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Protecting the health of Americans and their pocketbooks 

A close up of the hands of a doctor and patient during a consultation
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As a result of Washington’s out-of-control spending, the U.S. credit rating was recently downgraded—only the second time in modern history—because of a high and growing general government debt burden, rising spending, and an erosion of governance. Today we come with solutions and a plan for action. 

Like a household with an unbalanced checking account, the federal government has spent more money than it has taken in for years. Today, the U.S. national debt is an unsustainable $32.6 trillion or 123 percent of GDP and climbing. Nearly one third of the total $6.4 trillion in federal government spending this year will be on health care, which is projected to grow from $1.9 trillion to over $3.4 trillion by 2033.  

With ten thousand baby boomers retiring every day, annual Medicare spending alone has already surpassed spending on national defense, and by 2033, is projected to more than double to $1.7 trillion.  

Runaway health care spending is crowding out other priorities like defense and jeopardizing America’s good credit, risking a sovereign debt crisis and the viability of the health care safety nets.   

If we want to course correct and bend the debt curve, we must act now to get Washington’s health care spending under control. In a recent study, economist Paul Winfree estimates that Congress must reduce federal health spending by $1.6 trillion over the next decade to get the budget back to a sustainable level.  

Unfortunately, poor policy has only made the Herculean task of shifting gears more difficult, doubling down on central planning and the wasteful and inefficient federal spending that goes with it. For example, ObamaCare piled millions of childless, work-capable adults onto Medicaid—a program designed to support the most vulnerable.  

Most concerning, we are not getting value for the growing amount of tax dollars devoted to health care. Research suggests low-income Americans on Medicaid have inferior access to health care and notably poorer health outcomes compared to privately insured patients.  

To make matters worse, as the government continues to pay more for less, billions of dollars are being wasted on improper or fraudulent payments. Last year alone, the Government Accountability Office — the official watchdog of the federal government — reported over $80 billion in improper payments in Medicaid alone.  

To put that in perspective: improper payments for one program in one year cost over three times as much as NASA’s entire annual budget of $24 billion. 

To tackle unsustainable health care spending, Republicans on the House Budget Committee are launching a task force to focus on key drivers of health care costs to the federal budget. Our task force will convene members from various committees as well as independent experts and stakeholders from across the health care sector to reform what’s broken and build on what’s working.  

The Task Force is intended to serve as an incubator for finding new ways to improve health outcomes while reducing federal spending. We will serve as a forum for developing and modeling legislation to improve spending efficiency, returns on federal investments, and an overall more cost-effective health care system.  

We will examine the Congressional Budget Office’s capabilities to forecast the longer-term budgetary impacts of legislation to ensure policymakers are equipped with the best data when crafting solutions.  

The Task Force will not be searching for cost savings alone. Many Americans are also deeply unhappy with our health care system, and seek more innovative care offering greater personalization, convenience and lower prices.  

Fortunately, this is an exciting time for technological innovation and groundbreaking cures. Telehealth and artificial intelligence can increase the efficiency and convenience of care delivery while expanding access for the most vulnerable. Scientists are continuing to make discoveries that were once thought impossible, such as cell and gene therapies for rare diseases and conditions like sickle cell anemia, hemophilia and Duchenne muscular dystrophy.  

Payment model reform have also began to focus on rewarding value-based care and paying providers to care for populations, improving quality and clinical outcomes over antiquated fee-for-service payments that reward volume of services. Innovative therapies can save lives, technology can improve the efficiency and productivity of care delivery, and new payment models can ensure that we pay for the right results. All have the potential to increase access to quality care and save taxpayers a boat load of money. 

The credit rating downgrade was our wakeup call. We must move with urgency to rein in mandatory spending on our entitlement programs and save our health care system from financial collapse. 

If we don’t change course, our children and grandchildren will lose both their health security and the quality of life every generation of Americans deserves.  

Jodey Arrington is chairman of the House Budget Committee. He is the representative for Texas’s 19th District and serves on the House Budget Committee, Ways and Means Committee, and the Joint Economic Committee. Michael C. Burgess, M.D., is the representative for Texas’s 26th District and serves on the House Budget Committee, Energy and Commerce Committee, and Rules Committee.  

Tags budget Medicaid

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