STEVE INSKEEP, HOST:
President Trump says he wants Republicans to be known as the party of health care. So how do they achieve that, given their record? When they controlled both houses of Congress, the promises to repeal Obamacare and replace it with something better ended in nothing. More recently, the Trump administration backed a lawsuit to overturn the Affordable Care Act with no replacement in sight. Now, the president does say he is counting on senators to fill that gap - senators including Rick Scott, our next guest. He is a former hospital executive and former governor of Florida, now a newly inaugurated United States senator. Senator, good morning.
RICK SCOTT: Good morning. That's right. The - well, let's - I think we can all thank the president for his interest in health care. I've been involved in health care all my life. And so I'm glad with that. And I'm going to work hard to try to drive down the cost of health care. That'd be the most important thing to Americans.
INSKEEP: Well, you said drive down the cost. Let's talk about what the Republican approach really is here. From talking with others Senate Republicans, we get the impression the idea is to really stop trying to repeal and replace Obamacare and just find some narrower improvements in the existing system. Is that a fair description?
SCOTT: Well that's what I'm doing. Steve, drug prices are too high. So I put a bill out last week that would require transparency, so you know what things cost. But on top of that, Americans - it's not fair that we pay more for drugs than Europeans pay. I had the same problem when I was in the health care business. I had hospitals in America and in Europe. And the drug companies wanted to charge us more in America. And I said, that's not fair. And I'm not going to do it. And I think we have to have the exact same attitude. Why are we paying more than Europeans or Canadians or Japanese for drug prices? That's my bill. That's what I'm focused on.
INSKEEP: You're going for, in a sense, a free market solution. You want more transparency so that people know what they're paying. And maybe they can shop around for cheaper drugs at pharmacies and that sort of thing. But isn't it still going to be really hard for the average consumer to navigate such a complicated system where, in the end, insurance companies, they would hope, are paying most of the bills?
SCOTT: Oh, look. I think that it's difficult. But I grew up in a family that didn't have money. And I remember asking my mom one time, how much would it cost - how much would there be a change in a drug, you know, if you're going to pay for it before you would change pharmacies? She said, less than a buck. I think if we tell people - give people information, they'll make good decisions. One of the companies I had in health care was a walk-in doctor's office company who put all the prices up on a menu board, so people could decide, do I want my insurance, or do I want to pay out of pocket? And it worked. So I think transparency works. I think giving people information works. But on top of that, we - the drug companies have raised their prices too fast. And so we're going to - I want to stop them from being able to charge us more than they charge Europeans.
INSKEEP: I want to ask about another source of costs in the health care industry, one with which you have direct experience - hospitals. You founded a large hospital corporation. And a lot of people - laymen - will know that hospitals are famous for charging immense bills which are often inexplicable to us. Presumably, insurance firms will just pay them. But there is this huge bill. Are hospitals a big part of the problem?
SCOTT: I think you have to look at - the entire delivery system is an issue. We - I passed legislation when I was governor to require hospitals to disclose their prices. We've got to make this more simplistic, more transparent, so you as a consumer have better information. And that's true for the pharmacies. That's true for the hospitals. That's true for the insurance companies. Take insurance companies as an example. You probably know if you're on a stat (ph), as an example. Insurance companies should tell you what your copayment is before you buy the insurance that year. And they shouldn't change it on you for the 12 months. I mean, that's not fair. And so I think every part of this - we need to have - what I always thought about it is you've got to have more competition. And you've got to let people make more of the decisions on their own. They'll spend their money smartly if they have the information.
INSKEEP: Now, you, of course, are in a Senate where I'm sure every Republican and every Democrat will be in favor, in theory, of lower prescription drug prices. Do you believe there is sufficient bipartisan support for the same approach to this?
SCOTT: Well, clearly - I was in the Budget Committee last week. And everybody, including Bernie Sanders, was all in on lower drug prices. I think this idea that we should not pay more than Europeans pay - I think that's pretty common sense. And so I'm optimistic that we can get that done. I think - look. It's very partisan. I've just been up here three months. It's a partisan place. But that's why you've got to find things that everybody agrees on to get it done. I mean, look. We've got a divided Congress. And even in the Senate, takes 60 votes. So it takes Democrats to be onboard to get anything done, which - I'm fine with that. We ought to figure out how to work together.
INSKEEP: Well, Senator, thanks very much for the time. Really appreciate it.
SCOTT: All right. Have a great day.
INSKEEP: Rick Scott, former governor of Florida, now U.S. senator. NPR's Alison Kodjak covers health care for us. And she was listening in. She's in our studios. Alison, good morning.
ALISON KODJAK, BYLINE: Morning, Steve.
INSKEEP: What do you hear there?
KODJAK: Well, the thing that stood out right at the beginning was that he really wasn't interested in engaging on a replacement for the Affordable Care.
INSKEEP: He was frank. That's not the goal anymore.
KODJAK: Exactly. But last week, the Trump administration changed its position and said it wants the law overturned in court. If it gets its way, that's going to leave a huge void in the health care system. And it doesn't look like the Senate's looking to step up and find a replacement.
INSKEEP: You said it doesn't look like the Senate's looking to step up and find a replacement. But the president is looking there. We have Rick Scott introducing this bill. But the prospects don't seem very good when you observe this from the outside?
KODJAK: Well, the bill he is introducing is about drug prices, which is not a replacement for the Affordable Care Act. It's not going to get people insurance if they have pre-existing conditions. And this lawsuit actually overturns that law. It is - the issue of drug prices is very important. And lowering health care costs is very important. Senator Scott - the other thing that he talked about - he focused on drug prices but slid over the issue of hospital costs. He's a former hospital executive. Hospital costs are much higher, generally, than drug prices. They take up a huge share of the medical costs that this country spends. Drug prices are rising faster.
INSKEEP: If I'm concerned about my insurance costs, hospitals are a huge part of that, even though drug prices get the attention?
KODJAK: Yeah. Drug prices are rising faster, but hospitals take up a much larger share of our overall health care spending.
INSKEEP: Have they had much success in restraining hospital costs in this country over the last several years under Obamacare?
KODJAK: Not really. They've had success in restraining payments to doctors but not overall payment - not overall costs charged by hospitals.
INSKEEP: When you look at what Senator Scott just said, what other Republicans have said, what the president has said, do you see a coherent approach to health care by the Republican Party?
KODJAK: I would say not an overall approach because if they - the president is saying he wants the Affordable Care Act completely overturned. And Republicans in the Senate and in the House and the president are also saying that they want people with pre-existing conditions protected, young people able to get affordable insurance. Nobody's looking for - to how to replace that and put those things in place if this law is overturned.
INSKEEP: Alison, thanks for coming by.
KODJAK: Thanks, Steve.
INSKEEP: NPR's Alison Kodjak. Transcript provided by NPR, Copyright NPR.
