Health care and other issues as well. We will begin with health care. Ll call has the headline Head Health Care overhaul appears unlikely before the Midterm Election. Guest the biggest cost of health care the Biggest Issue is the cost of health care. It is time to start working on the true problem whether you get health care through medicaid, medicare, through your employer, or one of the health care plans, we have to work, cost of health care. We will have to start working on it. I had several conversations yesterday with other doctors in congress on how to fix it. We also want to go back this semester and work on fixing the obama pools. Set up value pools in every state. Host what is feasible . Also this headline gop may skip the budget, knee capping 2018 ambitions. Republicans are unlikely to annex their agenda, in other words, try to repeal more of the Affordable Health care act. Guest i think it is time to, to focus on metro problem the cost of health care. The true problem, the cost of health care. One fourth of our budget is being spent on health care. Lets fix health care. Host you are saying then, we shouldnt try anymore to repeal the Affordable Care act. Just focus on the cost . How do you do that . Guest i am in favor of repealing the Affordable Care act. It is the worst professional nightmare i have been through as a physician and as a person who has helped run a hospital. I am in favor of getting where the Affordable Care act, but to answer your question, how do we drive the cost of health care down . I think there are three basic principles. Transparency, innovation, and consumerization. Transparency each state should set up a website to show the cost. Every physician, hospital, pharmacy, would put their cost and outcomes for every procedure. Number two is innovation. If government would get out of the way, innovation would do more to drive the cost of health care down more than any bill i could write. Consumerization is placing the consumer in charge letting the consumer have access to the transparency, giving every person a Health Care Savings account. Whether you purchase your health care through medicaid or through the exchanges, give everyone an account. Those pencils will drive the cost of significant. Host do you have the backing of leadership . When would you get this done ahead of the Midterm Election . Guest certainly things move slowly, we have been talking about this in the caucus now since the day i got here. Every wednesday morning geticians in congress together and discuss problems like this. Were meeting privately with physicians, nurses in congress, trying to great momentum with them. A group called republican main street i expect they will come out with a position. I understand the next step would be leadership to show leadership we have the votes to do that. Host you call the Affordable Care act a nightmare, but heres this headline from the Kaiser Health network that despite acaressed sign up period, enrollment nearly matches last year. Certainly it continues to be popular. Guest it is not popular in my district. The kaiser model is different. They have 39 hospitals to take care of millions of patients. Kaiser does lots of things right. To compare them to the Affordable Care act is certainly apples and oranges. The Affordable Care act is a nightmare for physicians. More physicians and nurses quitting than ever before because of the paperwork generated by the Affordable Care act. Via for the character has done more to drive the cost up in health care that i think ive ever the Affordable Care act to drive the cost up in health care than anything ive ever seen. Host roger marshall, also former physician, here to take your questions about health care. Lets begin with robert in horseheads, new york. A republican. Robert, youre on the air. Caller ok. My thing about the Affordable Care act is that when it was in place i get my primary care through the v. A. There are bills in both the house and the senate to result the issue of resolve the issue of agent orange for bluewater sailors. It is held up in committee. I heard they have a goldlevel obamacare plan that receives federal subsidies that cover 72 of the premier, so they pay about 28 of annual Health Care Premiums through pretax the notion, but have access to free or lowcost care through the office of the attending physician and free medical Outpatient Care at the mattel is this military facilities at the military facilities in the d. C. Area. This seems a gay good deal, but one of the reasons you want to repeal the eighth at this all seems like a good deal, but one of the reasons you want to repeal the aca even if it is repealed, you will enjoy many protection such as preexisting conditions and the protection under 26 protection. But 20 million other americans will not have these protections. For these tax cuts i am 61 years old, and i am deathly afraid no pun intended about what it is going to do to he future of medicaid. You guys are making it worse. Guest linda, to buy so much for the question. To your point, this is why the representative from arizona introduced in the house passed a bill that said whatever the rest of the country gets congress will live with the exact same health care policy. I acknowledge the points you made. You taught me some things. I did not know we had free access to outpatient surgery. That is good to know. I will have to double check that. I want to address these people that dont have Health Insurance. Certainly the Affordable Care act did not fix the problem. There are still 6 Million People that chose to pay the fine rather than get Health Insurance. A 7,000 deductible is like having no Health Insurance at all. We need to address that problem. How do we start driving the cost of health care down . The number one concern of Small Business today is the cost of health care. Host i want to get your reaction to this piece trump secret plan to scrap obamacare. According to a document that had not been public now, it appears that while the effort looked chaotic, officials developed an laborate plan to undermine the law regardless of whether congress repealed that and the document lists 10 executive actions the Trump Administration plans to take, and they included calling for stricter verification for people that try o set up outside of the open enrollment period, cutting the ignup period in half, and giving states authority to determine whether insurers had to cover the full range of benefits required by obamacare, and whether their network of doctors were sufficient. Those policies were among seven in the play that have been in limited. Four of the ideas and a portion of the fifth have been publicly proposed but not yet finalized the document was shared. The Obama Administration opposed. What do you think . Guest the number one problem is the cost of health care. The obamacare regulation 20,000 pages of regulations. President trump was committed to rolling back those regulations and make health care for efficient. I am not sure i can agree with everyone of those ideas, but his intent was to roll back egulations, and already back home i have hospitals calling me saying thank you for slowing down the regulation. Host how does that lower the cost of health care . Will they pass on those savings of deregulation on to consumers . Guest i sure hope so. I think it is the first step in rolling back the cost of doing business for a hospital. I know in our own hospital, as obamacare came online, we had to hire your four more people to keep track of the paperwork and statistics. That added to our cost of doing business and took nurses away from seeing patients in our own office we had to get by with patients. In our own office we had three nurses, and suddenly i needed five nurses. It turned nurses and doctors into Computer Data entry people, driving up the cost of health are. Host jim is in connecticut. A democrat. Caller i am listening to your guest, and i have to say i am covered under the affordable are act in connecticut, and it is a beautiful system for anyone that wants to receive Affordable Care through the exchange. O rece care through the exchange. The guest has stated this increase in paperwork that i think is garbage rhetoric. An oath of office to enforce and defend the laws of the country. The Affordable Care act is the law of the land, and republicans and many other people have done absolutely nothing about upholding this really good law that helps a lot of people. Ruleshere are a lot more under the Affordable Care act and the we increased the umbrella that protects everybody whether you are covered through the exchanges or through workerfunded health care, or through medicaid, and possibly even medicare. The umbrella is a lot wider. More people are covered through this really good law that was passed, and i really find it host jim, still there . Caller challenging that you folks dont do a better job of trying to fix it. Guest jim, thanks for your comments. You called my comment about increased paperwork data entry garbage. I respectfully disagree. I have lived this for the last 25 years of my life. On an average visit i spend my time mostly looking at a computer computer screen rather than looking at a patient, and i think you will find that situation over and over again. Certainly, i am concerned about these individuals that dont Purchase Health insurance through their employer, through medicare, medicaid, or the v. A. It is about 7 of the population. The Obamacare Exchanges are crashing. Theres nothing i can do to save them. That is why i think we need these value pools. Each state needs to set up high risk posted take care of people like yourself, and not only a pool, but an insurance pool at the federal level. 10 of the people use about 90 of the health care dollars. Those people, especially these people in these value pools, need a concierge, a doctor, nurse practitioners, to walk them through this complicated Health Care System so they get better care and more efficient care. Lets talk about solutions. I respectfully disagree the exchanges work. They simply did not work. They have not improved health care. They have not improved access. It is one more broken piece of the system. The new exchanges that are coming online look like medicaid. The reimbursement that these new exchanges have are going to look like medicaid reimbursements to hospitals and physicians, shifting more and more the cost of health care on the backs of employers. Small businesses are already paying about 2 3 of the health care dollars. Guest we will go to kentucky host we will go to kentucky. Romney, a republican. Caller the biggest problem is the price. 50 for aspirin. Dont have nurses doing paperwork. Have keepers at 10 an hour. Host lets talk about that kid what about the price of 50 for aspirin . Guest i understand what you are saying. Even though you get this bill that says the hospital charges 50 for an aspirin. Blue cross, medicare, medicaid, they could care less what the cost is on a breakdown. They are reimbursing on a diagnostic code. They could say an aspirin cost 2,000, but medicares still only going to reimburse a certain amount of dollars to that hospital for a hip replacement. I understand your point. Lets talk about solutions again. If there was total transparency a website that would say we do mris of the knee for x amount of dollars in other hospitals would say it place their prices, it would not matter how many aspirants you got before the mri, but there is a set price for it, and if we allowed the consumer access to that the American Consumer would figure it out. Host monica. New york. Independent. Good morning to you. Stephen. A democrat. You are on the air. Guest good morning, stephen. Ow are things in new york . Caller i am not in new york. I am in south carolina. Host we moved on. Caller we are still doing the same thing, not doing anything by talking about Affordable Care act. If we were talking about the way americans eat, we will be talking about health care cost. Or cigarettes. You are throwing up all the stuff that is not going to make any difference. The thing is, it is run by insurance companies, lobbyists. Republicans keep saying we dont have enough money, this is a problem, this is a problem. They blame us, they blame the system. Look at the europeans, the canadians, and find their system and apply that. It is not that hard. Host lets hear reaction from the congressman. Guest thanks for the question. If anyone is upset with the direction of health care with the Republican Party it would be these big insurance companies. Nobody has filled my inbox more than the Insurance Company is, how upset they are we have not taken care of their csr, basically a subsidy from the federal government for the exchanges. Were talking about solutions today. I dont think there is a one size fits everybody resolution