Joe Biden on Health Care
Former Vice President; previously Democratic Senator (DE)
BIDEN: I say it's ridiculous. It's like saying that the fact that there's a public option that people can choose, that makes it a socialist plan? Look, the difference between the president and me: I think healthcare is not a privilege, it's a right. Everyone should have the right to have affordable healthcare, and I am very proud of my plan.
TRUMP: He wants socialized medicine. His vice president, she wants it even more. The Democrats want it. You're going to have socialized medicine.
BIDEN: People deserve to have affordable healthcare, period. Period, period, period. And the Biden care proposal will in fact provide for that affordable healthcare. What we're going to do is going to cost some money. It's going to cost over $750 billion over 10 years to do it. And they're going to have lower premiums.
"The idea [that] middle class taxes aren't going to go up is just crazy," Biden added.
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."
BIDEN: I'm going to restore the cuts, reduce out-of-pocket expenses and premiums, and add a Medicare option for those who want it. If you have private insurance, and you like it, keep it. If they cancel the policy, you can buy into the Biden plan. I'm adding $1 billion for dealing with drug abuse and opioids. I can pay for it by making sure people pay their capital gains at whatever their tax rate is.
Sen. Bernie SANDERS: Medicare For All will cost substantially less than the status quo. Medicare For All will end the absurdity of paying the highest prices in the world for prescription drugs and health care, while we have 87 million uninsured and underinsured. Under Medicare For All, one of the provisions we have to pay for it is a 4% tax on income, exempting the first $29,000. So the average family in America that makes $60,000 would pay $1,200 a year, compared to that family paying $12,000 a year.
Joe Biden: [Sen. Sanders' healthcare plan] costs $30 trillion. Let's get that straight--$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. 16% of the American public is on Medicare now and everybody has a tax taken out of their paycheck now. Tell me, you're going to add 84% more and it's not going to be higher taxes, at least before he was honest about it. 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.
HARRIS: I have been listening to American families, who said four years is just not enough to transition into this new plan, so I devised a plan where it's going to be 10 years of a transition. I listened to American families who said I want an option that will be under your Medicare system that allows a private plan.
BIDEN: Any time someone tells you you're going to get something good in 10 years, you should wonder why it takes 10 years. And the plan in 10 years will cost $3 trillion. You will lose your employer-based insurance. This is the single most important issue facing the public. And to be very straightforward, you can't beat President Trump with double-talk on this plan.
Biden: My plan makes a limit of co-pay to be $1,000, because we further support the ability to buy into ObamaCare. No one has to keep their private insurance, but if they like their insurance, they should be able to keep it. Nothing is demanded in my plan that there be private insurance. If the 160 million who have it like their employer insurance, they should have a right to have it. If they don't, they can buy into the Biden plan.
Biden: My plan will cover everyone. Number two, the fact is that my plan also calls for controlling drug prices. Biopharma is now where things are going to go. It's no longer chemicals. It's about all these breakthroughs that we have with the immune system. What we have to do is have a form that says, as you develop a drug, you got to come to us and decide what you can sell it for. We will set the price. And secondly, you cannot raise that price beyond the cost of inflation from this point on.
Biden: I have the only plan that limits the ability of insurance companies to charge unreasonable prices, flat out, number one. Number two, we should put some of these insurance executives who totally oppose my plan in jail for the $9 billion opioids they sell out there.
In June 2016, Biden unveiled the federal Genomic Data Commons--a database for consolidating all the key clinical trials, stats, and treatments [among other actions on the "Cancer Moonshot"].
"You know, last year, Vice President Biden said that, with a new moon-shot, America can cure cancer. Last month, he worked with this Congress to give scientists at the National Institutes of Health the strongest resources that they've had in over a decade. .
"So tonight, I'm announcing a new national effort to get it done. And because he's gone to the mat for all of us on so many issues over the past 40 years, I'm putting Joe in charge of mission control. For the loved ones we've all lost, for the families that we can still save, let's make America the country that cures cancer once and for all. What do you think? Let's make it happen. And medical research is critical."
A: Absolutely. We have to view it in three ways. Prevention. You know, an ounce of prevention worth a pound of cure is real. We virtually do not have anything that rewards those people who are engaged in their physician’s or insurer’s companies that emphasize prevention. The second thing we have to do is we have to provide for changing the way we think of it as an employer-based system totally. We have an overwhelming opportunity now to get universal health care, because business needs more than labor or business needs it more than the uninsured. They cannot compete internationally. We have to think about it really differently, but the delivery of health care we have to think about differently, too. The idea we’re not going to be opening up little clinics in shopping centers all across America that is going to generate avoidance of operating of emergency rooms is just not reasonable.
A: We need not just 100,000 new cops, but 100,000 new nurses that we fund in order to make things better. We have to be in a position where we don’t let the perfect become the enemy of the good. In the first year, I’d insure every single, solitary child in America and make sure catastrophic insurance exists, and for every single person in America, while we move toward a national health care system covering anybody.
Running is a horrible strain, and those with long memories will recall that Biden survived two aneurysms more than a decade ago. Racing to Iowa every spare second to go to farm breakfasts at 5:30 a.m., making calls every minute begging for money, flying commercial (coach, no less) day after day, gets old awfully fast if you don't have that fire in your belly.
BIDEN: What I'm going to do is pass ObamaCare with a public option, and become BidenCare. The public option says that if you qualify for Medicaid and you do not have the wherewithal in your state to get Medicaid, you automatically are enrolled, providing competition for insurance companies. That's what's going to happen. Secondly, we're going to make sure we reduce the premiums and reduce drug prices by making sure that there's competition, that doesn't exist now, by allowing Medicare to negotiate drug prices with the insurance companies. Thirdly, the idea that I want to eliminate private insurance, the reason why I had such a fight with 20 candidates for the nomination was I support private insurance. That's why. Not one single person with private insurance would lose their insurance under my plan, nor did they under ObamaCare. They did not lose their insurance unless they chose they wanted to go to something else.
BIDEN: I think that healthcare overall is very much in jeopardy as a consequence of the President's going to go directly after this election directly to the Supreme Court within a month to try to get ObamaCare wiped out after 10 million people have already lost their insurance from their employer and wants to take 20 million people out of the system as well, plus 100 million people with pre-existing conditions.
TRUMP: We got rid of the individual mandate on ObamaCare, and now you could actually say it's not ObamaCare because you had to pay a fortune for the privilege of not having to pay for bad health insurance, so we got rid of that. By the way, we're always protecting people with pre-existing conditions, and I can't say that more strongly. The problem with ObamaCare, it's not good. We'd like to terminate it, and we want a much less expensive healthcare that's a much better healthcare.
TRUMP: There aren't a hundred million people with pre-existing conditions. Joe, the hundred million people is totally wrong. I don't know where you got that number.
FactCheck by NBC News, Sept. 20: A 2017 study from the Department of Health and Human Services estimated that about 133 million people had a pre-existing condition that would make them unable to buy insurance.
BIDEN: It does not. It's only for those people who are so poor they qualify for Medicaid they can get that free in most states, except Governors who want to deny people who are poor Medicaid. Anyone who qualifies for Medicaid would automatically be enrolled in the public option. The vast majority of the American people would still not be in that option.
BIDEN: First of all, in the middle of this pandemic, what is the President doing? He's in Federal Court--Federal Court trying to do away with the Affordable Care Act. What I would do is reinstate the Affordable Care Act and add a public option. So would go without being able to be covered for what they need. Healthcare is an absolute right.
BIDEN: Under the Affordable Care Act, there is a provision that by 2021, it will be available to anyone who has insurance, and all will be eligible for insurance. It will be available and the insurance companies must pay for it.
BIDEN: I think we should have a debate on health care. I think Obamacare worked. I think the way we add to it, replace everything that has been cut, add a public option, guarantee that everyone will be able to have affordable insurance, number one. Number two, I think we should look at cost. My plan costs $740 billion. It doesn't cost $30 trillion, $3.4 trillion a year, it turns out, is twice what the entire federal budget is. How are we going to pay for it? Thus far, Senator Warren has not indicated how she pays for it.
Sen. Elizabeth WARREN: Pres. Obama transformed health care. Now, how best can we improve it? I believe the best way we can do that is we make sure everybody gets covered by health care at the lowest possible cost. How do we pay for it? Those at the very top, the richest individuals and the biggest corporations, are going to pay more. And middle class families are going to pay less.
NYC Mayor Bill DE BLASIO: I don't know what the vice president is talking about. There's this mythology that folks are in love with their insurance in America. The folks I talk to say that their health insurance isn't working for them.
BIDEN: ObamaCare is working. The way to get to [ten million uninsured Americans] immediately is to build on ObamaCare. Take back all the things that Trump took away, provide a public option, meaning every single person in America would be able to buy into that option if they didn't like their employer plan, or if they're on Medicaid, they'd automatically be in the plan. It would take place immediately. It would move quickly. And it would insure the vast, vast, vast majority of Americans. In the meantime, what happens? Did anybody tell you how much their plans cost? My plan costs $750 billion. [Medicare-for-All costs] $30 trillion.
Q: Would you bring back the individual mandate?
BIDEN: Yes. Yes, I would bring back the individual mandate.
Q: You think that will be popular?
BIDEN: Well, it's not -- yes, now it would be, compared to what's being offered.
RYAN: Give younger people, when they become Medicare-eligible, guaranteed coverage options that you can't be denied, including traditional Medicare. Choose your plan, and then Medicare subsidizes your premiums.
BIDEN: It's a voucher. Now they got a new plan: "Trust me, it's not going to cost you any more." Folks, follow your instincts on this one. What we did is we saved $716 billion and applied it to Medicare. We cut the cost of Medicare. We stopped overpaying insurance companies. And it extends the life of Medicare to 2024. They want to wipe this all out. It also gave more benefits. Any senior out there, ask yourself: Do you have more benefits today? You do. If you're near the doughnut hole, you have $600 more to help your prescription drug costs. You get wellness visits without copays. They wipe all of this out, and Medicare becomes insolvent in 2016.
RYAN: And it would deny seniors choices.
BIDEN: All you seniors out there, have you been denied choices? Have you lost Medicare Advantage?
RYAN: Because it's working well right now.
BIDEN: Because we changed the law!
Q: Why not very slowly raise the Medicare eligibility age by two years, as Congressman Ryan suggests?
BIDEN: I was there when we did that with Social Security, in 1983. We made the system solvent to 2033. We will not, though, be part of any voucher [that says] when you're 65, go out there, shop for the best insurance you can get; you're out of Medicare. This voucher will not keep pace with health care costs, because if it did keep pace with health care costs, there would be no savings.
RYAN: A voucher is you go to your mailbox, get a check and buy something. Nobody's proposing that.
Whether to pursue major health care reform in the first year had been a furious topic of debate going back to the transition. Rahm believed that pushing something too big on health care in 2009 was a mistake.
Joe Biden was on Rahm's side. He said during the transition that the Americans he and Obama had met on the campaign trail would understand if health care reform had to be delayed because the government was busy avoiding a depression. "They'll give you a pass on this one," he told the president. Anyone who knew Congress understood that getting a bipartisan bill would be difficult amid so much economic wreckage.
A: Yes, I do.
Q: How would you pay for it?
A: I would pay for it by three ways. 1) I start off dealing with going into a prevention-and-treatment mode here that required us to simplify and modernize the system. That could save $100 billion a year in redundancy that goes on right now. 2) I would immediately provide for catastrophic health insurance for all Americans, and I’d immediately move for insuring every single child in America. That would cost less than what the top 1% tax break costs, $85 billion a year. 3) Then what I would do is I would move to insuring everyone through one of two vehicles. Either a system we work out among the stakeholders, an agreement that everyone essentially gets Medicare from the time you’re born or a system whereby everyone can buy into the federal system. Those who don’t have the means to buy in, then you subsidize them into the system. I would pay for that by direct revenues.
BIDEN: 220,000 Americans dead. You hear nothing else I say tonight, hear this. The expectation is we'll have another 200,000 Americans dead between now & the end of the year. If we just wore these masks, we can save a 100,000 lives. And we're in a circumstance where the president has no comprehensive plan. What I would do is make sure we have everyone encouraged to wear a mask all the time. I would make sure we invest in rapid testing. I would make sure that we set up national standards as to how to open up schools and open up businesses so they can be safe and give them the wherewithal, the financial resources to be able to do that. Folks, I will take care of this. I will end this. I will make sure we have a plan.
Q: [to TRUMP]: You said a vaccine will be coming within weeks. Is that a guarantee?
TRUMP: No, it's not a guarantee, but it will be by the end of the year. I think it has a good chance.
TRUMP: 99.9% of young people recover. We have to recover. We can't close up our nation. We have to open our schools and we can't close up our nation, or you're not going to have a nation.
BIDEN: We're about to go into a dark winter, and he has no clear plan. He says that we're learning to live with it. People are learning to die with it. You folks home will have an empty chair at the kitchen table this morning. That man or wife going to bed tonight and reaching over to try to touch, there out of habit, where their wife or husband was, is gone. Learning to live with it. Come on. We're dying with it, because he's never said. See, you said, "It's dangerous." When's the last time? Is it really dangerous still? Are we dangerous. You tell the people it's dangerous now. What should they do about the danger? And you say, "I take no responsibility."
Q: What do you say to Americans who are fearful that the cost of shutdowns, the impact on the economy outweighs the risk of exposure to the virus?
BIDEN: What I would say is, I'm going to shut down the virus, not the country. It's [President Trump's] ineptitude that caused the country to have to shut down in large part, why businesses have gone under, why schools are closed.
Q: But you haven't ruled out more shut downs?
BIDEN: I'm not shutting down today, but you need standards. If you have a community that's above a certain level, everybody says, "Slow up. More social distancing. Do not open bars and do not open gymnasiums." But when you do open, give the people the capacity to open safely. For example, schools. They need a lot of money to be open. They need to deal with ventilation systems. They need to deal with smaller classes, more teachers.
BIDEN: I suggested that we should be seeking access to the source of the problem. Trump never pushed that.
Q [to TRUMP]: Why did you only put in place a travel ban from China?
TRUMP: I put it in very early. Joe Biden was two months behind me, and he called me xenophobic and racist.
BIDEN: All the way back in the beginning of February, I argued that we should be keeping people in China. There were 44 people on the ground [in China]. All those 44 people came home [as US citizens despite the ban on non-citizens]. In addition to that, I pointed out that I thought in February, I did a piece for USA Today saying, "This is a serious problem." Trump denied it. He said it wasn't. He missed enormous opportunities and kept saying things that weren't true. "It's going to go away by Easter"; "When the summer comes, it's all going to go away like a miracle." He's still saying those things.
BIDEN: Not back then. From March on, I stopped doing big meetings, I started wearing masks. The head of the CDC said, "While we're waiting for a vaccine"--he held up a mask--"You wear this mask, you'll save more lives between now and the end of the year than if we had a vaccine." If we wore masks, we could save 100,000 lives. And what's Trump doing? Nothing. He's still not wearing masks.
Q [to TRUMP]: At White House events, people were not wearing masks.
TRUMP: Well, they do a lot of testing in the White House. I'm okay with masks. I tell people, "wear a mask." But just the other day, they came out with a statement that 85% of the people that wear masks catch it.
Q: It didn't say that. I know that study.
TRUMP: That's what I heard. Hey, I'm President. I have to be out.
Q: You can see people with a mask, though.
TRUMP: I can, but people with masks are catching it all the time.
BIDEN: At a time when the science was saying, and his key people, Dr. Fauci were saying, "You should be taking these precautions."
TRUMP: Dr. Fauci said, "Don't wear a mask," right? Then he changed his mind.
BIDEN: Look, you and I know, the words of a president matter. No matter whether they're good, bad, or indifferent, they matter. And when a president doesn't wear a mask or makes fun of folks like me, when I was wearing a mask for a long time, then people say, "Well, it mustn't be that important." There should be a national standard. Remember what the president said to the governors, "Well, they're on their own; it's not my responsibility. The governors can do what they need to do." It is a presidential responsibility to lead, and he didn't do that. He didn't talk about what needed to be done because he kept worrying, in my view, about the stock market. His barometer of success to the economy is the market.
BIDEN: It depends on the state of the nature of the vaccine when it comes out, and how it's being distributed. But I would think that we should be talking about, depending on the continuation of the spread of the virus, we should be thinking about making it mandatory.
Q [to TRUMP]: You have been having rallies despite being exposed?
TRUMP: As President, I have to be out there. I can't be in a basement. I want to see everybody. And I also say to people all the time, it's risky doing it. [But the White House tests everyone regularly].
BIDEN: Before I came up here, I took another test. I've been taking them every day. If I had not passed that test, I didn't want to come here and expose anybody. And I just think it's just decency, to be able to determine whether or not you're clear. I'm less concerned about me, than the people working in the Secret Service and the camera staff.
You should get out of your bunker and get out of the sand trap in your golf course and go in the Oval Office and bring together the Democrats and Republicans and fund what needs to be done now to save lives.
TRUMP: We would have lost far more people, far more people.
BIDEN: His own CDC Director says we could lose as many as another 200,000 people between now and the end of the year. And he said, if we just wear a mask, we can save half those numbers. Just a mask.
BIDEN: Do you believe for a moment what he's telling you in light of all the lies he's told you about the whole issue relating to COVID? He still hasn't even acknowledged that he knew this was happening, knew how dangerous it was going to be back in February, and he didn't even tell you. He's on record as saying it. He panicked or he just looked at the stock market. One of the two. Because guess what? A lot of people died and a lot more are going to die unless he gets a lot smarter, a lot quicker.
TRUMP: And they've also said the opposite.
BIDEN: No serious person has said the opposite.
TRUMP: Dr. Fauci said the opposite.
BIDEN: He did not say the opposite.
TRUMP: He said very strongly, "Masks are not good." Then he changed his mind. He said, "Masks are good."
BIDEN: He's been totally irresponsible the way in which he has handled the social distancing and people wearing masks, basically encouraged them not to. He's a fool on this.
BIDEN: We should have national standards laid so people can go to work safely. That requires us to have rapid testing, the protective gear, some Federal funding, particularly kids going back to school, making sure there's testing and tracing. There's a whole range of things we should have done. The President disregarded it. So there's a lot of empty chairs, and it's got to stop.
Q: Could you see a scenario where you downplayed critical information so as not to cause panic?
BIDEN: Not at all. If he had just acted one month, one week earlier, he would have saved 37,000 lives. But he knew it. He knew it and did nothing. It is close to criminal.
BIDEN: Wearing this mask is about making sure no one else gets sick. It's not to protect you so much is to make sure you don't infect someone else. I call that a patriotic requirement. Did you ever think you'd hear an Attorney General say that following the recommendations of the scientific community to save lives is equivalent to slavery. You lost freedom because you didn't act. Freedom to go to that ball game, the freedom of your kid to go to school, the freedom to see your mom or dad in the hospital.
TRUMP: They said at the Democrat convention they're going to do a national mandate. They never did it, because they've checked out and they didn't do it. And a good question is, you ask why Joe Biden--they said we're going to do a national mandate on masks. But he didn't do it. He never did it.
BIDEN (on Twitter): "To be clear: I am not currently president."
BIDEN: I don't blame him for the COVID crisis. I blame him for walking away and not dealing with the solutions. Columbia University Medical School said if he had acted just one week earlier, he would have saved over 37,000 lives, 37,000 fewer people would have not passed away. Two weeks earlier over 50,000 people. This is about telling the American people the truth, letting the scientists speak, listening to the science and stepping out of the way.
If this president is reelected we know what will happen. The assault on the Affordable Care Act will continue until it's destroyed, taking insurance away from more than 20 million people--including more than 15 million people on Medicaid--and getting rid of the protections that President Obama and I passed for people who suffer from a preexisting condition.
Biden: No. The World Health Organization offered the [coronavirus] testing kits that they have available and to give it to us now. We refused them. We did not want to buy them. We did not want to get them from them. We wanted to make sure we had our own. [Trump] said something like, "We have the best scientists in America," or something to that effect. We are not prepared for this. I agree with Bernie, we're in a situation where we have to now be providing for the hospitals that are going to be needed, needed now.
Sen. Bernie Sanders: This is a time for all of us working together. The World Health Organization is a very, very strong organization. It is sad that we have a President that has ignored the international community in so many ways, including in terms of international health crisis.
BIDEN: We've been through this once. We've been through this with the virus that occurred with Ebola in Africa. I was deeply involved on that. We were able to keep the disease overseas. The few that came to the United States, we were able to put together the following: We set up an office within the president's office to deal with infectious diseases, number one. Number two, we significantly increased the funding for NIH, National Institute of Health, as well as the CDC, to immediately begin to work on vaccines, which worked. We moved. Thirdly, what we did was we made sure that we were able to be honest with the American people, so that we had complete unity between the scientists and the president.
BIDEN: I think it's important that we understand that you have to have a president in charge. What I would do were I president now, I would not be taking China's word for it. I would insist that China allow our scientists in to make a hard determination of how it started, where it's from, how far along it is. Because that is not happening now. And we should be allowed to do that and they should want us to do that, because we have genuine experts who know how to confront these things. But we need to invest [in science agencies] immediately. We should have done it from the beginning, the moment the virus appeared. But we're getting late, but we've got good scientists. And I just hope the president gets on the same page as the scientists.
BIDEN: What we did with Ebola--I was part of making sure that pandemic did not get to the United States, saved millions of lives. And what we did, we set up, I helped set up that office on pandemic diseases. We increased the budget of the CDC. We increased the NIH budget. And our president today--and he's wiped all that out. [With Ebola], we did it; we stopped it.
Q: So, more funding?
BIDEN: I would immediately restore the funding. [Trump] cut the funding for CDC. He tried to cut the funding for NIH. He cut the funding for the entire effort. And here's the deal. I would be on the phone with China and making it clear, we are going to need to be in your country; you have to be open; you have to be clear; we have to know what's going on; we have to be there with you, and insist on it and insist, insist, insist. I could get that done. No one up here has ever dealt internationally with any of these world leaders. I'm the only one that has.
BIDEN: You’re asking, how do we prevent these 17-year-olds from getting HIV? All the things that were said here [by the other candidates] are good ideas; but they don’t prevent that. There’s neglect on the part of the medical and the white community focusing on educating the minority community out there. I spent last summer going through the black sections of my town, trying to get black men to understand it is not unmanly to wear a condom, getting women to understand they can say no, getting people in the position where testing matters. I got tested for AIDS. I know Barack got tested for AIDS. There’s no shame in being tested for AIDS.
OBAMA: I got tested with my wife Michelle, in public, when we were in Kenya.
BIDEN: And I got tested to save my life, because I had 13 pints of blood transfusion.
PALIN: He’s proposing a $5,000 tax credit for families so they can purchase their own health care coverage. That’s budget neutral. That doesn’t cost the government anything as opposed t Barack Obama’s plan to mandate health care coverage and have a universal government-run program.
BIDEN: McCain’s health care plan, you know, it’s with one hand you giveth, the other you taketh. You know how John McCain pays for his $5,000 tax credit a family will get? He taxes as income every one of you who has a health care plan through your employer. That’s how he raises $3.6 trillion: taxing your health care benefit, which his website points out will go straight to the insurance company. Then you’re going to have to replace the plan you get through your employer--on average it costs $12,000--you have to replace a $12,000 plan with a $5,000 check you just give to the insurance company. I call that the “Ultimate Bridge to Nowhere.
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.
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.
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