Issues That Matter: Dr. David Agus, Steven Brill on rising health care costs

Issues That Matter: Health care

In this installment of our series “Issues That Matter,” CBS News contributor Dr. David Agus and Steven Brill, author of “America’s Bitter Pill,” join “CBS This Morning” to discuss the costly health care issues facing the next president.  

Skyrocketing premium prices have made the Affordable Care Act a hot topic on the campaign trail. Some states have seen double-digit percentages and by next year, some popular plans will increase by an average of 25 percent – more than three times this year’s increase. Major insurance companies are also cutting back on participation in the exchange program.

So what’s going wrong with Obama’s signature health care law? 

Obamacare open enrollment begins as rates spike

“One of the premises is young people who never get sick would enter the system, contribute their dollars and it would subsidize the people because as you get older, you get more and more ailments and it would start to even out. These young people said, ‘I’m just going to pay a fee, I don’t want to enter,’ because the prices are going too high,” Dr. David Agus explained on “CBS This Morning” Thursday. “So when you don’t have that angle, that seesaw tips.”

Still, Agus thinks Obamacare is “great” because it got the principle right – that everyone should have a right to health care. Twenty million more Americans now have health care coverage

“But any policy needs to be refined,” Agus said. “You can’t just put out a policy and it’s going to work from day one, especially something as complex as health care.”

“But beyond Obamacare, premiums are going up for those of us that aren’t even on Obamacare,” co-host Norah O’Donnell said. “How is that justifiable?”  

“Well, it’s justifiable if we continue to be the only country in the developed world that doesn’t control the price of prescription drugs that allows so-called ‘nonprofit hospitals’ to make exorbitant profits, charging ridiculous prices in paying exorbitant salaries to its non-doctor executives,” Brill said.

Brill, too, agrees that Obamacare has kept its promise to make health care accessible to more people. But he said it hasn’t kept its second promise.

How will President Obama defend Obamacare after the sudden price hike?

“It also promised kind of vaguely – because it was a promise they could never keep – that it was going to do something to control the cost of health care. It has done nothing to do that.”

On Obamacare, Hillary Clinton and Donald Trump stand on opposite ends of spectrum. Clinton wants to expand the act and help people buy into Medicare earlier. Trump wants to repeal it all together and drop the requirement that everyone buy insurance or pay a penalty. 

Dr. Agus is against the latter idea. Instead, he argues, we should reform it by getting more people into the system, so that a small proportion of sicker people don’t deplete its financial stability.

“What we’re seeing is 5 percent of people spending 50 percent of the dollars in the Affordable Care Act. And so a number of people who are very ill are taking a disproportionate portion of the resources,” he said.

“But that not just Obamacare. That’s true in general,” O’Donnell said.

“And it is not new, we’ve known that,” co-host Charlie Rose jumped in.

“But we’ve seen those figures jump out at us,” Agus responded.  

“Well, that’s because people are getting older and we still have the same system before which is the more tests the doctor does, the more exams, the more everybody gets paid, and Obamacare does have some pilot project to try to go after that, they haven’t really been successful so far,” Brill responded.

For Brill, the “core issue” is to address the rising price of health care, which he called a “monopoly market.”

“I think the summary really is that the Affordable Care Act helps people. Both candidates want to change it but this is a bipartisan issue. Health care is not partisan and I think that is really the message,” Agus said. “It is partisan because you have abortion – yes, no. It’s partisan because they want the term kicked out. No matter how you do it, you’re not going to be able to remove health care from 20 million people. So the parties have to work together.”

“It’s not going to be repealed,” Brill agreed.