Senate Proceeding on Mar 23rd, 2009 :: 0:54:20 to 1:04:50
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0:54:20 to 1:04:50( Edit History Discussion )
Speech By: Amy Klobuchar

0:54:21 to 0:54:41( Edit History Discussion )

Amy Klobuchar: quorum call: ms. klobuc the presiding officer: the senator from ms. klobuchar: mr. president, i ask unanimous consent to speak as if in morning business for 10 minutes. the presiding officer: the senate is in a quoru ms. klobuchar: mr. president, i ask that the quorum call be vitiated. the presiding officer: without objection, so ordered. ms. klobuchar: and i ask to speak in machine for 10 the presiding officer: without objection.

0:54:42 to 0:55:02( Edit History Discussion )

Amy Klobuchar: ms. klobuchar: i am there talk about health care reform. i would mention first that i was just over with de debbie wasserman shuttle who last year battled prevent diser and today was there healthy and i'm proud to be the senate sponsor to focus

0:55:03 to 0:55:23( Edit History Discussion )

Amy Klobuchar: on increasing awareness among younger women about the risks of breast cancer. but we are a here today, mr. president, to talk about something else and that is how to bring costs down in health caimplet as we look at how to expand health care, how to improve the quality of health care, there must be work done to contain the cost and i believe based on i've seen in my state,

0:55:24 to 0:55:45( Edit History Discussion )

Amy Klobuchar: you can actually reduce costs and improve quality. a few weeks ago president obama convened a health care summit to bring together industry leaders, providers, and add row cassie groups to discuss our tiewrchtses to move forward with serious health care reform. that reform should begin with the medicare system. med compare is one of the most valued social programs that our

0:55:46 to 0:56:08( Edit History Discussion )

Amy Klobuchar: country has produced in the last half-century. yet it is also a program in dire need of reform, if it is to surve on a sound financial footing and continue to provide the fine medical care that our seniors have come to expect from it. and change is needed now. by 2011, the first baby boomers will enter the medicare system

0:56:09 to 0:56:32( Edit History Discussion )

Amy Klobuchar: and by 2016 the number of medicare beneficiaries will increase by almost 5%. this past winders i convened a health forum in minnesota to discuss the challenges affecting the medicare system. the message is clear: without action costs will continue to rise and waste will prft. medicare is the single largest

0:56:33 to 0:56:53( Edit History Discussion )

Amy Klobuchar: provider of health care. medicare's payment system, coding, quality reporting and record keeping are the industry standard. spending for the medicare program is projected to increase 114% in the next ten years. 20% of medicare beneficiaries suffer from one of five chronic diseases. medicare spends 66% of its

0:56:54 to 0:57:17( Edit History Discussion )

Amy Klobuchar: annual budget to treat this group. two-thirds of medicare spending, mr. president, helps one-fifth of medicare beneficiaries. and if we are going to sustain medicare as a healthy, highuality program that americans deserve, we must do something to address these challenges. in short we need to reform medicare so that it addresses efficient, high-colt care.

0:57:18 to 0:57:39( Edit History Discussion )

Amy Klobuchar: as i happens, doctors and hospitals in many preedges of the country including my state practice exactly this kind of high-quality, low-cost medicine and they should be rewarded for t but medicare does not reward them. instead, it punishes them. in fact at the health summit last week president obama actually asked the gathered group, why should we punish

0:57:40 to 0:58:01( Edit History Discussion )

Amy Klobuchar: minnesota because other states are less efficient? the problem is that despite periodic efforts at reform, medicare pays for quantity, not quality. more tests and more surgeries mean more money, even if the extra defendants and operations do nothing to improve a patient's condition. states that have historically delivered excessive procedures

0:58:02 to 0:58:24( Edit History Discussion )

Amy Klobuchar: are still rewarded for the wasteful practices of the past while efficient states such as minnesota are punished. now, if you look at this chart, you'll see that the areas in dark blue are the ones that receive the lion's share of medicare payments. the light-blue area states like iowa, montana, maine is looking good, i see the senator from

0:58:25 to 0:58:46( Edit History Discussion )

Amy Klobuchar: maine across the way, and a number of stas in the area you can see are areas where medicare spend something low but quality of care is high. it's as if there was a huge transfusion to, mr. president, that basically takes taxpayer money from one region, one area of the country and puts it in another and it's not to say people aren't sick in other parts of the country that they

0:58:47 to 0:59:10( Edit History Discussion )

Amy Klobuchar: don't deserve that help but look at the limited resources, we have to figure out what's working and how come areas of the country that tend to have the lowest health care costs also have the highest quality health care. it's not what you would think. you would think well the highest costs must have the highest quality. that tends to happen sometimes in clothing and other things. well, that's not what's going on

0:59:11 to 0:59:32( Edit History Discussion )

Amy Klobuchar: in this country right now. regions with more specialists and more hospital beds tend to provide more services and get more of the according to the dartmouth health institute for clinical practice, high-cost regions in medical care boasts 31% more doctors and 65% more medical specialists.

0:59:33 to 0:59:53( Edit History Discussion )

Amy Klobuchar: supply is driving demand. the result is medicare pays vastly more in some parts of the country than it does in others for medical care that is no better. medicare's own report shows quality of care is higher in many of these low-cost states. medicare spends more in places like florida and new jersey than it spends in states like minnesota and

0:59:54 to 1:00:14( Edit History Discussion )

Amy Klobuchar: let me in miami, florida, medicare spent roughly $15,0 patient per year in the year 2005.g? in minneapolis, a medicare patient received about worth of care that year. to put it another way, medicare

1:00:15 to 1:00:36( Edit History Discussion )

Amy Klobuchar: will spend $50,000 more on a 65-year-old patient in miami, florida, over the course of his or her lifetime than on a comparable patient minneapolis. $50,000, that's a lot of money. at $2.4 trillion per year, health-care spending represents close to7% of the american economy and will exceed 20% by

1:00:37 to 1:00:57( Edit History Discussion )

Amy Klobuchar: 2018 if continue. now, you look at this internationally. as you can see, the united states spends far more money on health care than any other nation without getting better care. we can and we must do better. a number of models are out there to provide direction f future. the mayo clinic based on my home state of minnesota is renowned

1:00:58 to 1:01:19( Edit History Discussion )

Amy Klobuchar: for the effective care provides at a reasonable cost. st think about this, this was a dartmouth study that came out and it showed this: if the rest of the hospitals in the country used the same kind of high quality with very high-quality efficiency ratings from family and high efficient care as the mayo clinic does in the last four years of a patient's life,

1:01:20 to 1:01:40( Edit History Discussion )

Amy Klobuchar: the country, the taxpayers of this c billion over five years. $50 billion over five years by simply following the protocol of having a more organized, ficient delivery system with one primary doctor, with experts that work together, without duplicate tests.

1:01:41 to 1:02:02( Edit History Discussion )

Amy Klobuchar: $50 billion every four years just by following a set protocol, with some of the highest quality ratings in the country. the congressional budget office found the potential for huge state savings. this chart reflects medicare spending would fall by 29% if

1:02:03 to 1:02:24( Edit History Discussion )

Amy Klobuchar: spending in medium- and high-spending regions were the same as that in low-spending regions. how do we change the medicare system in a way that will reduce disparities and reward our thing? real reform will start, madam president, when the system starts paying for quality. here are the three priorities i plan to start working on immediately: first, we need to

1:02:25 to 1:02:45( Edit History Discussion )

Amy Klobuchar: enhance medicare incentives that reward quality care. for many illnesses and conditions, the medical professional has widely -- professions has accepted practice guidelines that result in better health-care outcomes such as when to give as prince to heart patients and how often to perform cancer screenings. but they're not always followed.

1:02:46 to 1:03:07( Edit History Discussion )

Amy Klobuchar: a rand corporation study adults received recommended care for many illnees only 55% of the time. medicare needs to reward doctors and hospitals for doing the right things and achieving improvement in care. these quality guidelines can be the base seus for medicare -- basis for medicare payments. we need to rethink payment system.

1:03:08 to 1:03:28( Edit History Discussion )

Amy Klobuchar: right now medicare pays for test procedures one by one giving providers incentives to order more services. we need to have better coordination of care and less incentive to build medicare purely by volume. increasing the bundling of services in medicare's payment system has the potential to deliver savings and start rewarding value and not volume. third, we need to address the

1:03:29 to 1:03:49( Edit History Discussion )

Amy Klobuchar: shortage of the number of primary care physicians who are currently practicing across our country. today effective primary care is severely undervalued in our health-care system. yet, research suggests that improving access to primary care and reducing reliance on specialty care can improve the efficiency and the quality of health-care delivery.

1:03:50 to 1:04:10( Edit History Discussion )

Amy Klobuchar: to accommodate the needs of an aging population, we need to promote primary care and transition away from specialty-intensive health care. the he now needs major improvement. that means transform system to pay doctors for the quality care they provide and to turn the current disconnected reactive health-care system into

1:04:11 to 1:04:31( Edit History Discussion )

Amy Klobuchar: one that is integrated and concentrates on delivering the best care for patients. and again, i want to stress this. when we talk about saving costs, you look at these studies. those states that are most efficient, those areas that are most efficient have the high-quality care. i leave you with that figure. mayo clinic, last four years of a patient's

1:04:32 to 1:04:50( Edit History Discussion )

Amy Klobuchar: protocols were followed across the country, we would save $50 billion every five years in taxpayer money. that's an independent study, $50 billion. i know we can do better than this, reduce costs, we can improve the quality of care that our nation's seniors deserve.