U.S. Sen. Maggie Hassan was the keynote speaker at an April 5 event co-hosted by The Concord Coalition and focused on improving the health care system, including federal, state and community strategies to address cost growth.
The program, “Health Care Costs: Key Federal and State Strategies,” also featured a panel of three health policy experts. The program took place at the Warren B. Rudman Center at the University of New Hampshire School of Law in Concord.
“Access to affordable health care is critical to the freedom, dignity and well-being of all of our citizens,” Hassan said. “It also contributes to a productive workforce and a thriving economy.”
“But right now, people across our state and country are being squeezed by rising health care costs that present a real danger to their health and their economic security,” she said. “It’s clear we must do more to bring down health care costs.”
Hassan said that citizens are struggling to have their health care needs met and “want Congress to focus on improving our health care system and making it more affordable and accessible for all.”
The senator discussed her efforts to address surprise medical billing, the cost of prescription drugs and the protection of quality and affordable coverage.
The panel that followed her remarks consisted of Joseph Antos, Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute; Trish Riley, executive director of the National Academy for State Health Policy and president of its corporate board, and John McDonough, professor of Public Health Practice in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and director of the Center for Executive and Continuing Professional Education.
Bixby set the stage in saying, “When we talk about the unsustainable trend of federal budget policy . . . programmatically, there’s really no bigger challenge than health care spending.”
Antos said, “The four or five major health programs that the federal government finances now account for the largest share of spending of all the major categories of total federal spending.”
“That’s not a good sign,” he added. “Spending money does produce health care, and it produces health care for more people, but we’re not doing it efficiently. . . It’s not just a question of information, it’s also a question of execution, and we’re not very good at either of those things.”
Antos used Medicare as an example, for which spending is expected to double over the next 10 years because of the aging population and increasing use of services. When it comes to health care cost growth at the federal level, he said, many ideas for reform have been known for quite some time -- “So, Congress, get to work.”
He asked, “When people talk about reducing health care costs, what do politicians mean by that?”
“Do they mean reducing your personal health care costs, do they mean reducing the system’s health care costs, do they mean doing this in an appropriate way, and do they mean doing this by actually improving efficiency to the system?”
“Be careful when you listen to a politician,” Antos said. “You’re hearing a lot of suggestions about subsidies without mentioning who’s going to pay for it; nobody seems to want to talk about hard steps.”
Riley shared how states have been reacting to and interacting with the health care system. “States have been the action place for a lot of health reform,” she said. “States spend a good deal of money on purchasing health coverage.”
“The more our health care costs to buy, the more it competes against other public needs -- transportation, infrastructure, education -- and the more conflict the states feel,” Riley said. “So, the imperative to deal with cost is very real.”
She said states generally engage in similar efforts to improve affordability for individuals and employers, such as increasing individual subsidies, cutting benefits, shifting costs by increasing out-of-pocket expenses or slicing reimbursement rates. “They are band-aids because they don’t address the root cause, which is cost,” Riley said. “The issue is price; we pay more for everything, period.”
“We have to consider the role of states, both as bully pulpits and as laboratories of innovation,” she said. “They have served that role many, many times. . . . States are where the action is and worth watching to inform the federal debate.”
McDonough provided context on where the health care system is right now and on the state of public health.
“Legislative efforts in Congress to repeal and replace the ACA (Affordable Care Act), at least for the foreseeable future, are dead,” he said. “There is a search for common ground . . . on drug pricing, surprise billing and more.”
“And we’re starting an important and compelling national conversation about the future of our health care system,” McDonough said.
He also discussed ongoing policy efforts by the Trump administration and in various states regarding the Affordable Care Act and Medicaid, as well as lawsuits related to health care that may reach the U.S. Supreme Court.
“Public health doesn’t get talked about enough, and it really needs to be,” McDonough said. “We have seen life expectancy in the United States drop for three years in a row.”
“We are the only developed nation . . . that is experiencing anything like that trend,” he said. “Back in World War II, Americans were the tallest people in the world, and also the slimmest.”
“Today, among advanced nations, we are the shortest and we have the highest body-mass index,” he added.
Listen to "Health Care Costs: Key Federal and State Strategies” in its entirety by clicking here.
Materials related to the speakers’ remarks can be found on the event page, here. The program was co-hosted by the Warren B. Rudman Center, the UNH Law Institute for Health Policy and Practice, and The Concord Coalition. It was sponsored by the Peter G. Peterson Foundation.