“We want affordable, accessible, quality health care. And we can only get that through competition.”
WASHINGTON, DC – Three members of the GOP Doctors Caucus appeared yesterday morning before a breakfast meeting of The Ripon Society, where they not only laid out some of the key goals of the group, but how their experience as health care professionals is shaping their approach to lawmaking and service on Capitol Hill.
The members were: U.S. Rep. Earl L. “Buddy” Carter (GA-1), who spent over three decades running his own pharmacy before his election to Congress in 2014; U.S. Rep. John Joyce (PA-13), who spent over 25 years running his own dermatology practice before his election in 2018; and, Greg Murphy (NC-3), who spent three decades running his own urology practice prior to his election to the House in 2019.
Carter opened the discussion by talking about his years as a pharmacist, and how it gave him an appreciation for the pressure so many Americans face when they try to balance the cost of prescription medication with other priorities in their lives.
“I had my own business,” Carter recalled. “I was the one who had to go to the counter and tell the senior citizen how much their prescription was. I was the one who watched the senior citizen try to make a decision between buying groceries and buying medicines. I was the one who had to go to the counter and tell the mother how much the antibiotic was for her child and watch her in tears as she tried to figure out how she was going to pay for that antibiotic.”
According to Carter, this appreciation for what so many people are going through when faced with the high cost of prescription medication, along with an understanding of the industry consolidation that has driven drug prices up, has led him to believe that what America needs more than anything at this time is a President like Theodore Roosevelt.
“He busted up a lot of the monopolies that existed during the time,” the Georgia Republican said of TR. “We need him back again because the drug pricing system is a monopoly. We’ve got three pharmacy benefit managers – PBMs — that control 80 percent of the market. We have three group purchasing organizations that control 80 percent of the market. That’s not the kind of competition we need. My goal is to do something about that. There’s no question that pharmaceutical manufacturers need to do a better job with their pricing. But the real problem lies within the drug pricing system. Vertical integration exists there, where you’ve got the insurance company that owns the pharmacy benefit manager that owns the group purchasing organization that owns the pharmacy that owns the doctor.
“Do you know who the largest employer of physicians in America is right now? United Healthcare, an insurance company that employs more physicians than anybody else in the country. Now, there’s nothing wrong with working for United Healthcare. But I would submit to you that with almost 9 percent of all physicians in America working for an insurance company, there’s a problem there. I’ll be frank with you — no insurance company should own a PBM, and no PBM should own a pharmacy. They need to be busted up. They need to be regulated. Now, I’m not big on regulations. We live in a capitalistic society, and we all want to be successful. We all want to make money. I opened my own business because I wanted to serve patients, but I also wanted to be successful financially.
“But what is happening with the PBMs is out of control. It is causing prescription drug prices to be too high to where people can’t afford it. And I’ll say one more thing about it. You know, all of us — whether you’re a Republican, a Democrat, or Independent — we all want the same thing when it comes to healthcare. We want affordable, accessible, quality healthcare. Democrats want that. Republicans want that. Independents want that. And we can only get that through competition. We don’t have enough competition right now. This has got to be something that’s busted up.”
Joyce, whose wife Alice is also a practicing physician, agreed that high drug prices needed to be brought down, and opened his remarks by talking about another goal he is pursuing as a member of the GOP Doctors Caucus – to bring the Medicare reimbursement rate in line with inflation so more doctors will be able to treat the growing number of senior Americans who rely on the program for their basic health care needs.
“My district is mostly served by physicians who treat Medicare patients,” he stated matter-of-factly. “And we’re up against the wall when it comes to Medicare reimbursement right now. My wife continues to practice and is right now in the office seeing patients as we speak. But Medicare reimbursement has failed to keep up with what the practices required to keep the doors open, to keep the nurses paid, and to keep the lights on. And I’m going to specifically talk about those reimbursements and how that affects access to care.
“I talked to Ali about how the practice is going, how she continues to maintain things, and she’s actually limiting the number of Medicare patients that she sees because of the diminishing reimbursement from Medicare. I asked her this past weekend, ‘How many Medicare patients are you seeing? How do you limit that?’ She said that, ‘Among new patients who come in, it has to be one in four or we can’t continue to do this.’ The cost of providing the equipment and the cost of employing the staff has continued to rise, yet Medicare reimbursement continues to be a falling number. On top of that, we have medical inflation that continues to occur. And that medical inflation means that there are employees who are paid at a higher rate, and the medical products that are used in the practice continue to rise in price. So with that, one in four [patients] is all they’re able to adequately see.”
Joyce pointed to three possible solutions to begin correcting this imbalance.
“We need to eliminate the budget neutrality threshold,” he stated, referring to a requirement that was established over 40 years ago as part of the Omnibus Budget Reconciliation Act of 1989. “We need to have an automatic inflationary update each year. And we have to not flinch at being able to compensate physicians at an adequate amount of what they deserve, and what they need to keep the doors open and lights on.”
Joyce concluded his remarks by highlighting another goal he is working toward as a member of the GOP Doctors Caucus – to ease the physician shortage in his District and across America. To that end, he launched the Homegrown Health Initiative, a program that aims to encourage young people in his rural district to return to the area to practice medicine once they get their degrees.
“We want these students, the best and the brightest, to come home and be able to establish their medical careers here,” he said of the program, now in its sixth year of operation.
Murphy, who underwent successful surgery for a base of skull tumor earlier this summer, opened his remarks by returning to the real world experience he and his colleagues bring to their jobs on Capitol Hill.
“We’ve spent our lives dedicated to taking care of patients,” the North Carolina lawmaker stated. “I was one three months ago. And it matters in every way to each of us how we get health care — how it’s delivered, how we can afford it, how accessible it is, and so many different things. I’ve done a lot of work abroad in many different countries and have been able to see what folks do in other countries. And we have the greatest and the absolute most disastrous health care system here in the United States.”
Murphy also agreed with his colleagues that prices are too high.
“We have the most innovative drug companies in the world,” he said. “We cure people. But our costs are too high. We have to get drug costs down and there has to be buy-in by everybody.”
He also highlighted an effort he is leading as a member of the Doctors Caucus to get the Biden Administration to implement the No Surprises Act, legislation approved by Congress and signed into law by President Trump that would crack down on surprise medical bills.
“We passed a bipartisan, bicameral bill signed by President Trump,” he stated. “And this has been my greatest sorrow of coming to Washington, DC. The agencies said, ‘Forget what the law says, we’re going to do it this way.’ Thank God we had the Chevron doctrine. It’s going to pull back, I think, some of the power to this legislative body. We’re now submitting a correction to the surprise billing.”
To view the remarks of Carter, Joyce, and Murphy before The Ripon Society yesterday morning, please click the link below:
The Ripon Society is a public policy organization that was founded in 1962 and takes its name from the town where the Republican Party was born in 1854 – Ripon, Wisconsin. One of the main goals of The Ripon Society is to promote the ideas and principles that have made America great and contributed to the GOP’s success. These ideas include keeping our nation secure, keeping taxes low and having a federal government that is smaller, smarter and more accountable to the people.