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Public Statements

GOP Doctors Caucus

Floor Speech

Location: Washington, DC


Mr. DesJARLAIS. I thank the gentleman for yielding.

And you're absolutely right. I moved to start my practice in Tennessee in the fall of '93, and our program, TennCare, was implemented somewhat as an experiment in '94, January '94. So I witnessed it from its inception through what I would call its continuous failure.

The program continued to grow and expand, continued, as I think you referenced earlier, as substantiated by Senator Lamar Alexander, has drained our State's educational resources. And it got so bad that, in 2007, Governor Bredesen actually had to remove about 270,000 people from the program just to keep the State from going bankrupt.

So clearly, it was an example of how the program and the system does not work and did not work. And that's maybe a glimpse of what we can expect to see moving forward with the President's health care law. So it failed to accomplish its objectives, and just as we would have suspected, the costs grew exponentially. And so we have a great example in Tennessee of how the system does not work. So clearly, we need alternative reforms.

I would be happy to yield to the gentleman from Georgia, Dr. Broun.


Mr. DesJARLAIS. Thank you for yielding.

I just want to expound on your comments and on, actually, what the gentlelady from Wyoming talked about in terms of the efficiency in her study, where they could actually buy a policy for those cheaper than what the Federal Government has implemented.

We were promised better access to care at a lower cost with the Affordable Care Act, and the TennCare program in Tennessee really was an experiment of nationalized health care confined to one State. What we found was that more and more physicians, as you stated, were dropping out of the TennCare program because of reimbursement issues and also because of the bureaucracy and the frustration with trying to find specialists.

I had a primary care practice, and I actually had to hire an extra staff member, which drove up my costs, to sit after hours to try to find specialists to take care of these patients. It was very frustrating for us. It was very frustrating for them. Yet the reimbursement, compared to a privately paid patient versus a Medicare patient versus a TennCare patient, continually was less money.

Mr. HARRIS. So what you're saying is that you had patients under TennCare who had insurance cards. You just couldn't find anyone to take care of them.

Mr. DesJARLAIS. Right, which is exactly what we're going to see under the President's plan. You're going to see people who allegedly now have access to care, but they really don't because the reimbursement rates are so low that physicians really aren't even able to keep their doors open. The reimbursement rate for a TennCare patient in Tennessee was almost half of that from a private patient. It's not that physicians don't want to help and take care of these people. They do. It's just financially unfeasible, especially in solo practices, which are common in rural areas.

Mr. HARRIS. You may or may not be aware of the study done early last year that showed that, actually, whether patients have private insurance or no insurance or Medicare or Medicaid, when you compare the outcomes, Medicaid patients have the worst outcomes. In fact, they are 93 percent more likely to die of their illnesses than patients with private insurance. They were more likely to die than even patients who had no insurance. I don't know. Is the gentleman aware of that finding?

Mr. DesJARLAIS. I have heard of that study as well. Again, I think it is an access to care issue, and that's certainly a problem that has not been addressed.

The ObamaCare law does nothing to address access to care, and it does nothing to address the cost of health care. Frankly, we all know that the cost of health care is driving our national debt, so we need to look at solutions that have been offered by the Republican caucus and the Doctors Caucus that will make real reforms to health care: that will make it more affordable and involve a greater attempt to get government out of the way. Just like in small businesses, the number one complaint is that government bureaucracy is driving down the profitability. It remains the same in health care as well, and we need to look at more free market options in health care if we're going to actually reduce costs.


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