Doctor and former Oklahoma Republican U.S. Sen. Tom Coburn and believes Obamacare can be replaced, suggesting the Republican-controlled U.S. Senate and House look at two existing provisions within the law and the medical savings account concept — a measure President Donald Trump mentioned during the campaign.
Coburn spoke about the issue following his keynote address at the Fort Smith Regional Chamber of Commerce First Friday Breakfast, where he also spoke about the need for a Convention of States.
Of the federal healthcare law, Coburn said, “There is nowhere in the Constitution that gives the federal government the authority to run healthcare in this country. We’ve kind of forgotten that. It’s not in there. The original general welfare clause was not about providing healthcare.”
Using a cash-only Oklahoma City hospital as an example, the former obstetrician, who left Congress in 2015, said the hospital does 120 surgeries per day without taking insurance. “They’re all cash. They have people all over the country flying into Oklahoma City to have their surgeries whether it’s a hip or a knee or whatever. And they post their outcomes on their website. And if you have a complication from your surgery, it’s on them. They pay for it.”
A total knee replacement at the hospital is $6,900, he said, “and that includes therapy and everything else that goes with it.” He continued: “I don’t know what it is at Mercy or Sparks, but in Oklahoma City at the rest of the hospitals, the same treatment is about $35,000.”
Coburn said it made no sense that America trusts its markets in everything but healthcare.
“The consumer uses the markets in everything else, and the assumption of the federal government is that people are stupid. You can’t buy your healthcare. You can’t make a decision.”
HOW TO FIX IT
Coburn said there are two waivers within the ACA that could effectively be used to send healthcare back to the states for health insurance coverage and Medicaid.
“Combine both of those together. Then, create a medical savings account for everybody that earns under a certain amount, and create a payment in there the first two years that pays the deductible and premium for the first two years. Then give them the incentive that anything unspent in the deductible portion can be kept and rolled over.”
Turning to the Amish — a community for which Coburn said he delivered “500 babies” — he said they pay “about a third for healthcare from what everyone else pays because when they walk in, they want to know what the price is first before they’re going to let you see them.”
Referring back to the Oklahoma City cash-only hospital, Coburn said the decision to not take insurance reduces all overhead “except for the people who are giving direct care to the people that are there.”
MEDICINE AS ART, TRANSPARENCY, EXPERIMENTAL DRUGS
Coburn’s problems with the ACA and healthcare aren’t confined to cost. He also believes quality is going down because “40% of medicine is art” and not science.
“It’s knowing a patient, spending time with the patient, being able to be empathetic enough to where a patient will really share those things with you that actually get to the cause of a lot of their problems. We’re not taking the time.”
Coburn said concierge practices in healthcare have reduced the number of ordered tests by 75% than the average doctor because “they’re only spending about 45 minutes with you.”
“The number one axiom of medicine is, listen to your patient, and they’ll tell you what’s wrong with them. Now you may order tests to confirm that, but you’re not shotgunning tests all the time, which is part of the cost,” he said.
Coburn also said modern healthcare does nothing to address the issue of transparency in showing what insurance companies pay.
“Why shouldn’t we be able to see what everyone gets paid and what the outcome is — by doctor, by costs. If you had real markets in healthcare, you’d see a lot of changes and a lot of innovation.”
He continued: “The other side of that is you’ve got to reform the FDA. One hundred thousand people a year die in this country because the FDA inappropriately does not approve medicines that we know work and are safe. I’m a three-time cancer survivor, and I’m on an experimental drug now that the FDA won’t approve that MD Anderson gives to me anyway, kind of sticking their tongues out at them. And the fact is, they’re risk averse. If somebody’s dying of cancer, why shouldn’t they get to try whatever they want if they have a terminal disease? We can have an FDA and still have double-blind studies. But we can do it a different way.”
The average cost of a new drug is $2 billion, Coburn said, and that’s because “there’s not enough competition.”
“You take hepatitis C drugs. The first one that came out was $100,000 for a treatment. The second came out was $60,000. The third one was $40,000. When the other three or four finally get approved, it’ll be about $20,000 to cure a disease that is almost always going to lead to carcinoma and other diseases. The government is in the way.”