Bill Cassidy

Mr. CASSIDY

Mr. CASSIDY. The fact is that is misleading. And that is one thing I like in their plan and I like in our plan. I yield back.

Mr. CASSIDY. So next time someone gets up to the podium and says we don't believe that, that is incorrect; am I correct?

Mr. CASSIDY. Reclaiming my time, so if you will, what's being said by our colleagues across the aisle to misrepresent our positions, we absolutely favor insurance reform to allow folks with preexisting conditions to get coverage, correct? That's what you just said, correct?

Mr. CASSIDY. Reclaiming my time, you always give me these nice bridges to segue into. Some of the Republican alternatives--and you're actually addressing all of those very nicely. And if you're a member of Rotary, you can do that. Now, I like that. So can I call on my good friend, Dr. Fleming, if he can initiate some of the discussion of just what the Republican Study Commission is putting forth, not necessarily what Mr. Ryan has put forth or others, but even this step plan.

Mr. CASSIDY. May I add, that is part of some of the Republican alternatives that are being proposed. Allow those small business women and men to band together perhaps to purchase one of these empowering HSAs.

Mr. CASSIDY. Reclaiming my time, John, if I can ask you, those patients we talked about earlier, and maybe they haven't had the same educational opportunity, the same economic opportunity, but nonetheless, if gas were cheaper 3 cents a gallon on the other side of the interstate, do you think they would go over four lanes to get it?

Mr. CASSIDY. Reclaiming my time, for a similar-size family, similar benefits, with a health savings account costs are 30 percent lower relative to traditional insurance. Now, we've talked about and quoted David Brooks talking about the Congressional Budget Office comment that the plans being presented to us do not bend the curve; they elevate the cost curve. And yet here is something which has been proven--it's not a hope, but it's experience-- to lower costs by 30 percent.

Mr. CASSIDY. But now it's coming out of their pocket if they buy the expensive medicine as opposed to the insurance company.

Mr. CASSIDY. Reclaiming my time, you had a savings account for the patient, $4,200, that you put in there to help pay that high deductible?

Mr. CASSIDY. Dr. Roe, I think also you've had experience with putting patients in the middle with these health insurance plans. Can you relate that, please.

Mr. CASSIDY. Now, I like that because it puts the patient, the empowered patient in the middle so that she's making the best decisions not only for her wallet, but also for her health and, by the way, for her job because you are able to keep your costs down and keep her employed. Fair statement?

Mr. CASSIDY. Reclaiming my time, could she have used her HSA to buy the medication to help her get off of cigarettes?

Mr. CASSIDY. Reclaiming my time, you put a portion of that health premium into a bank account of sorts that the patient/employee then controls?

Mr. CASSIDY. Will you define what that is, please?

Mr. CASSIDY. Now, Dr. Broun, if I could reclaim my time, earlier, Dr. Roe had suggested--we spent the first half in kind of a critique of what our folks, our colleagues across the aisle, have put forward; but we've set aside our second half to kind of talk about what works. This is kind of a nice segue because I think, one, we know that lowering administrative costs will help, and we know that malpractice reform can also address some of these issues. I'll go back to the central theme, which has to be that any effective reform has to put the patient in the middle; and when you put the patient in the middle, you've got to give them transparent costs so they know what they're buying before they go in there, and you need to encourage them to make the lifestyle changes because, ultimately, a patient, she or he, is ultimately responsible for his own health. I know that, Dr. Fleming, in your business--because you're not only a physician, a congressman, husband, and a father, but you're also a small business man--could you relate your experience with health savings accounts? Perhaps define them for us and say how it worked in your small business.

Mr. CASSIDY. We just heard from our colleague from Arkansas that that's a critical thing to do.

Mr. CASSIDY. I'm sorry?

Mr. CASSIDY. If I can reclaim my time, Dr. Broun, as far as you know with the bill, how does the bill address tort reform?

Mr. CASSIDY. Reclaiming my time, I know there's supposed to be an ombudsman. In the 1,000-page bill, I've found one page that spoke of an ombudsman whom you would call up if you had a complaint. I guess the point I'm making about administration--I read an article in the McKinsey Quarterly. They said there are three things you absolutely have to do if you're going to control costs. You've got to decrease administrative costs. I look at that and it just gives me a migraine.

Mr. CASSIDY. I thank you for offering that. Reclaiming my time, Dr. Boozman, John, when you look at that, some patients aren't as sophisticated as others. Let's face it, some folks don't have the same education. Maybe they've had to struggle a little bit to get through life. Imagine if a patient had a problem with that and didn't have a counselor coming to them, as Dr. Broun mentions, but, by golly, they just have a doctor they don't like, don't get along with, and they want to complain to someone. Where would they complain?

Mr. CASSIDY. If I can reclaim my time, let's give credit where credit is due, because the advocates for a public option plan--I'm not an advocate of one, though--will point out that there's a decrease in administrative costs. So, Dr. Roe, will you look up at that chart once more--or maybe you will, Dr. Boozman--and give us a sense of what will be the administrative costs, do you imagine, with this publicly run health insurance plan.

Mr. CASSIDY. Thank you. Dr. Broun, you've joined us. May we have your thoughts on this, please?

Mr. CASSIDY. Reclaiming my time, 10 percent in Medicare, a generally accepted figure, is in waste and fraud. So we hear from our colleagues across the aisle that Medicare has lower overhead costs. If you include in that the 10 percent, which is a common way to define ``overhead,'' actually, that 3 percent becomes at least 13 percent. A fair statement. I think an economist would say, if your overhead is so meager that you can't watch out for fraud and abuse, then you need to lump the cost of the fraud and abuse into your overhead.

Mr. CASSIDY. Dr. Boozman, I would like your opinions on this. You're an optometrist from Arkansas.

Mr. CASSIDY. Reclaiming my time, let me just praise the motivations of the people in Tennessee. They clearly cared about the uninsured, as our Democratic colleagues, are. But it was a flawed model and couldn't be sustained, and we know that those patients were now uninsured again, probably worse off than before the experiment.