Collaboration a Key to Driving Down Healthcare Costs, experts say

Nov. 28, 2018

Senate hearing strikes collaborative tone after divisive midterm elections

by Kip Dooley

WASHINGTON — Lawmakers on Capitol Hill, still divided on federal healthcare legislation nearly a decade after the Affordable Care Act was passed, turned to local leaders Wednesday for input at a Congressional hearing.

Government officials and healthcare providers from across the country testified before the Senate Committee on Health, Education, Labor and Pensions on how healthcare providers, insurance companies and patients are collaborating to create innovative local solutions to problems that remain divisive and intractable on the national level.

Although the GOP and Donald Trump won back the White House in 2016 in part on a wave of anti-Obamacare sentiment, the Trump Administration’s recent efforts to undermine Affordable Care Act policies have become increasingly unpopular, and midterm polls showed that a majority of voters viewed healthcare as the election’s most important issue — and trusted Democrats more than Republicans to create viable solutions.

“We heard from voters across the nation…[who] soundly rejected the Republican strategy of sabotage,” said Ranking Member Patty Murray (D-Wash.) in her opening remarks. Chairman Lamar Alexander (R-Tenn.) registered disagreement with her, pointing to Democrats’ refusal to vote on Republican-led efforts to reduce healthcare costs last year, but struck a more conciliatory tone, saying he was hopeful about new bipartisan solutions.

For their part, the hearing’s witnesses avoided partisan commentary altogether.

Dow Constantine, executive of King County in Washington state, outlined how his administration convened patients, businesses, healthcare companies, and hospitals to design a high-quality, low-cost plan for county employees. The plan was one-third the cost of traditional plans, and saved the county $46 million over a five-year period, he said. Harvard’s John F. Kennedy School of Government awarded King County with its Innovation in Government award in 2013. “Our story illustrates that to succeed in moving forward with a more affordable, high-quality, and prevention-oriented healthcare system, you need partnerships,” he said.

Dr. Lee Gross, a physician from North Port, Fl. discussed the small network of insurance-free primary care clinics he created with colleagues to make basic healthcare services more affordable. Insurance companies make primary care more expensive than necessary, he said, by bundling them in plans with far more costly services like end-of-life care and long-term rehabilitation. “You don’t insure gasoline for your car. You don’t insure light bulbs for your home. Yet we’re using an insurance vehicle to pay for the most basic aspects of medical care delivery.”

He said the insurance-free primary care network has drawn patients from across the state and even the country, and estimates there are now over one thousand similar practices nationwide.

When asked by Sen. Lisa Murkowski (R-Alaska) whether his model would benefit rural areas with limited access to healthcare, Gross pointed to a rural surgical hospital that recently joined their network. The resulting increase in patients pursuing voluntary surgeries at the hospital helped keep its doors open, he said. “Even a ten percent increase in margin for a hospital like this is huge, it’s the difference between staying open and closing.”

Wednesday’s testimony was the most recent in a series of hearings held by the committee on making healthcare more affordable. “One fact that was very clear to me in all of our hearings is that all stakeholders — all of them — need to be involved in bringing costs down,” said Ranking Member Murray.