Boyle Opening Statement at Hearing on "Breaking Up Health Care Monopolies"
WASHINGTON, DC —Today, Pennsylvania Congressman Brendan F. Boyle, Ranking Member of the House Budget Committee, delivered opening remarks at a Budget Committee hearing on “Breaking Up Health Care Monopolies: Examining the Budgetary Effects of Health Care Consolidation.”
(Click for video of remarks as delivered)
Ranking Member Boyle’s remarks as delivered:
Thank you, Mr. Chairman, and thank you for holding this hearing today. When I first saw that you were holding a hearing called ‘Breaking Up Monopolies’, I said, my God, Jodey's becoming a Democrat. This is great. I welcome that with open arms — the road to Damascus.
But I have to say, I appreciate his thoughtful approach, in general, but then specifically to this issue because it is so complex and frankly, if there's an area that it's hard to categorize as left or right, it is the enormity that is our health care system.
As we look and take a step back at where we are right now in the United States in 2024 when it comes to health care, first, some good news that I hope that we all should be able to cheer.
First, the national uninsured rate hit an all time low in American history last year with a record breaking 21.3 million Americans signed up for health care coverage under the ACA. That is, whether you call it Obamacare or originally, Romneycare, the idea at long last has become popular and has worked.
It is one piece of the larger piece of our rather hybrid health care system. Some people are on a direct government provided health insurance such as the VA. Some have health care provided, insurance, through Medicare and Medicaid. Some on the exchanges, which of course, I remind everyone again, pool together private plans. And then, of course, the biggest piece of all are the employer provided health insurance.
So we have had very good news. I hope people saw the New York Times article a couple months ago showing that actually health care costs came down far greater in the last decade than anyone projected. So that is, clearly good news that we can celebrate and it's why we can't turn the clock back and have to make sure that we preserve the gains that have been made.
At the same time, as we take a step back and look at the whole system systematically, we spend approximately 17.5 percent of our GDP on health care in the United States. Germany, the UK, Canada, France: they’re all below 10%. So we are spending a much higher percentage of our GDP on health care than any of our peer countries.
And we aren't necessarily getting better health outcomes for those dollars. Why is that? How can we do better there in terms of getting essentially a better bang for our buck and bringing down the costs? Now, as we move forward, in looking at this and specifically the consolidation in the industry that's happened over the last 10 years, we have to realize it's not just patients that are in the industry, but it's providers.
And a lot of times it is physicians and providers that are being affected, indeed adversely affected, by this dramatic consolidation. You know, doctors who just want to be able to, to have a standalone practice who are finding that more and more difficult. Theirs is a perspective that also needs to be listened to.
It is obviously a crucial part of the health care system. So I hope this is the first of a number of hearings that we will have in this realm. We all know that as we look toward the early part of the next decade, we run into funding issues when it comes to the Medicare trust funds. We are going to clearly have to be looking at ways in which we can become more efficient, when it comes to Medicare.
Yet, at the same time, make sure that by, a cut here and a cut there to physicians and doctors, we don't create a death spiral in which we reach the point in which providers actually just want to opt out of the system altogether. Let’s be wary of death by a thousand cuts as we're looking to making the Medicare trust funds solvent for the next generation.
I'm confident that we can do that. I end where I began: when you look at all of our peer countries, they have different kind of systems. UK and Canada is more government run: the government has the hospitals, the physicians are government employees. I think there are very few people in the United States who would think that that's an appropriate model for the U.S. that would work.
You have other hybrid type of systems though: France, Germany, Japan, where the government plays a stronger role in providing insurance for everybody. But it's the private sector, doctors and hospitals are private within that system. Whichever model you choose, all of them seem to be spending less and are spending less on health care than we are in the United States.
So focusing on what we can do to bring down costs, be more efficient, and ultimately provide better outcomes for all in the system, most especially patients, is what we need to do as a country. And with that, I'll yield back.
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