Senator Marshall: The Real Problem is the Affordable Care Act Isn’t Affordable
Senator Marshall Joins The Hill to Discuss The State of Healthcare in America
Washington – On Tuesday, U.S. Senator Roger Marshall, M.D. (R-Kansas), joined Julia Manchester from The Hill during The Hill Health Next Summit to discuss his background in medicine, what’s wrong with healthcare in America, the government shutdown, women’s health, and more.
Click HERE or on the image above to watch Senator Marshall’s full interview.
On what it’s like to be both a Senator and a Doctor:
“So I practiced in rural America, delivered a baby every day for 25 years. I’m an OBGYN. I think what makes me unique up here, though, is I’m the only member of Congress that’s ran a hospital as well. A group of doctors and I went together, formed our own rural hospital, had some success, and I also oversaw three county health departments. So I think I’ve seen this from all sides. Of course, we all train in a big medical center, and we went to a big residency program.
“But I think it’s having the practical experience, you know. So the ACA is something that I had to implement when I was running the hospital, as well as medical practices, the worst nightmare in my life, trying just to organize and, you know, taking nurses off the floor and turning them into data entry people and seeing doctors having to spend more and more time as data entry. So I think it gives me a real perspective of what’s really driving the cost of healthcare up.”
On how long the government shutdown is expected to last:
“Yeah, I don’t think anybody knows that. And… I don’t really believe that the ACA is the real issue. I think it’s really a political issue. And that Chuck Schumer got in such trouble with his base, and I know if it’s his base or AOC’s base, for not shutting the government down. You know, they want to do something to respond to President Trump. I mean, he’s had some incredible successes, the One Big, Beautiful Bill, the most consequential legislation of our lifetime, you know, perhaps as well. So he had to do something.
“And then they have taken this hostage, which is the Covid subsidies. And I think that’s a big misconception. Not many Members of Congress understand the difference between the original subsidies versus these additional COVID subsidies, where we went from the government paying 80 to 90%. You know, the problem with the Affordable Care Act is that it isn’t affordable. That’s the real problem here. The real problem is the cost of healthcare. And the friends across the aisle think they just keep throwing money at it. If we just keep throwing money at it, but regardless of what we do, premiums are going to go up 20% right? Regardless of what we do, premiums are going to go up 20%.
“And then there’s so much fraud being involved with these COVID subsidies. When we started having people with zero pay, in having their insurance, we saw fraud go way up. So there are people out there that are making a living. All they need is a person’s name and their birth date, and then they’re selling them this insurance product, but the person doesn’t even know it. I think, like 30-some percent of people on these Covid subsidies don’t even use their insurance, which means they don’t know they’re on it, as opposed to having to make a monthly payment, then they would say, wait a second, where is this payment going? So we have to address the fraud, and we have to address the true problem is that the Affordable Care Act is not affordable.”
On how Republicans can better message the key issues around the shutdown:
“Yeah, and I think it is very challenging, because it’s a very deep issue. And look, I want everybody to have healthcare as part of my MAHA, you know, pillars is that everyone has access, meaningful access to affordable healthcare as well. I think that they’re asking the wrong polling questions. I think if you ask polling questions, like if you knew that these Covid subsidies, that there was 25 to $50 billion of waste, fraud, and abuse, would you suggest that we fix it? Or just keep going on as is? So I think we’re asking the wrong polling questions, but it’s very hard to message because it’s a complex topic.”
On Making America Healthy Again and its progress:
“Yeah, well, you know, we’re on Trump time now. So it’s not fast enough. It’s very hard to move this needle around. You know, you think about America. You want me to drive down the cost of healthcare? We have to address America’s health. 70% Americans have a chronic disease right now. 20% of our children are on a prescription drug. 30% of our children are obese. 40% of our children have a chronic medical problem.
“So it’s very, very hard to turn around the health of America. So what I’ve tried to focus on is the four pillars. Secretary Kennedy is doing what he can through executive order, and then I’m working on a legislative package to address these pillars. So my four pillars are our number one is precision agriculture and healthy soil. And then number two would be food as medicine. Number three is access, meaningful access to affordable primary care. And then number four, address the mental illness and the neurodegenerative disease of our children as well. So we have packages of legislation. It won’t be simple to get those through, so it’s not going quickly enough.
“I think that the first MAHA report maybe missed the mark a little bit. I think the second report was a little bit better. And I think most importantly is Secretary Kennedy and the MAHA group and agriculture are now on the same page. Okay? And what I think is healthy soil is where agriculture meets MAHA. So, we’re there telling our farmers what we can’t do. Tell them this is our goal. Our goal is healthy soil. And with proper precision agriculture, we can use 50% less fertilizer and chemicals. And we can decrease the drift of those chemicals from the field by 90% right? And therefore less toxins in the water. So we’re getting there. We’re getting there. We’ve got a long ways to go.”
On vaccine skepticism and where the focus of American healthcare should go in the future:
“Yeah, you know, that’s a tough one. And you know, the sad thing is, Congress has spent 95% of our time this quarter…working on vaccines. Look, vaccines are 1/10 of 1/100th of a percent of what we should be working on from a MAHA concept. So it’s too bad that we’ve let that sideline us. I’m very much of the opinion in valuing the patient-physician relationship and informing patients, you know, the pros and cons, and we don’t need to dive down there, but this vaccine skepticism was actually created by Dr. Fauci when he lied to America about the MNRA vaccines and what it [would] and wouldn’t do, as well. So I think they lied about the origin of the virus, all these types of things. So we’re inheriting that. We’re inheriting this vaccine skepticism and and I don’t know why, but people are just obsessed with it. But I’m so ready to move on and let parents and decide with their doctors decide what’s best for their children.”
On what Senator Marshall’s advice would be to obtain medical information:
“Yeah, how about your doctor. I don’t understand what the confusion is. I know your history. I know what you’re at high risk for, what you’re doing, and your social history as well. And let’s make a decision together on this Hepatitis vaccine for your child, as well. So I think your doctor, you know, the nurses typically do a really good job as well. And you’re right, there’s just too much information out there. And everybody overreacts to one study. If I overreacted to every study I saw that something something, coffee causes cancer. Wine causes cancer. No, wine is good for you, wine’s bad for you. So, you know, just quit. Quit it. Quit it. Take it all with a grain of salt and ask your doctor.”
On what initiatives exist for women’s healthcare:
“Well, you know, what’s driving maternal mortality? Let’s start there. When I was in med school and residency, the drivers of maternal mortality were strokes and infection, hemorrhaging, complications from anesthesia. So when I came to Congress, oh my gosh, Bernie Sanders says, how come maternal mortality is going up? And I cited the things I just cited. But I said, you know, I haven’t seen a really good study in a long time to really figure out why we’re having this spike.
“So we passed legislation to fund a study, and guess what it showed? We had experts in front of HELP, and I’m asking them the same question: what’s the number one cause of maternal mortality? When you measure maternal mortality, you go for the year after having the baby. Guess what the number one cause of maternal mortality is now? So it’s suicide and a fentanyl overdose. So what that means to me is, after this patient’s delivered, you know, the delivery is not over with. I mean, we have to hang on to that patient and figure out what’s going on in their personal life as well. And certainly there’s risk factors, and I don’t want to get too quirky on here, go too deep. But I think that would be one thing.
“The other thing that’s exploded, of course, is diabetes of pregnancy. You want to know why our C-section rate is going up; in addition to malpractice issues, it’s obesity. I mean, I just dedicate one day a week to doing nothing but taking care of having a diabetic clinic… I would typically have 40 to 60 patients every day, but one of those days was just for my diabetics. And of course, those turned into type 2 diabetics later, etc. So I think, you know, the MAHA thing, there’s nothing magical. We need to execute a simple plan well. So it goes back to nutrition. Give me a healthy mom with good nutrition before she gets pregnant, and I’m going to celebrate. I mean, that’s all I asked for as a healthy mom. But when they come in with type 2 diabetes, all your risk of complications doubles and triples. So I think it’s, it’s simple things like that. I would start there.”
On the impact diet has on health outcomes, especially diabetes:
“Yeah, all the above. Certainly, 70% of America’s calories are ultra-processed food. I challenge everybody to spend a week and don’t open a sack or a box. Okay, just try it. And so 70% of our calories are ultra-processed. It’s the sugar and the salt as well. But it’s all linked to the type two here. The Diabetes of pregnancy is certainly linked to obesity, but then for some women, they have a genetic predisposition to it as well. And I won’t bore you on the insulin receptor business here. But you throw in a pregnancy and hormones, and they start off overweight, you know, they’re just walking into type two diabetes pregnancy. It’s called A2 diabetic.”
On the challenges of patient advocacy and the advent of ‘drive-through medicine’:
“That’s a tough one. I don’t understand it. I mean, that’s why I wanted to be a doctor, is have a relationship with you, and now people want drive-through medicine, just like they have drive-through fast food, and it doesn’t work.
“My wife has an asthma problem. I’m a Senator. It took me six weeks to get her to see a doctor up here. And she ends up seeing a PA. I mean, with all due respect, the reason we chose a pulmonologist and not a primary care doctor is because she has a very significant asthma problem. I want a doctor who went to four years of medical school, did four years of residency, and has seen 100 asthma patients this week, not a PA.
“So we went to this drive-through medicine, you urgent cares, and ER visits, and you know, frankly, I don’t understand today’s medical students and new residents. I mean, they want to work 30 hours a week, like, come on, that’s not why we signed up for this. I worked 100 hours a week my whole life. That’s just who I am.
“So I’m baffled by that as well, but I think you’re on to something that it is the relationship part of this. But you know, by the way, I can link this back to the only people whose healthcare costs aren’t going up are people that are, you know, self-payment model, self-insured, and direct primary care. Were this one doctor and this team of PAs and nurse practitioners are managing these 200 patients, or 2000, whatever it is. And the secret there is that relationship. So that when someone calls me up and says, you know, this is what’s going on, I know you. Okay, you’re having chest pain, you’re a farmer, and you don’t want to get off the tractor, you know, my gosh, you’re having a heart attack. Get your butt in here. So you have to know the patient. Like, who you need to coach up.”
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Contact: Payton Fuller
