U.S. Senate candidates on the issues: Health care spending

AdventHealth Shawnee Mission. (File photo.)

Last month, we asked our readers what issues they wanted to hear the candidates running for office address ahead of November’s general election. Based on the input we received, we developed a five-item questionnaire for candidates running for the open U.S. Senate seat in Kansas.

We’ll be publishing the candidates’ responses to one item per day, each day this week. Today we’re publishing the candidates’ responses to item #4:

The United States currently spends more per capita on health care costs than any developed country — yet our citizens’ health outcomes continue to lag, with rates of obesity and chronic disease much higher than our peers. What does the U.S. need to do to lower its health care spending and improve health care outcomes for its residents? Should universal health insurance be a priority and, if so, what form should that take?

Roger Marshall (Republican)

I believe there are three pillars for lowering the cost of healthcare while improving outcomes: transparency, consumerism and innovation. As a rural physician for nearly three decades and now a member of the Congressional Doc Caucus and Republican Study Committee’s Healthcare Task Force, I have always prioritized providing better care for people with pre-existing conditions while lowering the cost of healthcare for all Americans.

We must be more transparent in our records and expenditures. I want patients to own their own medical record. If you can securely access your banking information on your phone, I’m confident we can do the same for medical records.This will help you walk into any doctor’s office and provide your full medical history. And if patients are allowed to know the real price of a procedure or prescription, I am confident Americans will make informed decisions that will help increase competition and drive down the price of care.

This transparency will allow patients to again become consumers of their healthcare. I want patients to be able to choose their physician, determine where they have a surgery or MRI done and compare the price of a prescription from multiple pharmacies.

And we must allow for greater innovation in our health care industry. Government control and overregulation will only stifle innovation and increase costs. We have seen significant medical advances of the past 30 years and as we have witnessed with our response to the COVID-19 virus, it takes research and expertise from all parts of the healthcare industry to meet the needs of patients.

Barbara Bollier (Democrat)

I believe everyone deserves healthcare, no matter their income or where they live. That’s why I’ve been fighting to expand Kancare for years. We must expand it to bring access to affordable health care to 150,000 more working families and veterans, help protect rural hospitals from closing, and inject millions that taxpayers have sent to Washington back into our state’s economy.

Now more than ever, we need to improve everyone’s access to quality, affordable care. And I will continue to work with both parties to find reasonable solutions to achieve this. For example, I’ll support efforts to incentivize Medicaid expansion in the states that haven’t expanded yet — like Kansas — creating a public option in order to ensure accessible and affordable health care for all Americans even if they lose their job, while ensuring that Americans who are happy with their employer-based healthcare can keep it. I do not support mandating Medicare for All.

Additionally, I support allowing Medicare to negotiate with pharmaceutical companies to bring down prices. We all know healthcare is too expensive and often difficult to access and this would be a good step forward in driving down the cost of prescription drugs.

Sadly, my opponent has voted to repeal the Affordable Care Act, opposes expanding Medicaid in the middle of a pandemic, and voted against a bipartisan effort to reduce prescription drug costs. That’s putting partisan politics above the needs of hardworking Kansans.

Jason Buckley (Libertarian)

I believe that healthcare prices would decrease and quality and availability of healthcare would increase if providers were freed from government meddling and control.

Virtually every person wants access to quality healthcare at an affordable price. I think the best way to achieve this is by removing government interference and enabling free markets. Government inappropriately controls our healthcare in many ways:

  • Government and a handful of insurance companies have a virtual monopoly as payers. Because of this, they make most of the decisions about what kinds of healthcare are available.
  • Government regulates where, when, and who may open new healthcare facilities.
  • Government agencies greatly slow development of and access to new medicines, devices, and technologies that may improve quality of care and reduce cost of care.
  • Currently, the healthcare industry is virtually monopolized by the government and a handful of insurance companies. They hold the checkbook and wield it for their own benefit.

Each year, the government sets prices that they will pay providers including doctors and hospitals. Each year, these payments increase at less than the cost of inflation, while the cost of providing medical care increases by a far greater amount. This has unpleasant consequences for everyone. Providers are incentivized to do what is quick and cheap, not what is in the best interest of a particular patient. Doctors are forced to reduce the time they spend with patients, and this reduces quality of care. Hospitals are discouraged from upgrading facilities, and this reduces quality of care. Worse yet, insurance companies often set their payments according to the government’s prices. This regular ratcheting down on payments to providers, while actual costs to provide care increases, makes providers less able to provide high quality healthcare.

Government also regulates where medical facilities can be built, who can build them, and when. The process for applying for permission to build facilities is very costly and very slow, thus it favors the biggest corporations and prevents smaller organizations from opening new facilities that could serve patients. This greatly limits patients’ access to medical care and increases costs compared to a system where government permission was not required.

Institutions such as the Food and Drug Administration also limit cost-effective access to quality care. The approval processes for new drugs and technology is lengthy and expensive. Because of this, the process favors the biggest companies with the most lawyers. There are many stories of patients dying while waiting for approval of a new device or medicine. Instead, I call for free-market testing which will be inherently incentivized to be efficient and fair in their processes. Additionally, I believe in the “Right to Try”, especially in situations with a terminal diagnosis. The government must not be permitted to deny patients access to new medical advances.

Tort reform would also greatly reduce the cost of health care. The current tort system raises the cost of care by encouraging unnecessary testing and procedures which increase the cost of medical care by forcing medical teams to devote significant time and resources to preventing or defending against unwarranted legal actions. When legitimate claims arise, they should be taken seriously and resolved fairly through the courts. However, frivolous and fraudulent claims should not be tolerated, as our current system does. These disparage our healthcare providers and the quality of medical care they can provide and that we can receive. I oppose fraud in all forms.

In short, I believe that each person has the right to make their own medical decisions. I support removing government meddling from healthcare. I think this and tort reform are the best ways to improve the quality of healthcare, increase access to healthcare, and decrease prices of healthcare in our country.

Tomorrow, we will publish the U.S. Senate candidates’ responses to the final item on our questionnaire: 

Climate change continues to be a major concern for Shawnee Mission Post readers. What steps should the federal government be taking now to address the impact of the changing climate in the coming decades? How would you work to see those steps enacted?