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Public Statements

Health Care

Floor Speech

Location: Washington, DC


Mr. COBURN. Mr. President, if the Senator will yield, one of the important points he made a moment ago is a doctor sitting down and listening to their patient. Mayo has it right. If you are not going to pay us enough to sit down, we refuse to practice medicine the way Medicare is directing us to practice: Listen a little bit and then cover it with tests.

The reason costs are out of control is because Medicare wouldn't pay for a physician to sit down and truly listen and come to a centered point on what the patient's problem is and the way to get around it. Consequently, what we have seen in the Medicare Program is doctors have to see so many patients that they don't get to listen to them and they consequently cover that lack of listening by ordering more tests.

What do we know about tests? We know we order $ 1/4 trillion worth of tests every year that aren't needed. There are two reasons we are ordering them. No. 1, the reimbursement to sit down to listen to the patient is so low the doctors can't afford to take the time to cover the test; and No. 2 is the threat of tort litigation. So now we are ordering tests not for patients, but we are ordering them for doctors. If we want to change health care, we have to drive costs down. I am proud Mayo recognizes we are not going to sacrifice our quality, so, therefore, we are saying: No, we are not going to take any more Medicare patients because we can't do it in a way that lends a quality outcome at an appropriate cost.

Mr. KYL. Mr. President, I remember sitting back in the cloakroom and listening to Dr. Coburn when he was talking about how he treats patients who come into his office. A child, he said, comes in who has had a fall on the playground and the parents, understandably, are very concerned. Dr. Coburn said to me: If I just sit down and talk to that young man, that child, talk to his parents for a while, I can usually figure out what kind of treatment is going to be necessary without necessarily ordering a bunch of tests. But under the medical malpractice situation we have to work under today, I am almost required to order those tests or, if something should go wrong, be accused of malpractice. I wonder if my colleague could relay that story.

Mr. COBURN. Every summer, we have thousands of kids hit the ER, whether they ran into a pole or they had a baseball bing them in the head. The standard of care now is to put that child through a CT scan. These are children the vast majority of whom have no neurologic signs whatsoever. But now we are not only spending that $1,200 per child, we are exposing those children to radiation they don't need.

So there are two untoward events for what has happened as we see the hijacking of medicine by the trial bar. No. 1 is we spend a whole lot more money unnecessarily, but No. 2 is we are actually now starting to hurt people by exposing them to radiation they don't need.

That is another cost. We know we can bring down costs if we change the tort system in this country to one that is sensible and reasonable and still allows, when doctors make mistakes, for them to be compensated for their economic damages and the harm that was caused to them. No one is saying we should eliminate that. What we are saying is, it should be appropriate and in a venue that represents the real risks without disturbing the practice of medicine because we cannot afford it, and the children who are getting these tests, their bodies cannot afford it. It is just common sense that we would go that way.

I wonder if the Senator will yield for a moment before we lose our time that I might discuss the amendment I am going to have up in a moment.


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