This view breaks the statement into its steps and names what each one does.
Mr. President, Procedure · 43 wordsI have been coming up here and talking about, well, a couple of things. How much does healthcare cost? Right now, people watching from the Gallery, people watching at home, people who happen to be in here--all of us are experiencing a commonality, ProcedureClaims · 7 wordswhich is that healthcare is incredibly expensive. Procedure · 6 wordsBy the way, you may say: ProcedureAside · 9 wordsNo, I have great insurance. It pays for everything.Aside Claims · 8 wordsNo, that is coming out of your wages. Aside · 5 wordsYou are a successful businessman.Aside Claims · 21 wordsThe people you employ, when you buy them insurance, that comes out of their compensation otherwise, and that is a reality. Reasoning · 24 wordsThe more you pay for health insurance, the less you get paid in your pocketbook because it is coming out of the same bucket. Procedure · 17 wordsBut if you are one of those who are just having a hard time making it happen, ProcedureClaims · 38 wordsif we look at the things we think of as being expensive-- utilities, entertainment for the family, car payments, groceries, college tuition--it just keeps on climbing--a mortgage. More expensive than all for a family of four is healthcare. Reasoning · 4 wordsThat is our problem. Claims · 43 wordsSo I have been trying to address it with something that I call the MVP agenda. We, under this plan, would give up to $2,000 to a family of four in a prefunded health savings account, 1and you add that to price transparency. Positioning · 16 wordsSo money in your pocket with value for the patient--the MVP plan. It seems really ambitious, PositioningProcedure · 17 wordsbut let me just put a little bit more of a point on why this is important.Procedure Claims · 10 wordsThe average family is carrying $10,000 in credit card debt.2 Procedure · 4 wordsNow, think about that--$10,000.Procedure Claims · 19 wordsA family is not paying that off every month. It turns out they are paying the minimum balance due. Procedure · 5 wordsHow do we know that?Procedure Claims · 54 wordsBecause the percentage of income going to credit card interest has almost tripled over the last number of years.3 They are paying the minimal amount and carrying greater and greater debt in order to make ends meet. Well, they are not really making ends meet; they are just trying to get by right now. Reasoning · 62 wordsSo that is what is stressing the importance of having a plan that actually addresses their needs, not some abstract ``Oh, can’t we do it in the by and by, and it may make some indirect difference.’’ No. You can directly help a family by putting money in the pocket and coupling that with price transparency to bring value to the patient. Procedure · 6 wordsNow, I have some good news.Procedure Claims · 72 wordsWe did something today in HELP Committee, the committee which I chair, called the Price Tags Act--Patients Deserve Price Tags.4 Roger Marshall and John Hickenlooper, Senators from Kansas and Colorado, came together for a bill, 5which my staff helped to put together, and we passed it out of committee, 6and it is the Patients Deserve Price Tags, which is price transparency for the goods and services you purchase in the healthcare arena. Procedure · 11 wordsNow, let’s put a little bit of a point on this.Procedure Anecdote · 115 wordsI suspect the Presiding Officer has gone into a restaurant where they don’t have the price on the menu. It is like a five-star French restaurant, if there are that many stars, and the waiter doesn’t tell you the price. If you ask the price, he looks at you like you shouldn’t belong there. If you have to ask the price, you can’t afford it. Usually, if that is the case for my wife and me--in fact, always--we excuse ourselves after having a couple of crackers, and we say: Thank you very much, but we have a crying baby at home. We look a little bit old for a baby. Well, it is a grandchild.Anecdote Procedure · 3 wordsThe point being: ProcedureReasoning · 13 wordsIf they are not telling you the price, probably you can’t afford it. Claims · 40 wordsNow, audience, people watching, anybody here, when is the last time you went to a hospital and you said ``Show me the price. Show me the price.’’ It just doesn’t happen. Do you know there are actually laws out there? Procedure · 5 wordsBut I can tell you, ProcedureClaims · 24 wordsif you ask ``Show me the price,’’ you are going to cause confusion. Now, I am a doctor. I have been in this environment. Aside · 7 wordsI always kind of admire--kind of chuckle.Aside Claims · 9 wordsI am a gastroenterologist. I used to do colonoscopies. Anecdote · 118 wordsSo the patient is there. He has been prepped, which means that his colon has been cleaned out and he has been having diarrhea for about 6 hours. He has a gown on that covers everything but the derriere, a thin sheet above him. And he is given a lot of pieces of paper to sign, and at that point, he has the ability to ask ``How much does this colonoscopy cost?’’ Now, that is--you are beyond the point of no return. You are not going to find actionable items, if they are even able to give you the price, at that point. You have already ordered at the French restaurant where they don’t show you the price, AnecdotePositioning · 25 wordsand they are bringing the food to the table, and by golly, you are going to pay for it no matter how much it is.Positioning Claims · 64 wordsBut we have passed the Patients Deserve Price Tags Act, and that means that now, the patient is going to be told how much something costs. If we have a health savings account or if you are just paying cash or in some way you are responsible for the goods and services that you are purchasing, you are going to be told the price. Procedure · 7 wordsWhy is that? Why is that important?Procedure Claims · 39 wordsA cardiologist friend told me recently--a couple of years ago, actually--of a cardioversion for atrial fibrillation. If you did it in the doctor’s office, it costs you $130; 7if you did it in the hospital, it costs you $13,000. Reasoning · 58 wordsNow, would it make a difference to someone, if they had a $4,000 deductible, to know that they either pay $130 if they went to the doctor’s office or they pay the full deductible and the insurance company pays more but they pay 20 percent of that more if they went to the hospital? I think it would. Claims · 14 wordsSo price transparency lowers the cost of being insured and increases wages over time. Procedure · 10 wordsBy the way, let’s get back to our restaurant metaphor.Procedure Anecdote · 122 wordsWhen you go and they don’t tell you the price, you kind of have a sense that no matter what you order, you are going to come out substantially poorer. But you are a little bit tight. You go in--you know, maybe when I was a teenager on a date, this was more common--and I can order the surf and turf with the lobster and the filet mignon, and it is going to cost me four times what the spaghetti costs. Now, depending on my budget, I may decide to get the spaghetti. I still have a great meal, still walk away full, nutrition is all satisfied, but because I had the price, I was able to control how much I spent.Anecdote Reasoning · 20 wordsThat is what price transparency does, and the Patients Deserve Price Tags Act begins to give them that price transparency. Claims · 7 wordsNow, by the way, that promotes competition. Reasoning · 38 wordsIf you know that if you get your colonoscopy here it is $1,000 and if you get it over there it is $5,000, I can promise you that the place charging $5,000 is going to lower the price. Claims · 24 wordsAnd the patient with the prefunded health savings account--remember, in the MVP plan--they will have money in their pocket. They have an extra incentive. Anecdote · 63 wordsI use the example of the woman whose child has an earache. She says: Hey, Siri, which urgent care center near me has the best afterhours price for an appointment for an earache? Well, here, it is $50; there, it is $250. She is going to go where it is $50, but the one that charges $250 is going to lower their price.Anecdote Procedure · 5 wordsNow, the advantage of this: ProcedureReasoning · 77 wordsIf you combine the money in the pocket, where they have the prefunded health savings account, with the price transparency, you begin to lower the price of being insured. The patient has the money in their pocket, but now, with the Patients Deserve Price Tags Act, they can spend that money wisely. Instead of that money put into their health savings account being something that people just rebuff, instead, it is something that they can spend wisely. Claims · 14 wordsBy the way, they can also begin to purchase a more affordable insurance policy. Procedure · 21 wordsThe Presiding Officer probably, in his businesses, gives a ``You can choose option A or B or C for your insurance.’’Procedure Claims · 14 wordsIf you choose the option with the higher deductible, then the premium is lower. Reasoning · 59 wordsIf we have put $2,000 into your health savings account, you can choose that higher deductible because the first $2,000 is covered, and that higher deductible means that you have a lower premium. The business owner saves money. He can use it to increase wages. But the employee saves money because their share of the premium is likewise less. Procedure · 8 wordsSo I try to put it this way: ProcedureReasoning · 30 wordsIf you have the Patients Deserve Price Tags Act and we are able to put money in the pocket and the patients choose the more affordable plan, they pay less. Aside · 17 wordsAnd if you look at the amount of money going to someone’s salary--can I see that one.Aside Claims · 55 wordsThis is the total compensation package that someone gets when they are employed. Now, some of it goes to payroll taxes. That is a fixed portion. That is going out of your income. There is nothing you can do about that. Your benefits--principally, what you pay for your health insurance-- is the next biggest slice. Reasoning · 23 wordsThe more healthcare costs, the more bread you spend on benefits. The less your healthcare costs, the more bread goes into your salary. Aside · 18 wordsNow, for those people who grew up in the sixties, ``bread’’ was the word they used for ``money.’’Aside Procedure · 8 wordsSo think about this as being something literal: ProcedureReasoning · 55 wordsYou have more money in your pocket not just because we have put money into your health savings account but because, as you pay less for insurance, you have less money to pay out of your pocket for the insurance, and the more money you get to keep to live the rest of your life. Claims · 9 wordsWe have been talking about people’s wages not growing. Aside · 1 wordsBoom.Aside Reasoning · 29 wordsThat is how wages start to grow again. They begin to shrink the amount going for benefits, which increases the amount somebody has for the rest of their life. Procedure · 13 wordsNow, let me just go back to the Patients Deserve Price Tags Act.Procedure Claims · 70 wordsThis is the most expansive, aggressive, comprehensive, patient-focused, business owner-focused piece of legislation for price transparency that has ever passed in Congress.Unearned certainty If we pursue further healthcare bills--for example, reconciliation--we can move the ``money in your pocket’’ portion, but this would stand on its own--a bipartisan piece of legislation that passed almost unanimously out of committee today and which would benefit almost every American who has got employer- sponsored insurance.8 Positioning · 6 wordsIt is a huge first step.Positioning Promise · 6 wordsWe will reconcile with the House, Claims · 34 wordswhich has passed their own version of price transparency.9 This administration has been very aggressive promoting transparency. I am pleased to say that a significant portion of the MVP agenda passed out of committee; Promise · 28 wordsit is going to be headed to the President’s desk soon; Vague promiseand, most importantly, individuals will have more money in their pocket and better coverage for their health.
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