House Proceeding 03-23-09 on Mar 23rd, 2009 :: 3:00:00 to 3:09:25
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2:59:56 to 3:00:17( Edit History Discussion )

Ted Poe: that is dr. timur fi from the great state of pennsylvania, dr. murphy, i would like to give you an opportunity to talk about some of the issues that you have been focusing on, not just as part of the republican doctors use caucus but since you came to congress some 6 1/2 years ago. i yield to the gentleman fro pennsylvania.

3:00:00 to 3:09:25( Edit History Discussion )
Speech By: Ted Poe

3:00:18 to 3:00:38( Edit History Discussion )

Ted Poe: mr. murphy: i thank the gentleman from georgia, not only for your leadership and heal care but for your time here. we have many times discussed the issues involved in health care. and although i hear many people talk about the issue of accessible and affordable health care, very often the

3:00:39 to 3:00:59( Edit History Discussion )

Ted Poe: solution is offered in this body is more government. that is, health care is expensive, let's have somebody pay for it, the goth. medicare and medicaid is listed as, so much is spent there, medicaid, about $350 billion, and between medicare and

3:01:00 to 3:01:20( Edit History Discussion )

Ted Poe: medicaid and the v.a., almost half of the mandatory federal budget is spend, but the question is, are they effective are th have quality-based health care? i want to bring up a uple of issues and emphasize the importance of the doctor-patient relationship. i'm a psychologist and for many years worked as hospitals in

3:01:21 to 3:01:41( Edit History Discussion )

Ted Poe: the pittsburgh region in pediatric, maternity, and general medicine settings but always had a strong relationship in working with a wide range of physicians and other health care specialists, recognizing that it's letting a team do their work that you end up with significant savings in quality of care. let me talk about the ways that

3:01:42 to 3:02:03( Edit History Discussion )

Ted Poe: does our. new england health care institute noted that the u.s. spends more on health care than any other nation on earth. many times people talk about the negatives of our health care system, talking about higher rates of infant mortality, but there are concer about how that data is reached but i won't get into

3:02:04 to 3:02:24( Edit History Discussion )

Ted Poe: that now. what i do want to point out is out of this $2.3 trillion health care system, which is very expensive and gets in the way of a lot of families affording health care, one concern is perhaps 30% to 40% of the health care dollars are wasted. wasted. $6 billion to $700 billion is what's listed in the report.

3:02:25 to 3:02:46( Edit History Discussion )

Ted Poe: let me name a couple of things that go into this and if we let the doctor-patient re take supremacy over this and let doctors make decisions for what patients need, changes we might see. first of all, differences in treatments,

3:02:47 to 3:03:08( Edit History Discussion )

Ted Poe: including end of life care and heart bypass surgery, potential oy voidable cost of $600 million. misuse of drugs, $52 billion. overuse of emergency department care, savings could be $21 billion. overuse of generic anti-hyper tensives, potential savings $3 billion.

3:03:09 to 3:03:29( Edit History Discussion )

Ted Poe: the question is, why would these conditions exist? actually, government itself stand in the way in many cases. sometimes the way health insurance is set up. if the issue was instead that physicians could be the ones moving forward in this, i believe a lot of savings could take place. what i bel doing is finding ways to break

3:03:30 to 3:03:50( Edit History Discussion )

Ted Poe: down the barriers and help improve. one of the points we made by a number of doctors on the floor tonight is having more physicians involved. lelt having a health care home is imrtant. one of the health care homes for people has to do with having a community health center. community health centers provide great quality of care with a wide range of medical

3:03:51 to 3:04:11( Edit History Discussion )

Ted Poe: services, as my colleagues note. yet there is a shortage of physicians, in part because it's not the best-paying po physicians want to help. the strange thing about this is that in a wade range of health care areas, if you work at a community health center, your medical malpractice sturns is

3:04:12 to 3:04:32( Edit History Discussion )

Ted Poe: -- insurance is paid and if you volunteer, you're on your own. there's different kinds of malpractice insurance, not important to get into at this point, but we want to make it so physicians could volunteer so psychologists could volunteer but the government says, no, we can't let you do

3:04:33 to 3:04:54( Edit History Discussion )

Ted Poe: that. there's also areas in terms of how we could let disease management work. here's one of the strangest things that happened with medicaid. one group that has a great deal of problems is people with severe diabetes. the severe diabetic, if they have problems with their circulation, their feet, for example they might have their feet amputated. but isn't it sange that

3:04:55 to 3:05:15( Edit History Discussion )

Ted Poe: medicare and medicaid won't pay for that fission sis -- physician or nurse to monitor the patient closely to do more than just giving them a pamphlet, to keep them out of the homent, to make sure they get theiinsulin to make sure they're monitored for their weight, etc., we won't pay for that. we'll pay $50,000 for the

3:05:16 to 3:05:38( Edit History Discussion )

Ted Poe: tradge i think surgery that could have been avoided but won't pay money to help really manage the care. i might say, a recent study that came out that i believe was filled with flaws saying that disease mana questionable applications, unfortunately, focus on those who oftentimes had the most severe illnesses. as i'm sure many physicians here can attest, the real value

3:05:39 to 3:05:59( Edit History Discussion )

Ted Poe: is getting to the patient early rather than wait to the end. i know in my career as a psychologist, i have a patient who is now deeply depressed, suicidal, in-patient when you could have been working with them years before, it makes a big difference in the outcome. we have to make sure that the system that we allow here with health insurance and with physicians working with

3:06:00 to 3:06:21( Edit History Discussion )

Ted Poe: patients really allows a great deal of making sure the care is there. let me mention a couple of other things. recent legislation under the house set aside nearly $2le with to help physician practice have health information technology. a good idea. the question is how it's done.

3:06:22 to 3:06:42( Edit History Discussion )

Ted Poe: if the health information technology is paying for keeping hospital records on a computer, that's not enough. that's a passive system that only makes it a little easier to pull up records rather than wait for records to arrive. what we need is a smart, interactive system that is portable for the patient, so that record follows the patient, not the patient has to follow the record. we have to make sure it's

3:06:43 to 3:07:03( Edit History Discussion )

Ted Poe: private, confidentiality is protected. we have to make sure it's personal so the relationship between doctor and patient is what's paramount, that is the physician and information they're writing, whatever they have a diagnosis, that's a smart record that help prossvide doctor about best practices, about feedback, about prescriptions, and even about feedback of whether or not that

3:07:04 to 3:07:24( Edit History Discussion )

Ted Poe: patient got that prescription if they're following through. all those things which in today's world, because there's a shortage of physicians, and becausinsurance or medicare, medicaid, private insurance does not pay for having the physician work t with the patient that heth i.t. is one big expensive thing on the desk of the physician

3:07:25 to 3:07:46( Edit History Discussion )

Ted Poe: but not really providing the care they need. let me mention one other thing, point of care lab tests. the system we designed is one that because some physicians have been found, when theywn the labs, the concern was, were they overprescribing lab tests. i'd love to input from think colleagues on that they said, let's not allow physicians to do this at all.

3:07:47 to 3:08:07( Edit History Discussion )

Ted Poe: sometimes the most valuable thing is if the physician says, i need an x-ray, i need a lab test, my need this informati right away. instead think send the patient to the lab send the information out, when the best way to improve patient compliance is quicker information. even to allow, for example, pharmacies and drugstores to provide lab information would

3:08:08 to 3:08:28( Edit History Discussion )

Ted Poe: be more valuable. all this feeds into the system that part of the way to save billion in the system is to put the tools in the hands of those who provide the health care. make sure there's enough physicians, make sure they have the the tools they need as they diagnose, as they work with colleagues in the health care field that information is

3:08:29 to 3:08:50( Edit History Discussion )

Ted Poe: shared in an effective way that's personal, that's private, that's portable and actually that it's permanent too. these records are not lost when they move on to another health care plan or whatever they do in life. part of what we'reoing h at the -- as the g. pomplet's doctor's caucus, we are all gathered here to work on making

3:08:51 to 3:09:12( Edit History Discussion )

Ted Poe: sure we are developing patient-centered, patient-driven health care reforms based on quality, access, affordability, portability, and choice. over the coming month, you will hear from us continually speak about this because we believe we have a health care system that can be based upon those, can save massive amounts of money, can save hundreds of th needs to be our goal.

3:09:13 to 3:09:25( Edit History Discussion )

Ted Poe: not only to do no harm, but to make sure we put health care back in the hands of those making the health care decisions and in so doing, we go with the very thing people are raising co making health care more