Instead of directly responding to questions about potential spending cuts, Oz focused on improving health, patient care, and payment systems using technology.
Dr. Mehmet Oz, the celebrity physician nominated to lead the Centers for Medicare and Medicaid Services, faced pointed questions from senators on both sides of the aisle during his nearly three-hour confirmation hearing.
President Donald Trump nominated Oz to head the federal agency that provides health coverage to more than 160 million people and spends one in five taxpayer dollars through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace.
The nominee appeared before the Senate Committee on Finance on March 14.
A graduate of Harvard University, Oz went on to earn a doctorate in medicine from the University of Pennsylvania School of Medicine and a master’s in business administration from the Wharton School.
Though he was an attending surgeon at New York-Presbyterian Hospital and a former professor at Columbia University, Oz is perhaps best known as the host of a long-running syndicated television program featuring health-related topics.
Democrats, concerned about a potential loss of health coverage for low-income Americans, questioned the nominee on his attitude toward possible funding cuts to Medicaid.
Republican questions focused on improving the health care system by solving some of its most costly and frustrating problems.
The Future of Medicaid
Ranking Member Ron Wyden (D-Ore.) raised the Medicaid funding question early in the hearing, asking Oz point-blank if he would oppose cuts to the program. “And I want a yes or no,” Wyden said.
Others, including Sen. Michael F. Bennet (D-Colo.), presented the candidate with a similar binary choice.
“Do you or do you not oppose the Medicaid cuts that so many people in the administration have said that they support?” Bennet asked.
The questions rose from concern over the House GOP budget blueprint, which seeks $1.5 trillion in spending cuts over 10 years, including $880 billion to be identified by the House Committee on Energy and Commerce.
Medicaid accounts for 93 percent of that committee’s spending authority according to the Congressional Budget Office, which makes cuts to the program appear likely if the desired reduction is made.
“Republicans are gearing up to deal the biggest blow to Medicaid in history,” Wyden said, which would mean “ripping health insurance away from millions of families struggling to get by.”
Oz declined to say that he would oppose reductions in Medicaid spending. His responses pointed instead to ways of improving Americans’ health, thereby reducing health care spending.
“I think it’s a belt and suspenders response,” Oz said in response to Bennet’s question. “We need to invest, especially, in the care of young people, because probably 40 percent of young people in America are on Medicaid.”
Oz suggested that empowering people to make better nutrition choices, get easier access to health information, and move into or return to the workforce would be more effective than perpetuating the current system.
“We have a generational opportunity to fix our health care system and help people stay healthy for longer,” Oz said in his opening remarks.
Democrats did not appear satisfied with the doctor’s responses on Medicaid funding. Sen. Maria Cantwell (D-Wash.) summarized their concern.
“All my colleagues are going to want to know about Medicaid,” Cantwell said. “We want to know, are you going to cut Medicaid? We don’t believe in cutting Medicaid.”
Program Problems, Solutions
Sen. John Cornyn (R-Texas) expressed frustration with Democrats’ seeming unwillingness to make changes to the program.
“There are people in Congress that don’t want anything to change when it comes to our health care delivery system,” Cornyn said. “That includes, presumably, $521 billion in fraudulent payments, included for our entitlement programs.”
Though some Democrats, including Bennet and Wyden, acknowledged the need to address fraud in the Medicaid system, others feared that Republican efforts might erroneously target beneficiaries rather than providers.
“[Let’s] make sure now we’re not kicking a couple and . . . their daughter off of Medicaid because we have some concept which is false about who it is actually benefiting,” said Sen. Catherine Cortez Masto (D-Nev.).
Republicans pressed Oz to tackle problems within the federal health payment system, including fraud, drug prices driven by pharmacy benefit managers, and needless delays and denials of treatment due to prior authorization requirements.
Sen. James Lankford (R-Okla.) expressed frustration that a bipartisan effort to regulate pharmacy benefit managers had failed last year.
Pharmacy benefit managers are companies that set drug prices and manage drug claims. They are often owned by large corporations that also own insurance companies and pharmacy chains. Their practices resulted in the closure of 450 independent pharmacies last year, according to Lankford.
The senator asked Oz what authority he would need to tackle the problem.
Oz said the ability of benefit managers to set prices and collect manufacturer rebates in secret contributes to price increases. “The lack of transparency into what goes on when that pill leaves the pharmaceutical company and ends up in your home is where a lot of the money is made,” Oz said.
Sen. Bill Cassidy (R-La.) noted that lengthy delays in treatment caused by prior authorization requirements hinder both providers and patients. “You know how sometimes care delayed is cared denied,” Cassidy said, asking Oz for possible solutions to the problem.
Calling prior authorization “a pox on the system,” Oz said the number of procedures that must be pre-authorized could be greatly reduced and artificial intelligence could be used to make coverage decisions almost instantaneously.
“Credit card approval doesn’t take you three months,” Oz said. “We will be able to do something similar so that pre-authorization could happen rapidly.”
If confirmed, Oz will use technological solutions to improve Medicare and Medicaid, he said.
That would include communication tools to empower beneficiaries to better manage their own health care, providing real-time information to physicians about patients under their care, relieving nurses of burdensome paperwork using artificial intelligence, and modernizing tools for detecting fraud and abuse.
If recommended by the committee, Oz will face a confirmation vote by the full Senate. If confirmed, he will report to Health and Human Services Secretary Robert F. Kennedy Jr.