Bernie Sanders on Health Care
Democratic primary challenger; Independent VT Senator; previously Representative (VT-At-Large)
SANDERS: We put $2 billion into a program which would provide debt forgiveness for doctors, nurses, dentists, we have a major dental affordable crisis in this country, to make sure that they are practicing in underserved areas. The advantage of a Medicare-for-All health care program, because it's not driven by profits for the drug companies and the insurance companies, we will have health care for all people in all parts of this country.
It is a four-year transition period. All of you know that right now to be eligible for Medicare you've got to be 65. What we do is in the first year, we go from 65 down to 55. Next year, 45. Next year, 35. And then we cover everybody.
SANDERS: We build in to our Medicare for All program a transition fund of many, many billions of dollars that will provide for up to five years income and health care and job training for those people.
SANDERS: Obama is right. We don't have to tear down the system, but people understand the system is not only cruel, it is dysfunctional. How do we have a system in which we spend twice as much as the people of any other country, and yet we've got 87 million uninsured. Five hundred thousand people go bankrupt because of medically related issues. They get cancer, and that's a reason to go bankrupt? We will introduce Medicare for all means no deductibles, no co-payments, no out-of-pocket expenses.
Rep. John DELANEY: We don't have to go around and be the party of subtraction, and telling half the country, who has private health insurance, that their health insurance is illegal. It'll underfund the industry, many hospitals will close, and it's bad policy.
SANDERS: The fact is, tens of millions of people lose their health insurance every single year when they change jobs or their employer changes that insurance. If you want stability in the health care system, if you want a system which gives you freedom of choice with regard to a doctor or a hospital, which is a system which will not bankrupt you, the answer is to get rid of the profiteering of the drug companies and the insurance companies, move to Medicare for all.
SANDERS: That's a very difficult issue. I think that is an issue right now that I am comfortable seeing in the hands of the state. It's a controversial issue. And the fear is, obviously, that it could be taken too far. But I think, probably, it is best dealt with at this point at the state level which is where it is right now.
SANDERS: You have a Republican leadership in the House and the Senate that tried, came within one vote of throwing 32 million people off of the health insurance they currently have. You have leadership there in the House and the Senate that wants to do away with the preexisting protections that people have in this country. You have a president and Republican leadership who supported a budget which would have cut Medicare by $500 billion.
Q: President Trump argues that Medicare-for-All could lead to worse coverage for many Americans who are happy with their private insurance plan. What do you tell them?
SANDERS: Right now, as a nation, we are spending twice as much per capita on health care as do the people of any other country, $28,000 a year for a family of four. That is unsustainable. 70% of the American people understand that Medicare is a good program, and it should be expanded to all people.
The Sanders bill would retain Medicaid for purposes of providing long-term services and supports, and would impose requirements on states to maintain eligibility standards and expenditures on long-term services and supports at 2017 levels.
Think about the extraordinary impact it would have on our economy if all Americans had the freedom to follow their dreams and not worry about whether the family had health insurance. Universal health care would provide a major boon to our economy, unleashing the entrepreneurial spirit of millions of people.
States looking to save money have pared away community mental health services designed to help people function, as well as the hospitable care available to help them heal after a crisis.
The result is that all too often people with mental illness get no care at all. Nearly 40% of adults with a severe mental illness--such as schizophrenia or bipolar disorder--had received no treatment in the previous year.
The time is long overdue to understand that a mental health problem should be treated like any other health-related issue. People must be able to get the mental health treatment they need when they need it.
Bad teeth can not only lead to pain and illness, but it has an economic consequence. Try applying for a job when your front teeth are missing and you can't smile. Having bad or missing teeth makes it clear to the world that you are poor, which makes it harder for you to find employment, which perpetuates the cycle of poverty. And for kids, toothaches are one of the major causes of school absenteeism.
The health insurance lobby and other opponents of single-payer care make it sound scary. It's not. In fact, a large-scale single-payer system already exists. It's called Medicare. People enrolled in the system give it high marks. More importantly, it has succeeded in providing near-universal coverage to Americans over the age of 65.
Establishing a single-payer system will mean peace of mind for all Americans. The goal of real health care reform must be high-quality, universal coverage in a cost-effective way. We must ensure that the money we put into health coverage goes to the delivery of health care, not to paper-pushing, astronomical profits and lining CEOs' pockets.
Thomas Salmon, a Democrat, very shrewdly and effectively picked up on 2 issues that the Liberty Union was fighting for: property tax reform and dental care for low-income children. Under the Salmon administration, a popular property tax rebate program was established, as well as a "tooth fairy" program which went a long way toward improving dental care for kids. Despite our paltry 1%, the Liberty Union made an impact on major legislation.
SANDERS: Nobody thinks that ObamaCare is perfect. It has its problems. But every American has got to recognize, we are the only major country on Earth not to guarantee health care to all people. We pay by far the highest prices in the world for prescription drugs because the pharmacy, the pharmaceutical industry is out of control ripping us off. So, what sensible people have got to do is not simply repeal the Affordable Care Act without any alternative, but you've got to sit down and say it's OK, what are the problems. How do we address it? How You just don't throw 20 million people off of health insurance. You don't privatize Medicare.
Q: But if that repeal happens, will you support piecemeal, step by step reforms?
SANDERS: Do we make sure that young people stay on their parents' health insurance? Do we make sure that there are no caps if you're dealing with cancer? It goes without saying that those patient protections have got to stay in place.
"The Trump administration must rescind this corporate giveaway to Gilead and make any treatment and vaccine free for everybody," added the Vermont senator.
Bernie Sanders: Well, first thing we have got to do, is to shut this president up right now, because he is undermining the doctors and the scientists who are trying to help the American people. It is unacceptable for him to be blabbering with unfactual information which is confusing the general public. Second of all, make sure that every person in this country finally understands that when they get sick with the coronavirus that all payments will be made, that they don't have to worry about coming up with money for testing. They don't have to worry about coming up with money for treatment. We have to make sure that our hospitals have the ventilators that they need, have the IC units that they need. Right now, we have a lack of medical personnel. Bottom line from an economic point of view, say to the American people, if you lose your job, you will be made whole. You're not going to lose income.
One of the reasons that we are unprepared and have been unprepared is we don't have a system. We got thousands of private insurance plans. That is not a system that is prepared to provide healthcare to all people. In a good year without the epidemic, we're losing up to 60,000 people who die every year because they don't get to a doctor on time. It's clearly this crisis is only making a bad situation worse.
What do we have to do? Whether or not the issue is climate change, which is clearly a global crisis requiring international cooperation, or infectious diseases like Coronavirus, requiring international cooperation, we have to work and expand the World Health Organization.
Obviously, we have to make sure the CDC, the NIH, our infectious departments, are fully funded. This is a global problem. We've got to work with countries all the over the world to solve it.
SANDERS: Well, for start, I would not do what Trump has done and cut funding for those federal agencies which deal with infectious crises. We would put more money into research to make sure that we are best prepared to what I fear may be happening more and more frequently. And we've got to go to the best experts that we can. But we need a global response to this global crisis.
Q: Is cutting off access with China, is that wise?
SANDERS: I don't think you want to cut off access. I think you want to put up protocols to do our best to make sure that we take a look at anybody who is coming into this country, I suspect. But I don't know you have to stop travel from China.
A: Bernie believes that vaccinations are safe and effective, and that electing not to vaccinate is dangerous and wrong: "I think obviously vaccinations work. Vaccination has worked for many, many years. I am sensitive to the fact that there are some families who disagree but the difficulty is if I have a kid who is suffering from an illness who is subjected to a kid who walks into a room without vaccines that could kill that child and that's wrong."
Sanders responded that the "status quo" offered by Biden will cost even more. "We are spending twice as much per capita as the people of any other country," Sanders told Biden, who was vice president during the passage of the Affordable Care Act championed by President Barack Obama. "Maybe it has something to do with the fact that the health care industry last year made $100 billion in profit."
Sanders and Sen. Elizabeth Warren favor Medicare for All--a plan that would eliminate private insurers--while the other candidates favor building on the Obama-passed plan with features like a public option.
Sen. Amy KLOBUCHAR: I think it is much better to build on the Affordable Care Act. If you want to be practical and progressive at the same time and have a plan and not a pipedream, you have to show how you're going to pay for it. I think you should show how you're going to pay for things, Bernie. I do.
SANDERS: Every study done shows that Medicare for All is the most cost-effective approach to providing health care to every man, woman, and child in this country. I intend to eliminate all out-of-pocket expenses, all deductibles, all co-payments. Nobody in America will pay more than $200 a year for prescription drugs, because we're going to stand up to the greed and corruption and price-fixing of the pharmaceutical industry.
Vice President Joe BIDEN: Anyone who can't afford it gets automatically enrolled in the Medicare-type option we have. But guess what? Of the 160 million people who like their health care now, they can keep it.
Two days ago, I had a remarkable experience which should tell you everything you need to know about what's going on in America. I took 15 people with diabetes from Detroit a few miles into Canada, and we bought insulin for one-tenth the price being charged by the crooks who run the pharmaceutical industry in America today.
But it's not just the price-fixing and the corruption and the greed of the pharmaceutical industry. It's what's going on in the fossil fuel industry. It's what's going on in Wall Street. We need a mass political movement. Stand up and take on the greed and corruption of the ruling class. Let's create a government and an economy that works for all of us, not just the 1%.
In the letter, Sanders asked Catalyst to lay out the financial and non-financial factors that led the company to set the list price at $375,000, and say how many patients would suffer or die as a result of the price and how much it was paying to purchase or produce the drug. For years, patients have been able to get Firdapse for free from Jacobus Pharmaceuticals, a small New Jersey-based drug company, which offered it through an FDA program called "compassionate use." The program allows patients with rare diseases access to experimental drugs when there is no viable alternative. Catalyst received FDA approval of Firdapse in November.
SANDERS: What you have is a president who promised the American people to provide health care to everybody, and then proceeded to support legislation to throw 32 million people off of health insurance. And most Americans think that health care should be a right of all people. We're moving in exactly the wrong direction. You have a president who campaigned, appropriately enough, on the outrageous ripoffs of the pharmaceutical industry, and he said he was going to take them on. And just the other day, he caved in, of course, and did not go forward in demanding that Medicare negotiate prices with the drug companies or that we allow our pharmacists and distributors to re-import low-cost medicine from abroad. So, I think what the American people perceive is, you have a president who says one thing and does another thing.
SANDERS: I'm willing to look at it, if you are willing to look at taking on pharma, which is the greediest of many greedy corporate interests. I'm introducing legislation to have Medicare negotiate prices with the pharmaceutical industry. I'm going to introduce legislation to allow Americans to buy less expensive medicine in Canada, the U.K., and other countries. Let's take on the greed of pharma, substantially lower prescription drug prices.
CRUZ: I voted with you in support of allowing drug re-importation. But a much bigger barrier is that, in the last 20 years, the FDA has approved only 3 child cancer drugs, because the burdens are so great.
SANDERS: That is not the major problem. The major problem with the pharmaceutical industry is they could double or triple the prices you pay for medicine tomorrow.
It has never made sense to me that our health care system is primarily designed to make huge profits for multibillion-dollar insurance companies, drug companies, hospitals, and medical equipment suppliers. Health care is not a commodity. It is a human right. The goal of a sane health care system should be to keep people well, not to make stock holders rich.
Our current system is the most expensive, bureaucratic, wasteful, and ineffective in the world. While the health care industry makes hundreds of billions a year in profit, tens of millions of Americans have totally inadequate coverage, and many of our people suffer and die unnecessarily.
The pharmaceutical industry is one of the most politically powerful industries in the country and spends endless amounts of money on lobbying and campaign contributions. The pharmaceutical industry has spent more than $3 billion on lobbying since 1998.
This is $1 billion more than the insurance industry, which came in second place in lobbying expenditures.
The pharmaceutical industry, because of its great power, rarely loses legislative fights. It has effectively purchased the Congress, and there are Republican and Democratic leaders who support its every effort.
The reason we pay two times, five times, ten times more for medicine than any other countries do is pretty simple. No other country on earth allows drug companies to charge any price they want for any reason. Somebody in Burlington, Vermont, can walk into a pharmacy and find that the price they pay for the medicine they've been using for years has doubled or tripled. And in the United States, that is perfectly legal. Drug companies can and do raise prices, sometimes in outrageous ways, simply because they can, because the market will bear it.
Sanders said that the ongoing coronavirus pandemic had hastened his decision to suspend his campaign, saying that continuing his presidential bid would only distract from efforts to combat the outbreak and damage it has done to the U.S. economy.
Sanders vowed to push forward with Medicare for All, saying the coronavirus is leading "millions" of laid off Americans to lose their health insurance. "In terms of health care, this current, horrific crisis that we are now in has exposed for all to see how absurd our current employer-based health insurance system is," he said. "We have always believed that health care must be considered as a human right, not an employee benefit, and we are right."
Bernie Sanders: Last year at least 30,000 people died in America because they didn't get healthcare when they should, because we don't have universal coverage. I think that's a crisis. One out of five people in America cannot afford the prescription drugs they need. They suffer. Some die. I consider that a crisis. Bottom line is we need a simple system, which exists in Canada, exists in countries all over the world, and that is if you are an American, you get the healthcare you need, end of discussion.
Bernie SANDERS: Over a 10-year period.
Q: But you can only explain how you'll pay for just about half of that. Can you do the math for the rest of us?
SANDERS: How many hours do you have? A new study that just came out of Yale University, published in Lancet magazine, said Medicare-for-All will lower health care costs in this country by $450 billion a year and save 68,000 lives of people who otherwise would have died. One of the options in our plan is a 7.5% payroll tax on employers, which will save them substantial sums of money.
Q: Senator Klobuchar, does the math add up?
Amy KLOBUCHAR: No, the math does not add up. [Sanders' figures miss] nearly $60 trillion. The Medicare-for-All plan alone on page eight clearly says that it will kick 149 million Americans off their current health insurance in four years.
According to the most recent Organization for Economic Cooperation and Development data, which is for 2018, US per capita spending on health care totaled $10,586. That's twice as much as every country, except for six. Sanders is correct that the U.S. spends a lot more than other nations. It spends more than double the $3,992 average for OECD countries ["OECD counties" means "the developed world," excluding developing countries -- ed.]. But Switzerland, Norway, Germany, Sweden, Austria and Denmark all pay a little more than half of what the U.S. does.
SANDERS: Americans have been hearing about it for a lot longer than you have been alive. Teddy Roosevelt, way back when, over 100 years ago, talked about universal health care. FDR talked about it in the '30s and '40s. Truman and Johnson talked about it. Obama talked about it, and Carter; Nixon even talked about it. But what has been the problem all of this time? The problem is, at the end of the day, if we want universal health care, if we want to do what every other major country on Earth does--this is not a radical idea. I live 50 miles away from the Canadian border. They do it. Everybody has health care. You don't take out your wallet or your credit card when you go to the doctor or the hospital. They spend one-half as much per capita as we spend.
V.P. Joe BIDEN: I think we need to tell voters what it's going to cost. A 4 percent tax on income over $24,000 doesn't even come close to paying for between $30 trillion, and some estimates as high as $40 trillion over 10 years. That's doubling the entire federal budget per year. The way to do it is to take ObamaCare, rebuild it, provide a public option, allow Medicare for those folks who want it, and reduce the cost of drug prices. That costs $740 billion over 10 years. I lay out how I'd pay for t
Joe Biden: [Sen. Sanders' healthcare plan] costs $30 trillion over 10 years. The idea that you're going to be able to save that person making $60,000 a year on Medicare for all is preposterous. You're going to add 84% more and it's not going to be higher taxes? It's going to increase personal taxes.
Sanders: That's right. We got to increase personal taxes, but we're eliminating premiums, we're eliminating copayments, we're eliminating deductibles, we're eliminating all out of pocket expenses and no family in America will spend more than $200 a year on prescription drugs.
Sen. Elizabeth WARREN: Costs will go up for the wealthy & for big corporations. For hardworking, middle class families, costs will go down. It is about what kinds of costs middle class families are going to face. So let me be clear on this. I will not sign a bill into law that does not lower costs for middle class families.
SANDERS: On the Medicare for All bill, premiums are gone, co-payments are gone, deductible All out of pocket expenses are gone. The overwhelming majority of people will save money on their healthcare bills. But I think it is appropriate to acknowledge that taxes will go up. They're going to go up significantly for the wealthy and for virtually everybody, the tax increase they pay will be substantially less, substantially less than what they were paying for premiums and out of pocket expenses.
SANDERS: Keep going. You're doing great!
Q: What is the priority on climate change compared to all these others, if you have to choose?
SANDERS: Well, I have the radical idea that a sane Congress can walk and chew bubble gum at the same time. And, you know, there are so many crises that are out there today. I worry very much that we lose 30,000 people a year because they don't have the money to go to a doctor when they should and that 87 million people are uninsured or underinsured. And I will implement as president a Medicare-for-all single-payer program. So to my mind, it's not prioritizing this over that. It is finally having a government which represents working families and the middle class rather than wealthy campaign contributors. And when you do that, then things fall in place.
DELANEY: We [should not] go down the road that Senator Sanders wants to take us, which is with bad policies like Medicare for all.
Q [to Sanders]: He previously has called Medicare-for-All "political suicide that will just get President Trump re-elected." What do you say to Congressman Delaney about whether it's "bad policy"?
SANDERS: You're wrong. Right now, we have a dysfunctional health care system: 87 million uninsured or underinsured; 500,000 Americans every year going bankrupt because of medical bills.
DELANEY: We can create a universal health care system [without] telling half the country that their health insurance is illegal.
SANDERS: Tens of millions of people lose their health insurance every single year when they change jobs. If you want stability in the health care system, if you want a system which gives you freedom of choice, a system which will not bankrupt you, the answer is to get rid of the profiteering of the drug companies.
SANDERS: It will be better because Medicare-for-all is comprehensive -- it covers all healthcare needs. For senior citizens it will finally include dental care, hearing aids and eyeglasses.
Rep. Tim RYAN: But you don't know that, Bernie.
SANDERS: I do know it; I wrote the damn bill. And many of our union brothers and sisters are now paying high deductibles and copayments when we do Medicare for all, instead of having the company putting money in to healthcare, they can get decent wage increases, which they're not getting today.
RYAN: Senator Sanders does not know all of the union contracts--the only thing they have is possibly really good healthcare. And the Democratic message is going to be, "we're going to take it and we're going to do better."
SANDERS: Please don't tell me that in a four year period we cannot go from 65 down to 55, to 45, to 35 -- this is not radical. This is what virtually every other country on Earth runs. We are the odd dog out.
SANDERS: I happen to believe that when I talk about healthcare as a human right that applies to all people in this country, and under a Medicare for All single payer system, we could afford to do that.
SANDERS: Every other major country on Earth, including my neighbor 50 miles north of me, Canada, somehow has figured out a way to provide health care to every man, woman, and child, and in most cases, they're spending 50% per capita of what we are spending.
Q: How do you implement it on a national level, given the fact that other states have not succeeded?
SANDERS: We'll do it the way real change has always taken place. We will have Medicare-for-All when tens of millions of people are prepared to stand up and tell the insurance companies and the drug companies that their day is gone, that health care is a human right, not something to make huge profits off of.
Sen. Mike BENNET: Bernie has said over and over again that this [single-payer Medicare-for-All plan] will make illegal all insurance except cosmetic--I guess that's for plastic surgery. Everything else is banned under the Medicare-for-all proposal.
Sen. Bernie SANDERS: You know, Mike, Medicare is the most popular health insurance program in the country.
BENNET: I agree.
SANDERS: People don't like their private insurance companies. They like their doctors and hospitals. Under our plan people go to any doctor they want, any hospital they want. We will substantially lower the cost of health care in this country because we'll stop the greed of the insurance companies. On this issue we have to think about how this affects real people.
But many of the candidates--even official "Medicare-for-all" co-sponsors--are at the same time edging toward a more incremental approach, called "Medicare for America." This proposed Medicare for America system would guarantee universal coverage, but leave job-based insurance available for those who want it. Unlike "Medicare-for-all," though, it would preserve premiums and deductibles, so beneficiaries would still have to pay some costs out-of-pocket.
The House vote to approve expansion in March attracted national attention. Sanders, a Democratic presidential candidate, called it a "major step." But since then, the Senate hasn't taken action on the legislation.
If Kansas increases eligibility in the program, which provides health coverage to low-income individuals and individuals with disabilities, to 138% of the federal poverty level, then the federal government will pay for 90% of the cost. For a family of four, that's $35,535 a year. The state's share of the cost of expansion has been estimated at somewhere between $34 million and $47 million a year.
CRUZ: Bernie and the Democrats want government to control health care. I trust you. And I trust your doctors. I think health care works better when you're in charge of your family's health care decisions.
SANDERS: The Republicans are now in a panic, because the American people have caught on that the absolute repeal of ObamaCare without a plan to make it better, would be an absolute disaster. So when Ted talks about giving people choice, here's your choice. You got cancer, and you go to the doctor, and the insurance company says, "We're not going to cover it. We can't make money on you because you have cancer. You have a pre-existing condition." And here's another choice you can have if we get rid of ObamaCare. If you have diabetes, and you're spending a whole lot, the insurance companies will say, "sorry, we're only going to spend X dollars, because we've got to make money off you." That's the function of private insurance.
I voted for the Affordable Care Act because, while it did not go anywhere near as far as I wanted, it did provide health insurance for about 20 million more Americans, ended the abomination of people being denied insurance coverage because of preexisting conditions, expanded primary health care, and significantly improved health care coverage for women.
In Mississippi, it also turned out that many people, despite being poor, were ineligible for Medicaid because of stringent and unfair state requirements. My Republican colleagues in Congress tell me, over and over again, that we have the "greatest" health care system in the world. Really? In Mississippi, and in many other areas of the country, there are counties in low-income areas where thousands of people have no health insurance at all and, for those who do, there is no access to medical care at all. That system doesn't sound so "great" to me.
I will never forget the day Reid called me into his office and told me that he was putting $12 billion more into the program, asd part of the Affordable Care Act, the largest expansion in FQHC history. As a result, many millions more Americans have been able to access the health care they need.
SANDERS: 29 million people have no health insurance today in America. We pay, by far, the highest prices in the world for prescription drugs. One out of five Americans can't even afford the prescriptions their doctors are writing. Millions of people have high deductibles and co-payments. I don't know what economists Secretary Clinton is talking to, but what I have said, is that the family right in the middle of the economy would pay $500 dollars more in taxes, and get a reduction in their healthcare costs of $5,000 dollars. In my view healthcare is a right of all people, not a privilege, and I will fight for that.
SANDERS: There is one major country that does not guarantee health care to all people. There is one major country--the United States--which ends up spending almost three times per capita what they do in the U.K. guaranteeing health care to all people, 50 percent more than they do in France guaranteeing health care to all people, far more than our Canadian neighbors, who guarantee health care to all people.
CLINTON: Senator Sanders and I share big progressive goals. I've been fighting for universal healthcare for many years, and we're now on the path to achieving it. I don't want us to start over again. I want to build on the progress we've made; got from 90 percent coverage to 100 percent coverage. I don't want to rip away the security that people finally have; 18 million people now have healthcare; pre-existing conditions are no longer a barrier.
SANDERS: Let's deal with the comments that Secretary Clinton made. Every major country has managed to provide healthcare to all people and they are spending significantly less per capita than we are. I do not accept that the US can't do that. I do not accept that the US can't stand up to the rip-offs of the pharmaceutical industry which charge us the highest prices in the world for prescription drugs.
SANDERS: I am on the Health Education Labor Committee. That committee wrote the Affordable Care Act. The idea I would dismantle health care while we're waiting to pass a Medicare-for-all is not accurate. The Affordable Care Act has clearly, as Secretary Clinton said, done a lot of good things, but, what it has not done is dealt with the fact we have 29 million people today who have zero health insurance, we have even more who are underinsured with large deductibles and co-payments and prescription drug prices are off the wall. So I do believe that in the future, we should have health care for all.
SANDERS: I think people will support my Medicare-for-All program because the United States today is the only major country on Earth that doesn't guarantee health care to all people as a right. I think the Affordable Care Act has done a lot of good things. But yet we have 29 million people without any health insurance. There are seniors today who cannot afford the outrageously high cost of prescription drugs because in America, we pay, by far, the highest prices in the world for prescription drugs. Last year, while one out of five Americans cannot afford the prescriptions their doctors write, the three major drug companies made $45 billion in profit because they spent hundreds of millions of dollars on lobbying and campaign contributions. I believe, as a principle, everybody should be entitled to health care as a right, comprehensive health care.
SANDERS: But that is an unfair criticism for the following reason. If you are paying now $10,000 a year to a private health insurance company and I say to you, hypothetically, you're going to pay $5,000 more in taxes, but you're not going to pay any more private health insurance, are you going to be complaining about the fact that I've saved you $5,000 in your total bills? So it's demagogic to say "oh, you're paying more in taxes." We are going to eliminate private health insurance premiums and payments not only for individuals, but for businesses, as well. We are the only country on Earth that allows private insurance companies to rip us off. We spend three times more than the British. We can do better than we're doing right now.
Q: But just to be clear, you are going to raise taxes to do this?
SANDERS: Yes, we will raise taxes, yes, we will.
CLINTON: The Democratic Party worked since Harry Truman to get the Affordable Care Act passed. I don't want see us start over again with a contentious debate. I want us to defend and build on the Affordable Care Act & improve it.
SANDERS: Her campaign was saying "Sanders wants to end Medicare." That is nonsense. I'm on the committee that wrote the Affordable Care Act. What a Medicare-for-all program does is finally provide in this country health care for every man, woman and child as a right. Now, the truth is: FDR and Truman, do you know what they believed in? They believed that health care should be available to all of our people. What we have to deal with is the fact that 29 million people still have no health insurance. My proposal: provide health care to all people, get private insurance out of health insurance, lower the cost of health care for middle class families by $5,000.
SANDERS: Secretary Clinton is wrong. You know that the US per capita pays far more than other country. It is unfair simply to say how much more the program will cost without making sure that people know that we are doing away with cost of private insurance and that the middle class will be paying substantially less for health care on the single payer.
CLINTON: Your proposal is to go and send the health care system to the state. And my analysis is that you are going to get more taxes out of middle class families.
SANDERS: I happen to believe that in a democratic, civilized society, all people should be entitled to health care as a right. Is this a radical idea? No, it's not. Every other major industrialized country on Earth does the same.
SANDERS: The U.S. remains the only major country on earth that doesn't guarantee health care to all of our people. And yet we are spending almost twice as much per capita. We have a massively dysfunctional health care system. And I do believe in a Medicare-for-all single-payer system, whether a small state like Vermont can lead the nation, which I certainly hope we will, or whether it's California or some other state. At the end of the day, we need a cost-effective, high-quality health care system, guaranteeing health care to all of our people as a right.
The fight for a national health care system today is not basically different than the struggle for universal public education which took place in this country 100 years ago. At that time, children of the well-to-do received an education; most of the children of working people and the poor did not. After enormous struggle, our society concluded that all children, regardless of income, were entitled to at least a high school education. Some day we will also accept that all people, regardless of income, are entitled to health care.
Sanders voted for the Affordable Care Act, but believes that the new health care law did not go far enough. Instead, he espouses a single-payer system in which the federal and state governments would provide health care to all Americans. Participating states would be required to set up their own single-payer system and a national oversight board would establish an overall budget.
[Sen. DeMint, R-SC]: The Democrats have Medicare on a course of bankruptcy. Republicans are trying to save Medicare & make sure there are options for seniors in the future. Medicare will not be there 5 or 10 years from now. Doctors will not see Medicare patients at the rate [Congress will] pay.
[Sen. Ayotte, R-NH]: We have 3 choices when it comes to addressing rising health care costs in Medicare. We can do nothing & watch the program go bankrupt in 2024. We can go forward with the President's proposal to ration care through an unelected board of 15 bureaucrats. Or we can show real leadership & strengthen the program to make it solvent for current beneficiaries, and allow future beneficiaries to make choices.
Opponent's Arguments for voting No:
[Sen. Conrad, D-ND]: In the House Republican budget plan, the first thing they do is cut $4 trillion in revenue over the next 10 years. For the wealthiest among us, they give them an additional $1 trillion in tax reductions. To offset these massive new tax cuts, they have decided to shred the social safety net. They have decided to shred Medicare. They have decided to shred program after program so they can give more tax cuts to those who are the wealthiest among us.
[Sen. Merkley, D-TK]: The Republicans chose to end Medicare as we know it. The Republican plan reopens the doughnut hole. That is the hole into which seniors fall when, after they have some assistance with the first drugs they need, they get no assistance until they reach a catastrophic level. It is in that hole that seniors have had their finances devastated. We fixed it. Republicans want to unfix it and throw seniors back into the abyss. Then, instead of guaranteeing Medicare coverage for a fixed set of benefits for every senior--as Medicare does now--the Republican plan gives seniors a coupon and says: Good luck. Go buy your insurance. If the insurance goes up, too bad.
Status: Failed 40-57
Opponent's argument to vote No:Rep. HEATH SHULER (D, NC-11): Putting a dangerous, overworked FDA in charge of tobacco is a threat to public safety. Last year, the FDA commissioner testified that he had serious concerns that this bill could undermine the public health role of the FDA. And the FDA Science Board said the FDA's inability to keep up with scientific advancements means that Americans' lives will be at risk.
Proponent's argument to vote Yes: Rep. HENRY WAXMAN (D, CA-30): The bill before us, the Waxman-Platts bill, has been carefully crafted over more than a decade, in close consultation with the public health community. It's been endorsed by over 1,000 different public health, scientific, medical, faith, and community organizations.
Sen. HARRY REID (D, NV): Yesterday, 3,500 children who had never smoked before tried their first cigarette. For some, it will also be their last cigarette but certainly not all. If you think 3,500 is a scary number, how about 3.5 million. That is a pretty scary number. That is how many American high school kids smoke--3.5 million. Nearly all of them aren't old enough to buy cigarettes. It means we have as many boys and girls smoking as are participating in athletics in high schools. We have as many as are playing football, basketball, track and field, and baseball combined.
Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.
Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7): This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.
Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.
SUPPORTER'S ARGUMENT FOR VOTING YES: Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction.
OPPONENT'S ARGUMENT FOR VOTING NO: Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.
Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.
Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56
SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. COBURN: The underlying legislation, S.1200, does not fix the underlying problems with tribal healthcare. It does not fix rationing. It does not fix waiting lines. It does not fix the inferior quality that is being applied to a lot of Native Americans and Alaskans in this country. It does not fix any of those problems. In fact, it authorizes more services without making sure the money is there to follow it.
Those who say a failure to reauthorize the Indian Health Care Improvement Act is a violation of our trust obligations are correct. However, I believe simply reauthorizing this system with minor modifications is an even greater violation of that commitment.
OPPONENT'S ARGUMENT FOR VOTING NO:Sen. DORGAN: It is not more money necessarily that is only going to solve the problem. But I guarantee you that less money will not solve the problem. If you add another program for other Indians who can go somewhere else and be able to present a card, they have now taken money out of the system and purchased their own insurance--then those who live on the reservation with the current Indian Health Service clinic there has less money. How does that work to help the folks who are stranded with no competition?
LEGISLATIVE OUTCOME:Amendment rejected, 28-67
Proponents support voting YES because:
Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:
Opponents recommend voting NO because:
Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:
Veto message from President Bush:
Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.
Proponents support voting YES because:
This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.
It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.
Opponents support voting NO because:
Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.
Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)
The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.
The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.
Amends the Public Health Service Act to require the Secretary of Health and Human Services to:
Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.
Medicare Access to Rehabilitation Services Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to repeal the cap on outpatient physical therapy, speech-language pathology, and occupational therapy services of the type furnished by a physician or as an incident to physicians' services.
SEC. 2. OUTPATIENT THERAPY CAP REPEAL.
Section 1833 of the Social Security Act (42 U.S.C. 1395(l)) is amended by striking subsection (g).
[Explanatory note from Wikipedia.com "Therapy Cap"]:
In 1997 Congress established per-person Medicare spending limits, or "therapy cap" for nonhospital outpatient therapy, but responding to concerns that some people with Medicare need extensive services, it has since placed temporary moratoriums on the caps. The therapy cap is a combined $1,810 Medicare cap for physical therapy and speech language pathology, and a separate $1,810 cap for occupational therapy ($1870 for 2011). Medicare patients requiring rehabilitation from disabilities, car accidents, hip injuries, stroke, and other ailments would be limited to roughly two months worth of treatments at an outpatient therapy clinic. Any patients that exceed the cap, whether they are healed or not, would have to stop therapy, or pay for the therapy services out of their own pocket.Several medical associations have lobbied against therapy caps because the bill inadvertently restricted disabled seniors, stroke patients, and other severe cases from receiving therapy treatments.
The Christian Coalition Voter Guide inferred whether candidates agree or disagree with the statement, 'Repealing the Nationalized Health Care System that Forces Citizens to Buy Insurance ' Christian Coalition's self-description: "Christian Voter Guide is a clearing-house for traditional, pro-family voter guides. We do not create voter guides, nor do we interview or endorse candidates."
A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn.
A bill to amend title 10, United States Code, to provide for the treatment of autism under TRICARE. Revises TRICARE (a Department of Defense [DOD] managed health care program) to authorize treatment of autism spectrum disorders, if a health care professional determines that such treatment is medically necessary.
|Other candidates on Health Care:
|Bernie Sanders on other issues:
Senate races 2021-22:
AK: Incumbent Lisa Murkowski(R)
vs.Challenger Kelly Tshibaka(R)
vs.2020 candidate Al Gross(D)
AL: Incumbent Richard Shelby(R) vs.U.S. Rep. Mo Brooks(R) vs.Ambassador Lynda Blanchard(R) vs.Katie Britt(R) vs.Judge Jessica Taylor(R) vs.Brandaun Dean(D) vs.
AR: Incumbent John Boozman(R)
vs.Candidate Dan Whitfield(D)
AZ: Incumbent Mark Kelly(D)
vs.CEO Jim Lamon(R) vs.Blake Masters(R)
vs.A.G. Mark Brnovich(R) vs.Mick McGuire(R)
CA: Incumbent Alex Padilla(D)
vs.2018 Senate candidate James Bradley(R)
vs.State Rep. Jerome Horton(D)
CO: Incumbent Michael Bennet(D)
CT: Incumbent Richard Blumenthal(D)
vs.Challenger Joe Visconti(R)
vs.2018 & 2020 House candidate John Flynn(R)
FL: Incumbent Marco Rubio(R)
vs.U.S.Rep. Val Demings(D)
vs.U.S. Rep. Alan Grayson(D)
GA: Incumbent Raphael Warnock(D)
vs.Navy vet Latham Saddler(R)
HI: Incumbent Brian Schatz(D)
vs.Former State Rep. Cam Cavasso(R ?)
IA: Incumbent Chuck Grassley(R)
vs.State Sen. Jim Carlin(R)
vs.Former U.S. Rep IA-1 Abby Finkenauer(D)
ID: Incumbent Mike Crapo(R)
IL: Incumbent Tammy Duckworth(D)
vs.U.S.Rep. Adam Kinzinger(? R)
IN: Incumbent Todd Young(R)
vs.Challenger Haneefah Abdul-Khaaliq(D)
vs.Psychologist Valerie McCray(D)
KS: Incumbent Jerry Moran(R)
KY: Incumbent Rand Paul(R)
vs.State Rep Charles Booker(D)
LA: Incumbent John Kennedy(R)
MD: Incumbent Chris Van Hollen(D)
MO: Incumbent Roy Blunt(R)
vs.Eric Greitens(R) vs.Scott Sifton(D)
vs.Eric Schmitt(R) vs.Lucas Kunce(D)
vs.Mark McClosky(R) vs.Vicky Hartzler(R)
vs.Tim Shepard(D) vs.Billy Long(R)
NC: Incumbent Richard Burr(R,retiring)
Erica Smith(D) vs.Mark Walker(R)
vs.Ted Budd(R) vs.Pat McCrory(R)
vs.Cheri Beasley(D) vs.Rett Newton(D)
vs.Jeff Jackson(D) vs.Marjorie K. Eastman(R)
ND: Incumbent John Hoeven(R)
vs.Michael J. Steele(D)
NH: Incumbent Maggie Hassan(D)
vs.Chris Sununu(R ?)
NV: Incumbent Catherine Cortez Masto(D)
NY: Incumbent Chuck Schumer(D)
OH: Incumbent Rob Portman(R,retiring)
Bernie Moreno(R) vs.Tim Ryan(D)
vs.Jane Timken(R) vs.Josh Mandel(R)
vs.JD Vance(R) vs.Mike Gibbons(R)
vs.Morgan Harper(D) vs.Matt Dolan(R)
OK: Incumbent James Lankford(R)
OR: Incumbent Ron Wyden(D)
vs.QAnon adherent Jo Rae Perkins(R)
PA: Incumbent Pat Toomey(R,retiring)
vs.Everett Stern(R) vs.Jeff Bartos(R)
vs.Val Arkoosh(D) vs.Carla Sands(R)
vs.John Fetterman(D) vs.Malcolm Kenyatta(D)
vs.Kathy Barnette(R) vs.Sharif Street(D)
vs.Conor Lamb(D) vs.Sean Parnell(R)
vs.Craig Snyder(R) vs.Mehmet Oz(R)
SC: Incumbent Tim Scott(R)
vs.State Rep. Krystle Matthews(D)
SD: Incumbent John Thune(R)
vs.State Rep. Billie Sutton(? D)
UT: Incumbent Mike Lee(R) vs.Allen Glines(D)
vs.Austin Searle(D) vs.Evan McMullin(I)
VT: Incumbent Patrick Leahy(D)
vs.Scott Milne(? R)
WA: Incumbent Patty Murray(D)
vs.Challenger Tiffany Smiley(R)
WI: Incumbent Ron Johnson(R) vs.Tom Nelson(D)
vs.Sarah Godlewski(D) vs.Alex Lasry(D)
vs.Chris Larson(D) vs.Mandela Barnes(D)
Senate Votes (analysis)
Senate Office SD-332, Washington, DC 20510