tv Rep. Larry Bucshon CSPAN June 23, 2022 1:23pm-1:56pm EDT
>> all right, drill, i'm going to hear from a gun owner before the house comes in. the lake in georgia. >> i am a gun owner, i do not support. the reason being is because if someone plans to go out of their way to buy a gun for find one, however they go about it. they are going to do it regardless of what laws are in place. so, it is better to have it and not need it and need it and not have it. i have a firearm and i have not had to use it. rest assured, if something was going on i know that i have the weapon to protect myself and those around me >> all right, kelly in salem, new hampshire, you support, kelly, why is that? >> yes, i support, i am almost 30 and i have been going through school shooting drills since i was about ten years old. so, when they say that kids are the only ones who are dealing with this adults are now voters who have lived with this. i very much support and i hope
that this is just the start and not necessarily the and. it is a band-aid for a situation that is just out of control. thank you very much. >> all right, thank you. some restrictions on firearms is not unconstitutional, i do not oppose reasonable restrictions on firearm possession. thank you for all of you for joining in the debate. joining us this morning is congressman larry -- a republican of indiana, a medical doctor, he sits on the energy and commerce subcommittee on health. he is also on the housing future task force doctor patient relationship subcommittee. he is the chair of that, thank you for joining us this morning. let's talk about this task force subcommittee. what is it? what is your goal? think>> you know, house republis want to make sure the american people know what we think about policy as it relates to health care. going into the fall election i think it is important to not
only talk about what you are not for and what you do not like about the current policy, but talk about what your ideas are moving forward so we can let the american people know. that is what this task force is all about, the part i am leading is the doctor patient relationship, for obvious reasons since i am for a position. we can let the american people know what we think and how we can get better care for our patients. >> some of the recommendations from a healthy future task force include reauthorized support for the patients and communities act, remove harmful federal mandates and improve quality metrics on providers. ease the complexity of electronic health records to ensure the patience is the main focus, in short access to quality providers and grants timely access to care for patients by performing prior authorization process. so, congressman, how does this reduce the cost of health care? >> here is the thing, the
biggest part that i am focusing on is the doctor patient relationship, the cost is a different issue that is a very big issue. it is very important and there are a lot of factors involved. when you talk to doctors out there the biggest complaints they have as they do not get a chance to spend as much time interacting with the patients and their families and they used to. the electronic medical records and what you have to submit to insurance companies, or to medicare to be paid is pretty onerous. they tell me they spend more time staring at a computer screen than actually talking to or examining their patient. that is one thing. and then, when it comes to the reimbursement side of things, particularly for primary care it is very difficult for physicians in rural america. the reimbursement and how much they get paid by medicare and private insurance companies has dropped so dramatically over the last 30 years that they find it troubling to try and practice in rural america. you add on top of that your education, educational that is
a big part of this when it comes to physicians and other professions. they just cannot afford to practice in rural america, we need to work on that. one of the things that happens is the prior authorization. you know what you want to treat the patient with, either a medication or in therapy. you have to wait for the insurance company to approve that. even though you as a physician, that is what you are recommending. that adds to the bureaucracy. as it relates to the patient and the physician interacting, all of the bureaucratic things that medical people have to go through. the latest patient care occasionally, and also makes it difficult for them to have a good conversation with their patient and the patients family. >> at this point i want to jump in, congressman, and encourage our viewers to call in and tell you what they're experiencing with their own doctor. if you are a republican, -- if you are a democrat -- and independents --
this is your time to call and talk to congressman larry, he is a medical doctor and part of a task force that is focusing on the doctor patient relationship, tell him and get his input on what you are experiencing when you go to the doctor. congressman, what about the support for patients and communities act? it is legislation to combat the opioid epidemic. why is it needed? >> we have an epidemic, as you stated. in fact, i have someone that i know in the political sphere in indiana who just had one of their family members succumb to a drug overdose. we have dramatic problems, not only in urban america but in rural america, most of my district is rural and people think you see on the news this is happening in urban america. let me tell, you rural america is in more trouble.
we have a plethora of drugs floating into our country from the southern border. we also have people mailing them from china, for example. we have tried to stop that. believe it or not they actually mail medication from china that is laced with fentanyl. so, this is affecting everyone. in the across the socioeconomic groups. this is not the old days where the impression was because of tv shows that this only affects certain people. this is affecting families, ethnic groups, racial groups, and social economic glasses. all the way from low income to wealthy people. it is a scourge right now, we know last year we lost 107,000 people in the united states to an overdose of opioids. anything we can do at the federal level to shine a light on that increases access to therapy, including medical
assistance treatment, it is important right now. let's get the call, rita in orleans park, illinois. a republican. good morning rita. good morning i just wanted to talk to the representative about i think it's on that he is doing this. i used to work in different positions, we actually went out of business due to new -- we could not affect these fees. in affected our patients. more importantly, the amount of paperwork was overwhelming. we used to have to weigh on approval just to treat our patients. the amount of paperwork, whether it was medicare or medicaid, regular insurance companies are doctors just threw their arms up it was so frustrating! i think it is something that needs to be done. i'm just not sure that, you know, they will ever address it. the insurance companies are so powerful. i think it is awesome. i support it. >> well thank you.
you're hearing directly from someone who has worked with physicians. i talk to different positions every day. you can go into health care whether it's a physician or nurse practitioner any of the health care providers, they want patients or action with patients and families. they want to help people with their medical issues. it becomes frustrating when you find yourself spending most of your time dealing with paperwork rather than talking to, for example, the patients. let me just tell you this it has been shown that if you have a poor relationship with the patient or family because we have not interact with them a lot, it results in more litigation. as far as medical malpractice claims. there is no personal relationship that has been established. this is a really big problem, one that we want to try to address. >> brenda, in california, democratic collar. a question or comment for the congressman? >> comment, my comment is, what
i have found as an african american woman, but i have found is, i used to have a really good doctor. he passed away. it is almost impossible to find another good doctor, who is going to take care of my needs and treat me in a respectful way. what i find is, with the new doctors that i go to if you need a test, they don't even order tests. they don't even follow up with you to make sure you are getting what you need. so yes, i want a doctor to be paid better because i work in health care. i work in a primary care clinic. i worked in this hospital for over 30 years. i know with the paperwork is. i know the struggles that
doctors have when they have to look at the computer and not at the person. when they are trying to evaluate them, and all the other people who have to get involved, so the doctor will be able to give help to their patients. i support it, but i also think that within it, you still need to deal with the issue of health care disparity. it is a real issue. it happens to people. that is also affecting, you know, patients. the patient doctor relationship. >> okay brenda. congressman? >> yeah, i agree with everything she just said. we do know there are health disparities, whether it's in parts of urban america based on, you know, different patient populations, including the african american population. let me tell you we also have
disparity in rural white america. this is what we are talking about here. it is hard to recruit new quality physicians, as she described, signing a new competent doctor in different areas of our economy. in rural america, or different areas of urban areas. physicians come out of medical school with a lot of debt, it is just not practical for them to go into a practice, for example, where all the patients are in the medicaid program. medicaid doesn't pay well enough for them to feel like they can pay back their student loans. i agree with everything she said. there are disparities, no doubt. different ethnic groups, rural groups in america, there are disparities, we know this! it is factual. that is what we are trying to address here. we want to make sure we can get quality physicians in every zip code in a country to take care of patients. >> in west jefferson, ohio. john is a republican. good morning. >> hey, larry.
i was just wondering, how come it is important that medical professionals report everything they do to the government. i mean, if i'm like a garage door open a repair person or something, i go out and replace a broken spring, i don't have to send paperwork to the federal government to tell them about it! but, if i go into a doctor and i have a cough, he's got to spend time entering it to the government. seems to me that if they did away with all that requirement, he's just a small businessman to you if he's just a general practitioner something. do away with that paperwork, he could lower his prices or make more money, or both. i mean, in the medical industry why is there all that
requirement, that is my question? >> yeah, that's a great question. the reason is because you have to submit all this information to medicare or medicaid program to get paid for what you're doing. you know, if you are doing an evaluation of a patient, there is different levels. different payment, depending on how complex evaluation of the patient's. to get paid properly for what you have provided for the patient you have to submit a certain amount of information to the federal government to the center of medicare and medicaid services, so they will reimburse you. the same is true for the private sector. if you submit insufficient documentation private insurance companies just won't pay you. they can deny it because they say you didn't properly document the valuation of the patient. that is part of the problem. i'm not saying you don't have to document your work but we have gotten to the point where payers, either the government
or the private sector, they find all kinds of technical reasons to deny payment for the services that you're providing. when i was in practice we had eight full-time people for 16 doctors basically spent all day, full-time, trying to get physicians paid for services that they provided. usually the denials were technical things like you forgot a number here, you didn't put the middle name of the patient on the document. this is what we are trying to fight against. >> miked in huntington, indiana, independent. >> yes, i just don't know why they don't put a tariffs on china until they stop sending opioids over. i am 77 years old, i put tariffs on everything from china until they stop that and stop it quick. >> congressman?
>> yeah, there are already a bunch of tariffs on a number of things coming from china, as you know, primarily put on china during the trump administration for that exact reason. one of the things they are doing is shipping medications directly to the united states, through the mail believed not. also providing product to the drug cartels in mexico who then produce the fentanyl which comes into the united states. that is already being done but this is such a big financial opportunity, so to speak, for people who provide illegal narcotics to americans, it is almost impossible to stop. you know we are doing our best. honestly, we also have to do something about the demand for these narcotics within the united states. it is a multi-pronged approach if we are going to stop this. there is just so much money involved that people in china
are doing this illegally, and from other countries, also. primarily mexico. it is really hard to stop it. we are talking tens of billions of dollars. >> milton in philadelphia, democratic collar. good morning, you are on the air with congressman barry bichon, medical doctor as well. >> good morning, thank you for taking my call. i would like to make three points. one, republicans four years have been blocking where medicare could go out and negotiate cheaper drug prices because out make it easier for seniors and who are disabled to blood drugs at a cheaper cost. they've been blocking. it second of all, republicans are always criticizing democrats for putting up health care plan. years after the obama care, at affordable care act, they have not yet put one plan on the floor. they want to do away with obamacare but they did not have a plan to replace it. this guy up here, republicans criticize elizabeth warren and
bernie sanders for wanting to do away with student debt, for kids coming out of college. he's proposing the same thing. when they said it, they called and socialist! thank you. >> first of all, let me just say that republicans did have an alternative to obamacare passed out of the house but it didn't make it through the u.s. senate. that was back in 2017. you know, it's factually not true that republicans do not have plans for health care. the other thing is we are always talking about who is paying for health care. both parties do that. whether it is people who are single payer like sanders and others, or people who believe in a combination of the private sector and strong public health programs like medicare in medicaid like i believe. and the one thing we don't talk about. i say this all the time, how can the bills are so high in the first place? we are never going to catch up to the medical system if we
continue to allow health care inflation to be so high. the bills are so expensive, no one can pay for! that not the government, not the private sector. we are working on that. as far as medicare negotiating drug prices, medicare and the federal government they don't negotiate. if you allow the federal government to price fix, which is what the democrats want, they want the federal government to price face medication in the united states. this is what we are paying, take it or leave it, then what happens is about half the medications that are available in the market will go away. how do we know the? because that is what happens in other countries around the world. price fixing medication, it makes it economically unfeasible for the companies to produce these medications. that said, the supply chain how we pay for medication in our country is really broken. we have pharmacy benefit managers, insurance managers who are middleman. they are making hundreds of millions of dollars off
medications. they get rebates to do this, that saving does not get passed on to the patient. the problem is real! the real problem is hydrant prices. the solution is not to price fakes at the federal level. if you do, you decrease access to medication. we do see this in other countries. >> congressman, what about the affordable care act? if republicans win back the majority this november, will you try again to undo provisions of the affordable care act? >> no, i don't think so. you know, that has been done in the past. i've been in congress since 2011. the affordable care act now has been the law of the land for a decade. there are a lot of people who are on the expanded medicaid which is primarily how they expanded health care access, through the medicaid program. we have some people who are on
these changes. i think they are baked in due to the health care system. i don't think, as far as actually repealing obamacare, quote unquote, is something that will be beneficial to the american people at this point. but we need to do is get the cost of health care down. we need to work on ways to get the cost of health care down. there are a lot of ways to do that. i talk about the pharmaceuticals with the pbms and the insurance plans. we need to address the cost. obamacare addressed how you pay for it. as i mentioned, we can have that debate. i think for the most part on obamacare we need to consider that, where it is, and work within the system to try to get the cost of health care down. >> brewster, new york, richard is a republican. welcome to the conversation. >> good morning. i want to thank -- you for being a patriot. having 43 years of c-span, and giving voice to the people.
good morning, representative. i have a problem with cannabis, marijuana. usually you had to go to greenwich village in new york city to get in marijuana, now it's all over. these towns appear voted against marijuana but the state, new york, it oked it. colorado had years ago, now they have an epidemic with emergency rooms, people going to the emergency room every day. also up this way, they want to have a farm, they call it, to grow marijuana indoors. i heard that from other sources in the media that marijuana should be grown outdoors. some kind of legal problem here. i want to know why these states okay it. i think it is a gateway drug to other things. i heard that marijuana today is
not as it was in the 1970s. it's a lot more powerful. they lace it with other products to the detriment of people thank you very much for your time. , sure. i obviously right now, do you see the active ingredient in marijuana is a controversial subject across the country. let me give you my medical view there are solid data out there to show that chronic use of thc products in young people up to the age of late 20's, 27 or 28, causes long term cognitive changes in the brain. i.e., you are going to have some permanent brain injury from chronic thc use, particularly in developing brains. i am against broad legalization of marijuana. again, that is a controversial subject. the reality is, there are very few medical reasons to use it. people that have cancer, who
have intractable vomiting, things like that, they say they benefit from it. obviously, there is no scientific data. one of the first things we need to do is allow people to study thc. right now it is a schedule one drug, you can't. it means it's in the same classes heroin. we have had some discussions about changing the schedule, make it a scheduled two drugs where people can research it, but with the current information i personally think that state government see this as a cash cow. i mean, they add taxes to it and they make tens of billions of dollars on taxing legal marijuana. the issue, as i mentioned, one is cognitive. the other one is law enforcement. talk to them! they will tell you they have impaired drivers all the time that blow zero as far as ethanol go. but they know they are impaired, there is no scientific way to prove in court that someone is impaired with thc.
there is no standard. that is the other concern. i see it primarily honestly, and the money making prospect at the state level. we do need to seriously look at changing the schedule from 1 to 2 so we can do research on thc. let's get the facts. >> let's go to california, charles, independent. charles, good morning. >> good morning! i'm calling because i have a strong background. i was one of the people who helped, 50 years ago, to establish the medicare system in baltimore. and that procedure was to set up the coach and the building process. it was not to give all the conversations about the medical deceiving that's going on now. it was a very simple system. i don't think we'll ever get back there.
but i want to share is story, because everybody is bombarded with answer the covid question in my doctor's office, and our medical billing services in doctors offices are being bombarded with the word covid. covid is a completion of a complete cycle, where all of the relationships of the doctor and the patient are guided by that word. now, in order to give an impact to you about what is going wrong, the word covid is a marketing word, and i'll stop there, doctor, but the thing that's happened is best told by a story that is going back 50 years. i was responsible for putting in a medical billing and also
the tracking systems for the atomic energy commission in washington. i went to all kinds of places. >> jaws, can you, charles, can you get to the point for the congressman? because we've got more people waiting -- >> conversation is this, yes, when you do a billing test, that test is not the end all. the doctor still has the responsibility, but it's been taken away by the word covid in all billing systems. >> okay. congressman fujian. >> yeah, well, there is some reason for that. because back in 2020 i think it's part of the as part of the cares act, replaced up reimbursement through medicare from hospitals for people that had the diagnosis of covid because it was overwhelming our hospitals and we want to make sure that they were properly reinforced so that they could take on all these extra patients. and so, there's a bit of
financial incentive to have the diagnosis of covid on a patient's chart. that is true. and so you know, we've looked at that and that's not going to go continue, i should say, into the future. but temporarily, during the pandemic, there has been a financial incentive for patient at least in hospitals to have the diagnosis of covid on their chart so if you look at some data out in new york that shows the patients who died from covid and i can't quite the exact numbers but basically what we found out is a lot of people died for other reasons with covid, not from covid. and they were admitted to hospitals for other reasons like a heart attack, and they happened to test positive for covid. there was a financial incentive for that to be put on their chart. so that data, there is solid data out of new york, i'd refer viewers to, from the state of new york, that shows that that is factual. and that's the reason why, i
think, covid on patients chart is very prominent. and rudy, in some city, california. democratic caller. i, rudy. argue there? >> good morning, brenda. good morning. i would like to make a proposal that the united states government to help people with medical school and they go where the government wants to send them whether it's -- barrow, alaska, duluth, or dakota, they don't go to practice in beverly hills or the hamptons. you know, is one of the conditions that, you know, your unit to help people. so what do you think about that? i take your response of. >> sure. well, i mean, you know, there's already private, i think, plans,
you know, where people get scholarships to go to medical school if they agreed to serve in certain areas of the country, particularly underserved areas. so you see that both at the, in the private sector, and honestly, i think, in some states incentivize people to practice in underserved areas. i went to the university of illinois in chicago, and we had an urban health program where students who got those scholarships would agree to practice in open areas of chicago after medical school for a certain period of time. you know, the big thing we need to do is to get the cost of the education itself down so there is more options for students. i mean, the tuition is extremely high and it's a complicated problem to solve. it's not only in medical school or law school, but just for undergrad and graduate degrees the cost of higher education is really spiraled out of control. so i don't think there's much, you know, that the federal government can particularly do
on the issue of getting physicians into certain areas of the country other than the things that we talked about right at the beginning. make sure reimbursement is enough that people feel like they want to, they want to practice in rural america. a lot of physicians want to practice in rural or urban america. they just can't afford to do it because they have to get the job, high paying job in a hospital and they can't afford to -- in certain areas of rural and urban america. so it's a very complicated problem. and you know, we can't address some issues like paperwork, reimbursement, but we really can't, you know, force people to practice medicine in areas of the country that we want them to or that we -- need him without some incentives. >> congressman, before we let you go, how will you vote on this senate gun violence or gun prevention proposal that going,
that's going to start, they're going to head toward final passage in the senate today? >> yeah, i mean, i want to see the final version come out. but it's likely i won't vote for it. i mean, i think, you know, this is a complicated issue and i know the american people want us to try to address it. but the reality is is that we have big issues that we're not we are not addressing. we are doing a disservice to people who were, like this young man that shot people in uvalde, i mean, you know, did he have a particular psychiatric diagnosis by is to try psychologist? no. he clearly was very disturbed and people saw that. so, you know, we have that, we have also lack of educational and economic opportunity in our cities that need to be addressed that are leading to a violent society. and so, i'm very skeptical, particularly on with the gun control measures and whether that will actually be make any
difference at all. so i think that will make a difference. we have a violent society right now. you know, people are, have been disrupted by covid. again, there's a lack of educational and economic opportunity in many areas of our country, including rural america. and we are not properly addressing some of the stress and psychiatric issues that people are experiencing, whether or not they have a specific diagnosis or not. so, i'm probably going to vote against it. but i want to see what the final version is. >> congressman, we appreciate your time this morning. thank you for talking to our viewers. >> you're welcome, thanks for having me. >> christian jaime is with me this morning. he is the vice president of policy for the brady group here to talk about gun legislation and his bipartisan proposal. remind viewers first of your group. >> yeah, absolutely, thanks so much for having me. brady is an organization that is named after jim and sarah
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