors 
would pay as much as $1,200 more each year by 2030, and $6,000 more by 
2050. For over half of Medicare beneficiaries with incomes less than 
$21,000, a $1,200 increase is a huge piece of their budget.
  He also proposes block-granting Medicaid, which would cut Medicaid 
funding by approximately $700 billion over the next decade and result 
in 14 to 19 million people being kicked off Medicaid, many of them 
children and seniors.
  These steps might make the budget look better, but they do nothing to 
actually reduce the cost of health care, and they hurt patients. We can 
reduce health care costs without harming beneficiaries.
  Here are five steps we should take to reduce health care costs the 
right way:
  First, and most importantly, we have to change the way we pay 
providers. Right now, we pay for each individual test and surgery. We 
pay for quantity rather than quality of care. Providers across the 
country are adopting payment for quality models, but they need 
Medicare, the largest payer, to get on board and pay for quality as 
well.
  The Centers for Medicare and Medicaid, or CMS, just completed a pilot 
where it bundled payments for 37 procedures and reduced spending by 10 
percent. This needs to be replicated across the board, and CMS needs to 
move the majority of its patients to physicians off fee-for-service 
over the next 10 years.
  Second, CMS needs to restructure and expand competitive bidding. It 
just completed a competitive bidding pilot for durable medical 
equipment and was able to reduce prices by double digits. While I have 
some concerns about the structure of that competitive bidding program, 
I believe it does need to be restructured to prevent suicide bidding 
and expanded to include more medical tests and services such as lab 
tests, CT scanners, and other items.
  Third, States need to be empowered and incentivized to reduce their 
health care costs. States like Arkansas have taken bold steps to reduce 
their health care costs by requiring their two largest insurers and 
their Medicaid program to join a shared savings plan. They are expected 
to save the State's Medicaid program $4.4 million in FY '13 and $9.3 
million in FY '14. We should be encouraging other States to follow the 
path of Arkansas and reduce Medicaid costs and improve care.
  Fourth, we have to modernize Medicare cost sharing and ask a bit more 
from those who can afford it. We should combine Medicare part A and B 
deductibles and cap them. We should increase means testing for premiums 
for part B. And we should limit first-dollar coverage for high earners. 
We have to protect our sickest seniors from high costs while asking a 
bit more from those with greater means.
  Finally, we have to improve price and quality transparency. We should 
prohibit gag clauses, which currently prevent hospitals from sharing 
health care pricing information. Without pricing transparency, 
hospitals can't negotiate for the best price for medical devices and 
physicians can't make cost-conscious choices for their patients.
  We do have to reduce health care costs, but there is a right way to 
do it and there is a wrong way. Mr. Ryan's plan is the wrong path. It 
harms seniors and fails to reduce underlying health care costs. By 
pursuing the five proposals I just outlined, we can reduce costs and 
improve quality, strengthening both our budget and our citizens.

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