GAO’s Goals for Healthcare

Gene L Dodaro, 8th Comptroller General of the U.S and Head of the U.S Government Accountability Office (GAO) appeared before the Subcommittee on the Legislative Branch, Committee on Appropriations, before the Senate on April 1, 2019 to report on GAO’s Fiscal Year 2020 Budget Request.

Dodaro pointed out how healthcare costs in terms of growth in federal spending for major healthcare programs is projected to grow faster than the economy. In particular, these healthcare programs include Medicare, Medicaid, and the Children’s Health Insurance Program along with federal subsidies for health insurance purchased through marketplaces established by ACA and related spending.

Federal spending also supports healthcare for American Indians, Veterans, service members, and for public health priorities, such as preventing and responding to infectious disease outbreaks plus bio health threats.

As he told the Subcommittee, “Federal commitments to healthcare programs are a key driver of the nation’s fiscal spending. Growth in federal spending on healthcare is driven by increasing healthcare spending per person and by increasing enrollment in part stemming from the aging of the population.

GAO has evaluated the rapid diagnoses of infectious diseases and GAO is assessing new technologies for dealing with emerging infectious diseases. These can include developing technologies that would be able to simultaneously test for multiple infectious diseases at or near the site of patient care. GAO has begun to recruit additional staff with expertise in biological/life sciences for emerging infectious diseases, epidemiology, synthetic biology, biosafety, and biosecurity work.

The agency is also currently assessing the impact of artificial intelligence on healthcare and is seeking additional staff with expertise in digital and communications technologies such as 5G wireless, Blockchain, quantum cryptography, artificial intelligence, and machine learning systems.

As Dodaro told the Subcommittee, “Additional resources for GAO’s healthcare work would help GAO to respond more quickly to congressional requests and enable us to expand our work on the drivers of healthcare costs.”

He continued to say, “Growth of the Medicare and Medicaid programs drives federal spending on healthcare. These programs are expected to place additional strain on the federal budget in the coming years, as each program is projected to top $1 trillion in annual expenditures within the next decade.”

GAO’s expertise enables the examination of incentives created by certain Medicare payment policies that drive excess and inappropriate utilization of services. The staff with Medicaid expertise is exploring issues like access, financing arrangements, delivery, and program integrity, which are critical issues that are made more complex by the variation among state Medicaid programs.

In addition to examining the sustainability of large federal healthcare programs, GAO is also studying the complexities of the prescription drug market and continues to provide objective, unbiased examinations of trends in drug costs and identify options on how to control these costs. has information on GAO’s testimony before the Subcommittee on the Legislative Branch, Committee on Appropriations, Senate (April 10, 2019).

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