Giving Medicare authority to negotiate drug prices is the best way to keep those spiraling costs under control for the program's recipients, departing Health and Human Services Secretary Sylvia Burwell said Monday.
"Those drug costs are continuing to grow," Burwell said at the National Press Club in Washington, D.C. The question, she said, is not whether Congress should give her department the necessary power, but rather "what is the alternative?"
Burwell largely devoted her remarks to defending the Affordable Care Act, the Obama administration health care law that is facing repeal by a Republican-controlled Congress and President-elect Donald Trump. HHS billed the speech as her last on the health law as the department's secretary.
As she touted the ACA's successes, Burwell acknowledged the law has fallen short in certain areas. In an exit memo released Friday, Burwell implored Congress to create a public option to increase competition in areas where few insurers offer plans. President Barack Obama also said last week he would have added that feature into the law if he could start over "from scratch."
She rejected criticism that the ACA, often called Obamacare, is collapsing.
"Are there things that need to be improved? Are there places where more competition could help affordability? Yes. But the idea of disaster and collapse -- those comments need to be examined."
Burwell also dismissed the idea of repealing the law without a comprehensive replacement in place, saying a delay would bring chaos to individual insurance markets. Insurers would drop out or raise prices, and consumers would be unable to find or afford coverage.
She said any replacement plan must meet three requirements: cover as many or more people as the ACA does, maintain quality care and keep down health care costs. Republicans haven't offered enough details to even evaluate a plan under those benchmarks, Burwell said.
"I don't think most women think it's a nitty-gritty detail whether their contraception is covered at no additional cost. I don't think it's a nitty-gritty detail whether or not your preexisting condition is covered," she said. "That's the level that the conversation needs to get to."
Both benefits are required under the health law.
Republicans who are trying to repeal Obamacare and replace it with an alternative are looking for easy solutions to a complicated problem, and one faulty move could wreck the entire health care system, Burwell said.
She compared the health law to Jenga, a game where players take turns removing one wooden block at a time from a tower of 54 without making it topple. Republicans, she said, are looking for easy pieces to take out of the law. But less-popular provisions -- such as the individual mandate requiring all Americans to purchase health insurance -- are akin to an integral Jenga piece that props up the more popular parts, like banning insurance companies from discriminating against people with preexisting conditions.
Silver bullets don't exist, she said.
"Instead, one of the most important things I've learned from implementing the Affordable Care Act is that if something sounds too good to be true, it usually is."