00:00Recognize Dr. Murphy. Thank you Mr. Chairman and thank you guys for holding
00:03this. I think this is an issue really that we have a lot of bipartisan support.
00:08I will tell you point blank I'm a fan of MA plans with a caveat. They do
00:15decrease hospitalization. We do have managed care. We prevent people from
00:19getting sicker. Absolutely. And I tell you when I was doing my research
00:23yesterday I applaud you guys for actually doing it right. I applaud y'all
00:28for doing it right. What I'd like to see are the United Healthcare, Humana and the
00:33Aetna sitting in front of us because they have bastardized the system and they
00:37have ruined Medicare Advantage to what it should be. You guys are doing it right.
00:42I went down to Puerto Rico several months ago. Ninety-five percent of the Medicare
00:46patients are on Medicare Advantage. They do it right. United left after three
00:51months because they couldn't squeeze enough money out of the system. So you
00:55guys are doing what it's intended to be and just like with PBM programs it was
00:59started out with a good plan. But when profit and actual fraud happens this is a
01:05problem. Mr. Chairman I have an article here how health insurers from the Wall
01:10Street Journal imagine that. They're good five good articles that I would love my
01:13colleagues to read. How health insurance racked up billion in extra payments for
01:17Medicare Advantage. I'd love that submitted for the record. It shows how
01:20especially United Health Group. I'm calling them out and I'll continue to call
01:24them out. Without objection so ordered. Some people that are probably going to
01:27end up going to jail because of the way they've ruined the system. The second
01:32thing is how United Healthcare Army of Doctors is the largest employer of
01:35physicians in the country. How they mobilize them. How they militarize them to
01:40upcode. I'd like to submit that article also for the record. Without objection so
01:46order. Thank you. You know I I've gone through this a couple times with my
01:50colleagues here before I ask any questions of what the what has happened
01:54with the with what's what's gone wrong with Medicare Advantage. Taking a good
01:58system where you guys are doing it well and taking it wrong. There's a diagnosis
02:03that poor Dr. Miller I've seen that look in your eyes when you've been up all
02:06night. I got that look so many times. Actually some of my colleagues had that a
02:09few weeks ago. We've gotten a little used to it here. We don't want to though. United
02:13Healthcare diagnosed something called secondary hyperaldosteronism in three
02:17quarter of their enrollee's. Three quarters of them. It's only three percent
02:21on fee-for-service. They are ruining a good system and sadly enough we have seen
02:25the nation respond against insurance industries you know after a tragic death
02:32of the United CEO. There were hundreds of thousands of dollars donated by people to
02:38the defense of the guy who murdered him. That's the outrage that we're seeing. So you
02:43know guys we have to correct this and this is a bipartisan issue. We can't we
02:48can't throw away a good program but we can throw away bad actors for sure. Dr.
02:53Miller, God bless you for staying up all night. Thank you very much. Can you tell
02:57me do we need the stars rating system? Absolutely not measuring quality is a
03:05mistake whether it's the quality of a physician a hospital or health plan. I
03:09think the problem with the star quality rating program is that the star quality
03:13rating program does not apply to fee-for-service as a health plan or ACOs
03:18and that fee-for-service as health plan ACOs don't have an opportunity to get
03:24that bonus. I think the other problem is that there's no downside. So ideally the
03:29stars quality rating program would apply to fee-for-service Medicare ACOs and MA and
03:35have upside risk and downside risk and that's something that Max could help
03:40with. Yeah I agree completely. This is something you know when we when managed
03:45care or rather MA plans came in especially with United they would
03:49undercut. I couldn't take their patients. I had patients that I've been seeing for
03:53years and all of a sudden they got Joe Namath. Joe Mamath brought them in and I
03:57can't take them because they don't pay anything or their denial rate was insane.
04:01This is something this committee and actually this Congress should change. The
04:06star system I'm still not a hundred percent sold on because I don't see its
04:09efficacy but for that matter it would be great to have it on the other side.
04:15Tell me a little bit private practice wise Dr. Miller I know you're not in
04:19private practice. How can how can private practice survive in the world of
04:23Medicare Advantage? Private practice and the opportunity for a physician to own and
04:28operate their own business and compete is getting crushed. So when you finish
04:34medical school residency fellowship you can go work for a large tax-exempt
04:38hospital corporation. You can work for a large university health system. You can
04:43work for the VA. It is hard to own and operate your own business. There are
04:47legitimate concerns about induced demand in a fee-for-service setting. Medicare
04:52Advantage is not that. We should look to empower private practice as a viable
04:57alternative to large tax-exempt hospital monopolies and have a stark waiver in a
05:02managed care setting to make private practice great again. Thank you. You know
05:07that I'll just say this the insurance lobby is the strongest lobby in this town.
05:11It has strangled this place and it is time for Congress to take back what was
05:16originally attended for health care and not let the insurance industry strangle
05:20this country. Thank you Mr. Chairman. I'll yield back.
