OTR Interviews

Medicare, 'Obamacare' and You

Sens. Tom Coburn and John Barrasso explain the effect of president's health care reform law on Medicare in handbook


This is a rush transcript from "On the Record," November 10, 2011. This copy may not be in its final form and may be updated.

GRETA VAN SUSTEREN, FOX NEWS HOST: Your health care and your money -- could they both be at risk? Senators Tom Coburn and John Barrasso say if you are on Medicare or your parents or your grandparents are, watch out. President Obama's national health care law could pose a big danger. The senators are also both doctors who have written their own version of the Medicare handbook. We spoke with them earlier tonight.


VAN SUSTEREN: Senators, and I should say, doctors, nice to see both of you.

SEN. JOHN BARRASSO, R-WYO.: Nice to see you.

VAN SUSTEREN: The government has Medicare new 2012 book out. And you guys have a competing Medicare 2012. This is your book. Is this a parody?

SEN. TOM COBURN, R-OKLA.: You might consider it. It's much more truthful than the other one.

VAN SUSTEREN: In what way?

COBURN: In terms of describing what the Obamacare legislation has done to Medicare patients.

BARRASSO: How they took $500 billion away from our seniors on Medicare not to save and strengthen Medicare but to start a whole new government program for other people, how they will have unelected bureaucrats decisions about who gets what care and how much the government pays for it. You can go item by item why Medicare is more at risk now in terms of going bankrupt than it was before Obamacare passed.

VAN SUSTEREN: So if I am clear, we were on an unsustainable path before President Obama's national health care. Then he shepherded through the national health care and we are still in the unsustainable path. But you say $530 billion was taken out of Medicare. Where -- what was it taken from? And where did it go?

COBURN: It's going to go for a innovation council, $10 billion. It will go to subsidize the state exchanges, mandated care that all of us will have to buy if we don't -- can't demonstrate that we have it. So there is a subsidy there.

So we are taking money that people have paid into Medicare, taking it out of Medicare and subsidizing the care for people who have not paid into Medicare.

BARRASSO: And it's going to come out of home health care, hospice care, hospital care, doctor care, physical therapy care, care for seniors, care that they need. So it's ultimately going to be denying care and refusing care.

VAN SUSTEREN: Is it fair to say in your opinion, it's out of services and more into administration, or bureaucracy? Is that a fair description?

COBURN: That's part of it. But the vast majority is going into other programs for other people for health care that Medicare dollars weren't paying for to begin with.

And remember, Greta, we have a problem. The hospital trust fund by the most rosy scenario, if you assume we are going to grow 4.5 percent, everything you would not assume, will be bankrupt in 2026. The conservative scenario of that by Medicare trustees is 2016. If you look at it, that's declining every year. It will be 2014 by 2013.

So the trust fund that actually pays for your hospitalizations will be bankrupt in less than four years. That money came out of that trust fund to go for these other programs. So what are we going to do? We're going to go to the marks with the international financial problems we are going to borrow money to pay for hospitalizations for our seniors? No, we're not. But we created all of these new wasteful programs and other programs in the health care that will take that money that should have been there and put it miles per hour else.

VAN SUSTEREN: It seems that is a problem we are going to feel in the near future, but not as near as the problem that's going to hit in January. A lot of doctors are going to lose a lot of reimbursement under Medicare, which I assume will discourage a doctor from wanting to care for people. It's going to be harder to find a doctor, or am I wrong on that?

BARRASSO: I think you're absolutely right. It's going to be harder for someone on Medicare to get a doctor to take care of them, especially if they move or their doctor retires. It's going to be much more challenging.

VAN SUSTEREN: And I don't blame the doctors. Frankly, I know you are both doctors, but it takes an awful lot to get to become a doctor. And to be submerged in this paperwork and to get the fees reduced, it's hard to run an office.

COBURN: One, if you really practice medicine the way we are trained, there is no way you can pay your nurses and overhead on reimbursement. But they don't because Medicare has such low over-imbursement, they end up seeing way too many people to be able to afford to see the patients and keep their office open. And what we will see is that going on down.

So the real question for Medicare is you have a Medicare plan, but if you can't get a doctor, do you have health care? That's what's happening across the country, the people who are turning 65 this year and becoming Medicare eligible, half of them are having trouble finding a physician.

VAN SUSTEREN: But even under the cut, if you find a doctor, under Medicare in light of the economic pressure we are putting on the doctors, they have to push you through quickly, so you don't get your questions worried and so I am not sure the level of care, especially if you get older and have health problem. The quality is going to go down.

COBURN: And one of the things that's a consequence of that, when the doctor doesn't spend the appropriate time with you, what do they do? They order a whole bunch more tests to cover what they didn't get to ask you about so that they make sure they are not missing anything. So we increase all of this testing that is really unnecessary because we won't reimburse and recognize the value of a physician relating to a patient and paying them for the time that they will spend with the patient.

BARRASSO: And the president uses the word coverage and care interchangeably, but they are very different. There may be a time coming very shortly where someone with a Medicare card can't get care.

VAN SUSTEREN: What would the president say if he were standing here and listening to you? I assume he would say you are dead wrong.

COBURN: He would disagree. He would disagree. He would say we had to do something.

VAN SUSTEREN: We have a problem. We all agree.

COBURN: One out of $3 in health care doesn't help anybody get well or prevent them from getting sick. That's a problem. Why is it there? The reason it's there is because the government controls 65 percent of it and has mandated down price control where have you disrupted the market.

I use an example I cared for 300 Amish families. They were the best purchasers in the world of health insurance, because they wanted to know what something cost and why you were doing the tests. They wanted you to explain what the risks of the test were. They wanted to know where they could buy it cheaper. In other words, they reconnected the purchase of health care with the payment. So therefore, they got great value. And I gave them great value because I was happy to get paid and not have to go through the insurance company or Medicare and file all the paperwork and everything else.

So what we have done, is we have -- we have two different philosophies. One is that the government's smart enough to run health care. We have proven that isn't right and the Obamacare expansion will destroy health care. I am not sure that's what we they intended so they can run it all. Number two what we know that the quality of care's going to decline in the future unless we really put patients and physicians back together making those decisions.

BARRASSO: We are talking patient-centered care, that's what we want, care that's best for the patients, so the patients get the care they need from the doctor they want at a price they can afford. But this law is bad for patients, it's bad for providers -- nurses and doctors and it will continue to be terrible for taxpayers.

VAN SUSTEREN: Senators, thank you, both.

BARRASSO: You're welcome.

COBURN: Good to be with you.