| 00:00:08 |
Ryan, Paul - U.S. Representative, [R] Wisconsin
PAUL RYAN GAVELLED IN. >> WE'LL BEGIN. MADAM SECRETARY THANK YOU FOR COMING. I'LL BEGIN WITH SOME BRIEF OPENING REMARKS. FIRST OF ALL, I WANT TO...
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| 00:05:24 |
Van Hollen, Christopher - U.S. Representative, [D] Maryland
TO THE PANEL AND TO THE OTHER WITNESSES WE'RE GOING TO HEAR FROM LATER. I WANT TO COMMEND YOU ON TWO INITIATIVES YOU'VE RECENTLY UNDERTAKEN TO HELP...
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| 00:13:24 |
Sebelius, Kathleen - Secretary
CHAIRMAN RYAN, RANKING MEMBER VAN HOLLEN, MEMBERS OF THE COMMITTEE, I APPRECIATE YOU INVITING ME HERE TODAY TO DISCUSS HOW THE AFFORDABLE CARE ACT IS...
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| 00:21:49 |
Ryan, Paul - U.S. Representative, [R] Wisconsin
WHICH I THOUGHT WAS PRETTY MUCH HEAD ON WITH HIS REMARKS ABOUT MEDICARE. THE TRUSTEES YOUR CHIEF ACTUARY PROJECTS THE TRUST FUND GOES BANKRUPT IN 2024,...
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| 00:22:18 |
Sebelius, Kathleen - Secretary
FEE FOR SERVICE SYSTEM HAS INCENTIVES IN ALL THE WRONG PLACES. SO WE ARE OFTEN PAYING FOR CARE THAT ACTUALLY DELIVERS VERY POOR HEALTH RESULTS. IN FACT,...
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| 00:41:52 |
Van Hollen, Christopher - U.S. Representative, [D] Maryland
BEGAN ESPECIALLY AS THEY RELATE TO COST SHIFTING. BECAUSE THAT IS EXACTLY WHAT THE AFFORDABLE CARE ACT ADDRESSES IN MANY WAYS. WHEN YOU HAVE TENS OF...
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| 00:45:57 |
Sebelius, Kathleen - Secretary
PAID AT ABOUT 113% OF FEE FOR SERVICE AND WHAT THE AFFORDABLE CARE ACT DIRECTS IS THAT OVER TIME THAT ADDITIONAL PAYMENT, WHICH AMOUNTS TO ABOUT $3.30...
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| 00:55:48 |
Price, Thomas "Tom" - U.S. Representative, [R] Georgia
OF HEALTH CARE BEING ACCESSIBILITY AND AFFORDABILITY AND QUALITY, RESPONSIVENESS OF THE SYSTEM, INNOVATION OF THE SYSTEM AND CHOICES FOR PATIENTS,...
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| 00:57:05 |
Sebelius, Kathleen - Secretary
BY ENFORCING THE AFFORDABLE CARE ACT? >> NO, BY HAVING THE FEDERAL GOVERNMENT DETERMINE WHAT COMPENSATION IS PROVIDED IN THOSE CARING FOR PATIENTS....
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| 01:01:22 |
Schwartz, Allyson - U.S. Representative, [D] Pennsylvania
A BIG CONTRAST HERE. THE BIG CONTRAST, AND WE'RE TALKING ABOUT THE FUTURE OF MEDICARE, WHAT WE WERE WORKING ON LAST YEAR WHICH IS NOW LAW, I WANT TO...
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| 01:05:13 |
Sebelius, Kathleen - Secretary
RIGHT, AND I THINK WE'VE JUST STARTED DOWN THE PATH IN ADDITION TO IP NONNOVATIONS, AND I'LL TALK ABOUT THEM IN A SECOND. I THINK THE NEW TOOLS THAT...
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| 01:06:51 |
Stutzman, Marlin A. - U.S. Representative, [R] Indiana
UP AND RUNNING. WHAT HAVE YOU DONE TO SET UP IPAB AS A FUNCTIONING AGENCY? >> CONGRESSMAN, THAT
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| 01:07:02 |
Sebelius, Kathleen - Secretary
WORK HAS NOT STARTED. I THINK THE PRESIDENT IS CONSULTING WITH POSSIBLE CANDIDATES FOR THE IPAB BOARD, BUT THERE IS NO SETTING UP AN AGENCY BEFORE...
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| 01:12:01 |
Blumenauer, Earl - U.S. Representative, [D] Oregon
UP A COPY OF IT AGAIN JUST IN THIS SECTION, THAT THE PROVISIONS HERE DO NOT -- ARE NOT TRIGGERED BY THE IPAB UNLESS AND UNTIL CONGRESS DOES NOT DEAL...
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| 01:13:33 |
Sebelius, Kathleen - Secretary
OKAY. I WANTED TO GET THAT CLEAR BECAUSE I THOUGHT THAT WAS THE CASE. SO WHAT WE'RE TALKING ABOUT HERE IS JUST SIMPLY BEING ABLE TO HAVE THE SAME...
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| 01:17:17 |
Ribble, Reid - U.S. Representative, [R] Wisconsin
CARE; IS THAT CORRECT? >> THE INDEPENDENT PAYMENT ADVISORY BOARD -- >> NO, NOT THE INDEPENDENT PAYMENT ADVISORY BOARD, BUT UNDER THE AFFORDABLE HEALTH...
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| 01:17:42 |
Sebelius, Kathleen - Secretary
THIS? >> HOPEFULLY IN 2013 WHEN THE HEALTH CARE IS SET UP, YOU WILL HAVE THE ABILITY TO COME INTO A MARKET WITHOUT PREDISPOSED HEALTH CONDITIONS,...
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| 01:22:07 |
Yarmuth, John - U.S. Representative, [D] Kentucky
DOESN'T THE ABILITY OF COMPETITION TO -- OR THE POTENTIAL FOR COMPETITION TO REDUCE COSTS DEPEND ON A FULLY INFORMED, FULLY FREE NEGOTIATION ON BOTH...
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| 01:22:27 |
Sebelius, Kathleen - Secretary
STRATEGY IS. >> AND WITH REGARD TO MEDICARE PART D, I THINK VIRTUALLY EVERYONE HAD THE SAME EXPERIENCE THAT I DID, THAT MY CONSTITUENTS FOR A LONG TIME...
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| 01:28:06 |
Ryan, Paul - U.S. Representative, [R] Wisconsin
THEIR HEALTH CARE, THEM OR THIS BOARD. I WISH WE HAD MORE TIME TO GET INTO IT. THE MEMBERS WHO HAVE NOT YET HAD THE OPPORTUNITY TO ASK WILL BE FRONT...
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| 01:29:32 |
Ryan, Paul - U.S. Representative, [R] Wisconsin
FETER OF THE URBAN INSTITUTE. BECAUSE WE HAVE VOTES, IT LOOKS LIKE AT ABOUT 1:20, WE'RE GOING TO STICK TO THE FIVE-MINUTE RULE FOR OUR PANELISTS, SO...
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| 01:30:12 |
Holtz-Eakin, Douglas J. - President
RIGHT. >> THANK YOU, MR. CHAIRMAN, MEMBERS OF THE COMMITTEE. IT'S ALWAYS A GOOD DAY IN THE BUDGET COMMITTEE. YOU HAVE MY WRITTEN TESTIMONY. I WON'T...
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| 01:35:11 |
Turner, Grace-Marie - Founder and President
CONSTRAINED IF WE HAVE ANY HOPE OF GETTING OVERALL SPENDING UNDER CONTROL, BUT CERTAINLY THERE IS A QUESTION OF USING THE ADVISORY BOARD AS A TOOL....
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| 01:40:22 |
Feder, Judy - Professor
IPAB, WHICH I BELIEVE SERVES AS A GUARANTOR OF THE ACA, THE AFFORDABLE CARE ACTS, INVESTMENT IN ENSURING ALL AMERICANS' QUALITY CARE AT LOWER COST....
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| 01:46:01 |
Flores, William "Bill" - U.S. Representative, [R] Texas
MEDICAID AS PRIVATE SECTOR PENSION PLAN. >> WE KNOW THAT PART OF MEDICARE IS RUNNING A CASH FLOW DEFICIT.
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| 01:46:11 |
Holtz-Eakin, Douglas J. - President
PART B, C, D WEREN'T SET UP TO BE ON THEIR OWN FOOTING. SO WE HAVE SOMETHING WELL OVER 250 BILLION, CLOSE TO $280 BILLION FLOWING OUT OF GENERAL REVENUE...
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| 01:49:40 |
Feder, Judy - Professor
TO LIMIT HEALTHCARE COSTS. >> SO THE GOVERNMENT AND THE HMO. >> ACTUALLY THE GOVERNMENT DID INVENT THE HMO IN THE REAGAN ADMINISTRATION. THEY PROMOTED...
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| 01:51:12 |
Pascrell, William "Bill" J. Jr. - U.S. Representative, [D] New Jersey
TERMS, YOU HEARD THE DISCUSSIONS ABOUT THAT. VALUE BASED PURCHASING PROGRAMS, VERY FEW PLACES HAVE DONE THAT, WHERE IT'S BEEN DONE, IT'S BEEN SUCCESSFUL,...
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| 01:54:05 |
Turner, Grace-Marie - Founder and President
THE TIME ABOUT LIMITED RESOURCES, BOTH FINANCIAL CAPACITY AS WELL AS CAPACITY OF THE MARKET TO DELIVER. >> MAKE A CHOICE IF YOU CAN AFFORD IT, IF...
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| 01:54:29 |
Pascrell, William "Bill" J. Jr. - U.S. Representative, [D] New Jersey
HAVE THIS DISEASE, AND WE'RE NOT GOING TO COVER YOU. ISN'T THAT RATIONING? >> WE HAVE -- >> ISN'T THAT RATIONING? >> WE DID NOT HAVE A FUNCTIONING ...
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| 01:54:40 |
Turner, Grace-Marie - Founder and President
HEALTH SECTOR. PEOPLE SHOULD HAVE MORE CHOICES. AND THE MARKET WOULD PROVIDE THAT. >> IS THAT RATIONING, MR. CHAIRMAN? >> DOES THE GENTLEMAN WANT TO...
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| 01:55:02 |
Ryan, Paul - U.S. Representative, [R] Wisconsin
WOULD COUNT AS RATIONING. >> OKAY. WOULD YOU AGREE WITH THAT, MISS TURNER? >> HAVING THE
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| 01:55:12 |
Turner, Grace-Marie - Founder and President
GOVERNMENT DENY CARE TO SENIORS THROUGH PAYMENT POLICY WOULD ALSO BE RATIONING, YES, SIR. >> HOW ABOUT IF INSURANCE
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| 01:55:20 |
Pascrell, William "Bill" J. Jr. - U.S. Representative, [D] New Jersey
COMPANIES DENY CARE AND COVERAGE TO A YOUNG COUPLE 40 YEARS OF AGE WITH THREE YOUNG CHILDREN. >> ABSOLUTELY. WE NEED TO
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| 01:55:28 |
Turner, Grace-Marie - Founder and President
REFORM THE SYSTEM SO THEY HAVE MORE CHOICES AND OWN THAT INSURANCE SO THEY CAN MAKE THEIR OWN CHOICES IN A COMPETITIVE MARKETPLACE. >> THANK YOU. IT...
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| 01:56:00 |
Ryan, Paul - U.S. Representative, [R] Wisconsin
MR. CHAIRMAN. >> NEXT WE HAVE MR. MULVANEY. >> THANK YOU, MR. CHAIRMAN. AS A LIMITED GOVERNMENT CONSERVATIVE, IT IS HARD TO EVEN KNOW WHERE TO START...
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| 01:56:17 |
Mulvaney, Mick - U.S. Representative, [R] South Carolina
TALK ABOUT WHERE SHE STARTS WHEN SHE LOOKS AT IT, SHE STARTS WITH HER FATHER. IT GOT ME TO THINKING ABOUT MY THREE SIXTH GRADERS. I LISTEN TO THE LIST...
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| 02:00:08 |
Feder, Judy - Professor
INDEPENDENT BOARDS WHICH HAVE VARIED RECORDS. WE RELY ON A FEDERAL RESERVE TO MANAGE THE BANKING SYSTEM. WE HAVE SOME UPS AND DOWNS WITH THAT ONE...
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| 02:01:53 |
Moore, Gwendolynne "Gwen" - U.S. Representative, [D] Wisconsin
UNFUNDED LIABILITY. AND HOW YOU MIGHT RECONCILE THIS. YOU SAY THAT, YOU STIPULATE HEALTHCARE COSTS IN GENERAL, NOT JUST IN MEDICARE, MUST GROW MORE...
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| 02:03:12 |
Holtz-Eakin, Douglas J. - President
THINK FUNDAMENTALLY THE KEY DEFECT OF MEDICARE AND MEDICAID PROGRAMS IS THEY DON'T IMPOSE ANY BUDGET ON THE PROGRAMS. THEY ARE OPEN ENDED DRAWS ON THE...
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| 02:05:07 |
Feder, Judy - Professor
INNOVATION IN THAT AFFORDABLE CARE ACT THAT MANY OF THEM ARE UNTESTED INVESTMENT WHICH MAY HAVE BEEN WHAT THE ACTUARY WAS TALKING ABOUT. THAT THOSE ACTUALLY...
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| 02:07:01 |
Black, Diane Lynn - U.S. Representative, [R] Tennessee
BACK TO IPAB. AS AN ELECTED OFFICIAL AND ALSO SOMEONE THAT BELIEVES IN THE CONSTITUTION, I BELIEVE THAT THIS IPAB IS A VERY, VERY SERIOUS BREACH IN...
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| 02:09:34 |
Holtz-Eakin, Douglas J. - President
A BUNCH OF SMART PEOPLE THAT GIVE IDEAS FOR PAYMENT REFORM TO CONGRESS AND THEN YOU GUYS WILL TAKE CARE OF IT. THERE EXISTS SUCH A GROUP, CALLED MEDPAC....
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| 02:10:48 |
Turner, Grace-Marie - Founder and President
THE FORCE OF LAW, BUT THERE'S NO ADMINISTRATIVE OR JUDICIAL REVIEW, AND PROVISIONS GO INTO EFFECT UNLESS CONGRESS REACHES EXTREMELY HIGH HURDLES...
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| 02:12:13 |
Wasserman Schultz, Debbie - U.S. Representative, [D] Florida
SENIORS UNDER THE RYAN REPUBLICAN PLAN AS PART OF THE REPUBLICAN BUDGET. UNDER AFFORDABLE CARE ACT, THE DONUT HOLE IS CLOSED OVER TEN YEARS. THE...
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| 02:15:56 |
Feder, Judy - Professor
YOUR ASSESSMENT AND LET ME GIVE MY INTERPRETATION OF HOW THAT OCCURS. AS I INDICATED, THE VOUCHER IN THE REPUBLICAN BUDGET IS TAKING ALL THE REDUCTIONS...
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| 02:17:46 |
McClintock, Tom - U.S. Representative, [R] California
HAVE EVER KNOWN IT. >> COULDN'T AGREE MORE. STATUS QUO IS DANGEROUS TO THE BENEFICIARIES, THE BUDGET AND THE ECONOMY. WE HAVE TO CHANGE
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| 02:17:55 |
Holtz-Eakin, Douglas J. - President
DIRECTION. >> ONE THING SCARING LOT OF FOLKS IN MY DISTRICT ON MEDICARE, THEY ARE FEELING TRAPPED. FINDING IT HARDER TO FIND DOCTORS THAT WILL TAKE...
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| 02:22:46 |
Van Hollen, Christopher - U.S. Representative, [D] Maryland
ALL. I WANT TO SAY WE KNOW FROM CBO AND FACTS THAT WE HAVE BEEN SUBSIDIZING THAT ABOUT 114% OF MEDICARE FEE FOR SERVICE. WHAT I WANT TO DO IS PURSUE...
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| 02:28:10 |
Feder, Judy - Professor
THAT MEDPAC EVIDENCE. YOU HAD IT FIRST IN YOUR MIND. THE ISSUE I HAVE BEEN THINKING ABOUT, WHAT IS IT YOU THINK THE PRIVATE HEALTH PLANS CAN PROVIDE...
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| 02:29:09 |
Lankford, James - U.S. Representative, [R] Oklahoma
JUST NOT IN THE LAW. IN A MEETING ABOUT FOUR WEEKS AGO THAT FRESHMEN LEGISLATORS OF BOTH PARTIES HAD WITH TIMOTHY GEITHNER TO TALK ABOUT SOME OF THE...
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| 02:32:11 |
Holtz-Eakin, Douglas J. - President
DECISIONS. HAVING MADE THEM, THE EXECUTIVE BRANCH HAS RESPONSIBILITY FOR IMPLEMENTING THEM, CONGRESS HAS TO THEN TURN AROUND, DO THE OVERSIGHT. THAT'S...
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| 02:32:47 |
Feder, Judy - Professor
WHAT I THINK WHAT MISS WASSERMAN SCHULTZ WAS LOOKING AT, TO LOOK AT AND ASSESS WHAT'S GOING ON IN PAYMENT AND MAKE RECOMMENDATIONS, AND NOT SO DIFFERENTLY...
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| 02:34:22 |
Woodall, Rob - U.S. Representative, [R] Georgia
GRAY, IT IS NICE TO HAVE SOME CLARITY. TELL ME ABOUT WHAT MISS WASSERMAN SCHULTZ SAID BEFORE SHE LEFT THE ROOM. SHE SAID WE USED TO HAVE A COPAY...
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| 02:34:57 |
Feder, Judy - Professor
THE AFFORDABLE CARE ACT. SOME OF THAT HAS GONE INTO EFFECT FOR PREVENTIVE SERVICE, BASED ON THE PREMISE GETTING A CHECKUP, GETTING SERVICE EARLY ACTUALLY...
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| 02:39:37 |
Ryan, Paul - U.S. Representative, [R] Wisconsin
SHOWS A COMPARISON OF IN PATIENT HOSPITAL SERVICE REIMBURSEMENTS. RIGHT NOW, MEDICARE IS PAYING ABOUT 66 CENTS ON THE DOLLAR TO PROVIDERS. THAT'S WHERE...
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| 02:50:12 |
Feder, Judy - Professor
SECTOR WHEN YOU DO YOUR 30 CENTS ON THE DOLLAR OR 60 CENTS ON THE DOLLAR, THAT THAT DOLLAR IS SOMEHOW IMMUTABLE AS TO WHAT HEALTH CARE OUGHT TO COST....
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| 02:52:04 |
Turner, Grace-Marie - Founder and President
WHAT HAPPENS IN MEDICARE TODAY. PEOPLE GO TO EMERGENCY ROOMS TO GET ROUTINE CARE BECAUSE THEY CAN'T FIND A PRIVATE PHYSICIAN TO SEE THEM. AND I BELIEVE...
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| 02:53:54 |
Holtz-Eakin, Douglas J. - President
REMAINS THE CAPACITY FOR THE REST OF THE U.S. BUDGET TO TRANSFER TO MEDICARE ENORMOUS AMOUNTS OF RESOURCES AND THE ONLY FIGHT IS HOW MUCH OF THAT...
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NOTE: The transcript for this program was compiled from uncorrected Closed Captioning.