Dedicated to lowering healthcare costs

Dedicated to lowering healthcare costs
© Joaquin Sosa

When Joel White was a congressional staffer, he took pride in helping pass the Chimpanzee Health Improvement, Maintenance and Protection Act of 2000, establishing a sanctuary system for chimps used for federal research.

But there was one bump along the way. 

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At a hearing on the bill, as he squeezed his way down the dais full of lawmakers, staffers there each took bananas out of their pockets and stacked them on top of a pile of papers he was holding. Under the gaze of a bank of television cameras, he had to balance the load to safety. 

Now, as president of the Council for Affordable Health Coverage, White does a different kind of high-pressure balancing act. 

He has to manage the needs of almost 30 business groups, insurers and healthcare providers, with the goal of lowering healthcare costs. 

“Coalition work is hard work,” White told The Hill in an interview in his downtown Washington office. “It’s very labor intensive.”

He spends about half of his time talking with members of the coalition, such as the U.S. Chamber of Commerce and Aetna, many of whom are bursting with ideas about healthcare costs. The other half is trying to put ideas into action on Capitol Hill or within the Obama administration. 

The animating force behind the coalition is the idea that 40 percent of U.S. healthcare spending is waste that does not benefit patients, such as duplicative or unnecessary procedures. Experts at the National Academy of Medicine and even Don Berwick, a former top Obama administration health official, roughly agree on that figure.

But White hopes more information and transparency can help eliminate this waste and save people money. 

“If we have the data and the technology to be able to spot at a very granular level where those cost hot spots are, we can apply that knowledge to eradicating that waste, and it means people are going to get paid less, which creates winners and losers,” White said. 

The part where doctors get paid less is what makes change difficult. 

“In general, providers would not be okay with getting paid less,” White said. “That’s why it’s going to be a hard fight.”

Other ideas for targeting the waste include new ways to pay doctors that incentivize quality over quantity. 

New reporting measures seek to find overuse and misuse of services, such as doing surgery when less expensive physical therapy could work.

The coalition is working on ideas to ensure people take their medication as prescribed, which saves money by preventing expensive treatments down the road. 

In the world of healthcare costs, there is no more heated subject at the moment than drug prices, which have come under fire on the presidential campaign trail. 

The story of Martin Shkreli, a hedge fund manager who raised the price of a drug to treat a life-threatening infection from $13.50 to $750 overnight, sparked debate nationwide.

But White argues the furor over drug prices is overblown. Drugs account for about 10 percent of overall healthcare spending in the U.S., compared with about 30 percent for hospitals, where the council focuses its efforts. 

“The drug pricing stuff is you find a boogeyman, you try and catch him,” White says. 

“If you want to focus on where is the healthcare dollar going and where is it increasing and do we need to be concerned about it, it’s in the hospital world, quite frankly,” White notes.

The council is also not swept up by Republican calls to repeal the Affordable Care Act. 

“That’s just rhetoric,” White said. “We’re about action. We’re about actually getting stuff done.”

Given the current situation, he says, “Politically, we have made a decision that repealing the Affordable Care Act is not possible right now.”

Instead, the group is focused on smaller-scale, bipartisan changes to the law to help small businesses. 

The group held more 100 meetings with lawmakers this year to help push through the bipartisan Promoting Access, Competition and Equity Act, which stopped ObamaCare’s expansion of the small-group insurance market. 

The council hopes to see another bipartisan bill passed this year that would overrule a 2013 decision from the IRS that imposed steep penalties on employers who offer tax-free reimbursements to employees to help them purchase individual health insurance plans.

White got his start in the healthcare world because his co-workers did not want to dive into these kinds of details. 

At the National Taxpayers Union in the early 1990s, no one wanted to handle the subject because it meant wading through hundreds of pages of new bills related to President Clinton’s healthcare reform.

“I was like low man on the totem pole,” White said. “They gave it to me, so I started reading this stuff, and I enjoyed the complexity of it.”

He then landed on Capitol Hill, working his way up to become staff director for the House Ways and Means health subcommittee under then-chairman Bill Thomas (R-Calif.). White became president of the Council for Affordable Health Coverage in 2008. 

Being off Capitol Hill gives him more time to spend with his wife and three kids in McClean, Va. 

He also coaches youth football and leads a church service organization called Arlington Bridge Builders. 

The organization has a food pantry, mentoring program and is starting English as a second language classes. 

“We try and bring lots of different folks together from north and south Arlington to help share the load,” White said. “Almost like a coalition.”