The Senate health committee has landed on a policy to ban surprise medical bills through a cap on the pay physicians, hospitals and air ambulances can collect for out-of-network care. The panel's chair, Sen. Lamar Alexander (R-Tenn.), formally introduced the policy Wednesday as part of a bipartisan legislative package aimed at lowering costs in hospitals and across the healthcare system. He is planning a committee vote on the legislation next week. On Tuesday, the committee held a hearing on the 165-page discussion draft of reforms, and there have been some tweaks in the final bill.
Senator Alexander sat down earlier with Guy Benson to discuss the bipartisan piece of legislation.
Guy Benson [00:00:00] Happy hour time on this Wednesday. Thanks for joining I am Guy Benson pleased that you are here with us. Also pleased that we can welcome back to the show Senator Lamar Alexander a Republican of Tennessee. He is the chairman of the Senate Health Education Labor and Pensions Committee which is a mouthful. We're going to focus on the health part of that because there's news today as he joins me on the program. Senator great to have you back.
Sen. Alexander [00:00:25] Thank you Guy. Congratulations on your show.
Guy Benson [00:00:27] Thank you very much I appreciate that. So you have a new piece of bipartisan legislation on health care that was introduced today. You were kind of breaking some news here with a committee vote coming up June 26. Tell us about the lower health care costs act of 2019.
Sen. Alexander [00:00:46] Well it answers this question that I hear almost every day. Tell me exactly what you can do to reduce the amount I pay for health care out of my own pocket. That's different than the Obamacare debate. And what we've been able to do is spend the last six months focusing on the fact that about half of all the spending on health care in this country according to experts of the National Academies is unnecessary. So we've agreed with nearly three dozen provisions from 16 Republicans and 14 Democratic senators to try to reduce those costs it ends surprise medical Billings. That means each after you go to the emergency room you won't get a bill for three thousand dollars. Two months later it encourages trade.
Guy Benson [00:01:31] Hang on. Let me just take this piece by piece so you talk about ending surprise billing. Yeah. How does that work though. Because if you if you show up in an emergency room or you go to the doctor I'm now accustomed to if I go see a doctor at some point a bill is going to show up in the mail is a little bit nerve wracking How big is this bill going to be. How do you change that. How do you allow people to still pay what they owe without this sudden amount showing up in an envelope.
Sen. Alexander [00:01:58] Well one provision another provision in the bill says you have to get your bill within 30 days. That's the first thing. But the second thing is today in some cases we have what's called an out of network physician a physician it's not a part of a hospital's network and that physician might be called in to be a part of an emergency room procedure. And as a result of that about one out of every five times somebody visits an emergency room they get their bill for what happened to the emergency room and then two months later they get the bill for the doctor who was called in that they didn't know about. So after we're through with this bill that won't happen anymore it's all going to be taken care of at the front end OK.
Guy Benson [00:02:38] That makes sense to me as something to aspire to another piece of this bill and a big component is what you call additional transparency when it comes to the costs of actual health care. This makes a lot of sense right. Because I think in a lot of ways it's a black box you show up. You get your care and then they spit out some number. This is what you owe us. You have no idea why there's no menu of prices generally of of procedures or what things should cost you just pay what they tell you to. How do you increase transparency. Because I think that feels like a no brainer.
Sen. Alexander [00:03:11] Well it is but it's important and there's seven provisions to do that I'll give you an example there. Last year Congress passed a new law by Senator Collins that eliminated and banned gag rules that prevented a pharmacist from telling you when you get your prescription drug what's the cheapest price would be. Sometimes it's cheaper to pay out of your own pocket than it is to use your insurance card. To do that. But there was a a gag clause in the contract with the pharmacy that prevented the pharmacy from doing that we get rid of a number of other gag clauses and anti-competitive provisions that exist in the law today to try to make sure that people have an easier idea of knowing what their health care costs really are. It's hard to lower your cost if we don't know what the cost is.
Guy Benson [00:04:02] That's right. No that's definitely true. And part of it also when it looks at when we're looking at prescription drugs and how to bring down the cost of prescription drugs that's a big issue for a lot of people again. Senator These are not necessarily sexy issues that are great rocking talk radio topics are going to light up the phone lines but it is an issue that matters to every single American in. You look at polling it's in fact the top issue for many many Americans. How can I make health care more affordable. That's what you're trying to do with this new bill the lower health care costs act of 2019. Talk about the prescription drug competition a piece of this.
Sen. Alexander [00:04:39] Well here's an example of that there are nine provisions in our bill that introduce more competition into the purchase of generic drugs. You know 90 percent of the prescription drugs you buy are generic drugs. They're they're not the brand name drugs they're supposed to be cheaper but the brand name manufacturers want to slow that process down and they've been using gimmicks to keep generic drugs from getting into the market. We eliminate a number of those gimmicks which will make prescription drugs cheaper. So if you have more transparency you have more competition. If you don't have a surprise bill come three months after you go to the emergency room all those things will reduce the cost of health care paid for out of your own pocket. And that is pretty important to the American people.
Guy Benson [00:05:26] No it definitely is. I guess my only concern about the prescription drugs element is if you are if you're making it much easier for generic drugs to flood the market and therefore it be cheaper for people. That's definitely a benefit. There's no question. But could that have the unintended effect of reducing the incentive for the drug makers to engage in expensive R and D research and development to come up with new drugs. Their argument would be we pour in all of this money trying to come up with new drugs and invent new solutions to help people live better and survive various diseases. If all of that labor is going to then be just sort of farmed out to anyone to take the technology or the formulas that we develop. Is it really worth all those investments? What's your your response to that potential criticism.
Sen. Alexander [00:06:16] Well we have provisions in the law for that. I mean the manufacturer of a drug may as you point out spent billions of dollars to develop a new way to identify Alzheimer's before symptoms. And it may fail or it may succeed. But in exchange for that money they get a long term exclusive patent which could be up to 20 years so they can sell what they invent for. For a long time at the higher price and then at the end of that patent the generic generic drug or what we call a biosimilars comes in. So we believe that we're not changing those laws. We're just trying to keep the laws from being abused. We want the drug manufacturers to have their patents but when the patents over we want their products to be cheaper and available at the drug counter for the people in this country.
Guy Benson [00:07:11] Senator Lamar Alexander you're talking about this new bipartisan piece of legislation that it's going to the committee markup and vote later on this month. It is separate and apart from the whole Obamacare repeal and replace debate which sort of seems to have stalled among Republicans after the failure in the last Congress. I'm curious about your your thoughts on a Medicare for all there's a poll that I talked about earlier. Two polls actually out showing that the vast majority of Democrats who are most likely to support Medicare for All or single payer health care believe falsely that people could keep their private insurance or their employer based insurance under the bills that are currently introduced in the Senate and the House by Bernie Sanders and some of the more progressive wing of of congressional Democrats. That's not true. It would actually go along right.
Sen. Alexander [00:08:01] No no it's not true. The first thing I do if I'm in McMinnville Tennessee and I'm speaking to the Rotary Club I say everybody here who gets insurance on the job raise your hand and most of the people room raise your hand and then I say all right Medicare for all takes that insurance away. It's gone. And they're shocked by that and then I say how many of you are on Medicare and that's most of the rest of them. And I say and how would you like to have one hundred eighty one million Americans who have their insurance on the job taken away dumped into your Medicare plan which is going bankrupt in five years according to the trustees. So as soon as people find out that the insurance they get on the job and that's one hundred and eighty one million Americans is taken away by Medicare for all the support for Medicare for all goes way then.
Guy Benson [00:08:46] Yeah it plummets for obvious reasons Senator last question we have about a minute left. You announced a number of months ago that you were not going to seek re-election in 2020. So you are looking at the exit. You see that on the horizon you have a year and a half left in the Senate. Have you changed your approach at all to how you want to serve the people of Tennessee and serve in the U.S. Senate over this final stretch of your career in the Senate now that you have that date in mind. Does this change your outlook at all?
Sen. Alexander [00:09:13] The short answer is No. Mean what I try to do here is I try to work with senators like Patty Murray she's a Democrat. She's a tough negotiator but she's the ranking Democrat on our committee. And when we can get 30 Republicans and she can get 30 Democrats to agree on something that's good for the American people. We try to put it out there and make a lasting contribution and we did that fix by fixing No Child Left Behind. We got rid of the common core mandate. We did that with 21st Century Cures. We did that last October where the opioids bill the president Trump said was the most important response to a public health epidemic in history. And we're doing that with the lower health care costs Bill. We hope to do it by updating the higher education act and making it cheaper for students to get their federal aid to go to college and simplifying their. Student loans so that's always been my process here. You know it's hard to get here. It's hard to stay here and while you're here I think it's a good idea to try to get some results.
Guy Benson [00:10:07] Now it sounds like you've got quite an agenda ahead for the next year and a half and you're gonna be putting your nose to the grindstone over that period trying to work across the aisle and get some stuff done in the lower health care costs act of 2019 is the latest Project Vote's coming up in the committee next week. Senator Lamar Alexander of Tennessee really appreciate your time.
Sen. Alexander [00:10:26] Thank you Guy. Thanks for your time.
Guy Benson [00:10:28] You got it.