The Doctors Caucus
Floor Speech
BREAK IN TRANSCRIPT
Mr. CASSIDY. Thank you, Dr. Gingrey.
Now, Dr. Gingrey, I'm struck. Sometimes folks think that when we speak about health care, we're only speaking about health care. That seems kind of a simplistic statement. But let's think about it.
Right now, States are having these huge budget crises. We see in Wisconsin where there's a protest. We see in some States where there may be as much as a $10 billion budget deficit. In my State of Louisiana, there is a $1 billion to $2 billion budget deficit. And if you think about this a little bit deeply, you understand that this can be related to health care.
Now, specifically, for Medicaid. Medicaid, for those watching who are unfamiliar with it, is a combined program in which the State puts up some money and the Federal Government puts up some of the money, and with this it is used to care for the elderly, for pregnant women, for children, typically people of low income. Well, as it turns out, it is this program which is bankrupting the States. In a State, if you're paying this amount for health care and this amount for roads and this amount for education, as the amount for health care increases, you either raise taxes or you decrease spending on the other areas. Now, as it turns out, this has had tremendous impact.
Today, the Governor of Massachusetts came and spoke to one of our committees regarding the impact of their health care program, which is very similar to the bill just passed last Congress, in Massachusetts, and I was struck by what a nice view he gave. If you heard Governor Patrick speak--I didn't have a chance to ask him questions, but if you heard him speak, there's no problems with it whatsoever. But as I logged on and, say, read the Boston Globe, I learned different things.
First, I learned that Massachusetts, which has already implemented a program like this, the amount of money spent on health care has gone from 21 percent of the State budget in the year 2000 to 37 percent now. So from 21 percent to 37 percent is the amount the State of Massachusetts is now spending on health care. Well, you can only imagine the crowd-out effect that has on spending for other issues.
Well, the Governor again, as he went on and praised their program, said that there has been no problems paying for it. Well, as it turns out, and according to the paper, there's about a $1.5 billion to $2 billion shortfall in the Massachusetts budget. And in Massachusetts, the Governor of Massachusetts has said that the Medicaid spending is unsustainable. Hmm, that's different. So this is, if you will, the beta version of the Affordable Care Act--or as I call it, the unaffordable care act. This is the beta version of it, but it gives us an idea of what our future is going to be like.
Now, in order to deal with these costs--again, I'm quoting the Globe--it says that ``most recently dental benefits have been slashed for hundreds of thousands of Massachusetts Medicaid patients and they have lost access to their dentists.''
Now, by the way, the goals of health care reform are to provide affordable, quality health care that is accessible to all; but if you can't afford it, you eventually lose access. And I think what we found in Massachusetts is that the inability to afford is, of course, decreasing access. And it's not just the fact that these folks lost access to their dentists. Last year, folks who are recent immigrants to the United States who have been enrolled upon Medicaid in Massachusetts were disenrolled. So, if you will, this Massachusetts Medicaid program that has grown from 21 percent of the Massachusetts budget to 37 percent and still growing, now the cost is being controlled by denying access.
Now, we also mentioned a third goal of health care reform, which is quality care. You know, there's actually now concerns about the quality of health care afforded by Medicaid. If you will, there's a study recently reported in the Archives of Surgery in which someone looked at the outcomes of patients covered by Medicaid, Medicare, private insurance, or uninsured. As it turns out, they say, of all four groups, the cost and length of stay associated with Medicaid was longer than the rest.
Also, mortality rates--now, that's a way to say how many people die. Mortality rates associated with uninsured, Medicare, private insurance, and Medicaid was highest for Medicaid. So if you had Medicaid, you had a higher death rate from your hospitalization than if you're on private insurance, if you're on Medicare, and if you're uninsured.
Now, it's so counterintuitive that being on Medicaid is worse than being uninsured in terms of outcomes. Clearly, this is an issue that has to be studied further, but it certainly calls into question the very premise of using Medicaid as the basis for health care reform.
Just to make a point, under the Affordable Care Act--or the unaffordable care act--many people are insured; 20 million Americans are put on Medicaid as a way for them to be now insured.
And yet if we see that it's bankrupting States, it's clearly not affordable. If we see that because it's not affordable States are now denying access to care, as is the case in Massachusetts, and the care that is provided is of problematic quality, we can say to ourselves that this is not the basis for reform. It's like the antithesis of reform.
So I will yield back to you, Dr. Gingrey, just pointing out that this not only involves health care but also involves our ability as a State to afford other things, like roads and education. And to use that State government-Federal Government program as a basis for reform does not serve patients, does not serve the States.
BREAK IN TRANSCRIPT
Source