Earlier this week, members of Congress pressed some of the nation’s top health care leaders, including Rick Pollack, President & CEO of the American Hospital Association and David Aizuss, MD, Chair of the Board of Trustees for the American Medical Association, about the role of health care providers in controlling health care costs.
This was the third hearing in a series on health care affordability (the first two featured insurance companies and pharmaceutical companies) held by the Health Subcommittee of the House Committee on Energy and Commerce. It focused on how payment policies, competition, transparency, and other incentives shape patient access and the cost of care.
It was an important moment in the nation’s capital, where hospitals and other providers had the chance to share their perspectives (AHA’s testimony is here) on the widely acknowledged challenge of keeping care affordable, without sacrificing access to that very care.
The reality is that this is a problem we can no longer afford to discuss in the abstract. The key to affordability is coverage, but that coverage is being narrowed, burdened with high deductibles, or removed altogether. Too many Californians cannot access the care they need because of cost — that’s not a situation that hospitals created, but it is one for which we now have an important role to play in resolving equitably.
The good news is that hospitals are already part of the solution. As we shared in a statement to the committee, California’s per-capita hospital spending ranks among the lowest in the nation — a testament to years of hard work by your teams. Innovations like telehealth expansion, clinically integrated care models, and AI-assisted documentation are making care better and more cost-effective. That work matters, and it should be recognized.
But we also need to be honest: hospitals cannot solve this alone. Nearly two-thirds of health care spending happens outside our walls. Government programs — Medicare and Medicaid — reimburse only 83 cents on the dollar, forcing hospitals to seek higher commercial payments just to break even. Meanwhile, insurance company profits in California grew more than 20% between 2022 and 2023, far outpacing spending on actual patient care.
This moment calls for deeper conversation — among hospital leaders, policymakers, pharmaceutical companies, labor, payers, and the communities we serve — about how responsibility for affordability is shared across the entire system. There are no simple answers here, and hospitals must be engaged in these conversations, with honesty and a clear sense of purpose, and with patients at the forefront.
We’ll continue to press these points — both on Capitol Hill and in Sacramento — as we make sure the vital services you provide and their value to patients are not relegated to afterthoughts during these heated debates.
