[Congressional Record Volume 168, Number 147 (Tuesday, September 13, 2022)]
[Senate]
[Pages S4553-S4556]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Healthcare
Mr. SANDERS. Madam President, I understand that there is a lot that
is going on in the world today. We are worried about climate change and
what that is doing to our planet. We are worried about the terrible war
in Ukraine and all of the destruction taking place there. We are
worried about inflation and the fact that wages are not keeping up with
the prices that people are paying. We are worried about the massive
level of income and wealth inequality that exists in our country and
the increased concentration of ownership that we see in the United
States, among many, many other things that are on people's minds. But
to my mind, Madam President, the American people remain and always are
deeply concerned about an issue that, by definition, touches each and
every one of us, and that is our collapsing and dysfunctional
healthcare system.
While it is not discussed much in the corporate media or here in the
Halls of Congress, we have today in the United States the most
inefficient, bureaucratic, and expensive healthcare system in the
world. And that is not just what I believe; that is what the American
people know to be true because of their lived experience with the
healthcare system.
Madam President, I would hope that all Members of Congress take a
hard look at a poll that was published yesterday by the Associated
Press-NORC Center for Public Affairs Research, and this is some of what
the poll disclosed.
At a time when I hear many of my colleagues tell us that we have the
best healthcare system in the world, it turns out that, according to
this poll, just 12 percent of the American people believe that
healthcare in general is handled very well or extremely well in the
United States. Twelve percent.
At a time when we pay the highest prices in the world for
prescription drugs, only 6 percent of the American people believe that
prescription drug costs in the United States are being handled well or
extremely well. Six percent.
At a time when COVID has exacerbated the crisis, only 5 percent of
the American people believe that the mental health care system in the
United
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States is being handled well or extremely well. Five percent.
When so many older Americans have died unnecessarily in nursing homes
and when so many cannot even find the nursing home bed that they need,
just 6 percent of Americans believe that the quality of care at nursing
homes in the United States is very good or exceptional. Six percent.
Madam President, the American people increasingly understand, as I
do, that healthcare is a human right, not a privilege, and that we must
end the international embarrassment of the United States of America
being the only major country on Earth that does not guarantee
healthcare to all of its citizens. Again, that is not just Bernie
Sanders talking; that is what the overwhelming majority of the American
people believe.
According to yesterday's AP poll, 66 percent of the American people
believe it is the Federal Government's responsibility to make sure that
all Americans have health insurance coverage. Sixty-six percent.
Over 86 percent of the American people believe that it is absurd that
millions of senior citizens lack dental care, hearing aids, and vision
care, and they believe that Medicare should be expanded to cover these
basic healthcare needs. It happens to be an issue I have been working
on for several years. Eighty-six percent of the American people believe
that Medicare should cover dental care, hearing aids, and vision care.
Eighty-six percent.
At a time when our long-term healthcare system is in shambles, 81
percent of the American people believe that Medicare should cover the
outrageous cost of long-term healthcare for senior citizens and people
with disabilities. Eighty-one percent.
Madam President, I ask unanimous consent to have printed in the
Record this AP-NORC poll.
The PRESIDING OFFICER. Without objection, it is so ordered.
There being no objection, the material was ordered to be printed in
the Record, as follows:
[Sept. 12, 2022]
Americans Give Health Care System Failing Mark: AP-NORC Poll
(By Amanda Seitz)
Washington (AP)--When Emmanuel Obeng-Dankwa is worried
about making rent on his New York City apartment, he
sometimes holds off on filling his blood pressure medication.
``If there's no money, I prefer to skip the medication to
being homeless,'' said Obeng-Dankwa, a 58-year-old security
guard.
He is among a majority of adults in the U.S. who say that
health care is not handled well in the country, according to
a new poll from The Associated Press-NORC Center for Public
Affairs Research.
The poll reveals that public satisfaction with the U.S.
health care system is remarkably low, with fewer than half of
Americans saying it is generally handled well. Only 12% say
it is handled extremely or very well. Americans have similar
views about health care for older adults.
Overall, the public gives even lower marks for how
prescription drug costs, the quality of care at nursing homes
and mental health care are being handled, with just 6% or
less saying those health services are done very well in the
country.
``Navigating the American health care system is exceedingly
frustrating,'' said A. Mark Fendrick, the director of the
University of Michigan Center for Value-Based Insurance
Design. ``The COVID pandemic has only made it worse.''
More than two years after the pandemic's start, health care
worker burnout and staffing shortages are plaguing hospitals
around the country. And Americans are still having trouble
getting in-person medical care after health centers
introduced restrictions as COVID-19 killed and sickened
millions of people around the country, Fendrick said.
In fact, the poll shows an overwhelming majority of
Americans, nearly 8 in 10, say they are at least moderately
concerned about getting access to quality health care when
they need it.
Black and Hispanic adults in particular are resoundingly
worried about health care access, with nearly 6 in 10 saying
they are very or extremely concerned about getting good care.
Fewer than half of white adults, 44%, expressed the same
level of worry.
Racial disparities have long troubled America's health care
system. They have been abundantly clear during the COVID-19
pandemic, with Black and Hispanic people dying
disproportionately from the virus. Black and Hispanic men
also make up a disproportionately high rate of recent
monkeypox infections.
Fifty-three percent of women said they are extremely or
very concerned about obtaining quality care, compared to 42%
of men.
While Americans are united in their dissatisfaction with
the health care system, that agreement dissolves when it
comes to solutions to fix it.
About two-thirds of adults think it is the federal
government's responsibility to make sure all Americans have
health care coverage, with adults ages 18 to 49 more likely
than those over 50 to hold that view. The percentage of
people who believe health care coverage is a government
responsibility has risen in recent years, ticking up from 57%
in 2019 and 62% in 2017.
Still, there's not consensus on how that coverage might be
delivered.
About 4 in 10 Americans say they support a single-payer
health care system that would require Americans to get their
health insurance from a government plan. More, 58%, say they
favor a government health insurance plan that anyone can
purchase.
There also is broad support for policies that would help
Americans pay for the costs of long-term care, including a
government-administered insurance plan similar to Medicare,
the federal government's health insurance for people 65 or
older.
Mr. SANDERS. Madam President, it is hard for me to imagine how anyone
could defend a healthcare system in which over 70 million people today
are either uninsured or underinsured. As we speak, this moment, there
are millions of Americans who would like to go to a doctor, who need to
go to a doctor, but cannot afford to go to a doctor because of the
outrageous cost of medical care in this country.
Frankly, I am tired of talking to physicians who tell me about the
patients who died--who died--because they were uninsured or
underinsured and who walked into the doctor's office when it was too
late. Time and time again, I hear from doctors who tell me about a
patient who walked in, and they said to the patient: Why didn't you
come in when you first noticed your symptoms?
The patient responded: I don't have the money; I can't afford the
copayment; or I have no insurance at all.
Madam President, we are talking about--and I know we don't talk about
it much, and maybe we should--we are talking about some 68,000
Americans who die every single year because they are uninsured or
underinsured and don't get the medical care that they need. This is the
United States, the wealthiest country in the history of the world;
68,000 Americans should not die every year unnecessarily.
I am tired of seeing working-class families and small businesses pay
far more for healthcare than they can afford, which results in more
than 500,000 Americans every year declaring bankruptcy because of
medically related expenses. Half a million Americans declare bankruptcy
because of outrageous healthcare bills they simply cannot afford to
pay. Families in America should not be driven into financial ruin
because someone in that family became seriously ill. Sickness should
not be a cause of financial ruin.
I am tired of hearing from Americans who lost loved ones because they
could not afford the unbelievably high cost of prescription drugs, and
I am tired of hearing from constituents who are forced to cut their
pills in half due to the cost. Today, unbelievably, almost one out of
four patients cannot afford the prescription drugs their doctors
prescribe.
When you want to talk about an irrational and dysfunctional
healthcare system, think about a system in which people go to a doctor,
they get diagnosed as to their healthcare problem, they get a
prescription drug prescribed to them, but they can't afford to buy the
drug the doctor prescribes. So what ends up happening? They end up
getting sicker. Maybe they end up in the emergency room at an
outrageous cost. Maybe because they couldn't afford the prescription
drugs in the first place, they end up in the hospital at a very high
cost. Maybe they die. That is an irrational and absurd healthcare
system.
I am tired of talking to people and families of people who are
struggling with mental illness but cannot afford the mental health
counseling they desperately need. Last year, as you know, a
recordbreaking 100,000 Americans died of drug overdoses. And I will
tell you that in my office--and I am sure that in every other Senate
office--we get desperate calls from family members looking for
affordable mental health counseling. Far too often, that care simply is
not there in the community.
People are struggling with husbands, wives, kids who are on the verge
of doing something terrible to themselves, to others, and yet, in this
country, despite spending far more for
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healthcare than any other country, we don't have the capability of
helping those people. It is not there. The mental health counseling,
the help that people need is not there because in this system, geared
toward the profits of the insurance companies rather than the needs of
the American people, we don't have enough psychologists, counselors, or
social workers.
Unbelievably, despite spending far more per capita on healthcare than
any other nation, we don't even have enough doctors. We are facing a
major doctor shortage in America now, which will only get worse in the
years to come if we don't address it. We don't have enough nurses. We
don't have enough dentists. We don't have enough medical providers in
general. We have, however, more than enough people who bill us and more
than enough debt collectors who hound us to pay for a bill we cannot
afford, but we just don't have enough people to provide the healthcare
that we desperately need.
By the way, the crisis of lack of healthcare providers is only going
to get worse as our society continues to age.
At a time of declining life expectancy in the wealthiest country on
Earth, your health and your longevity should not be dependent on the
amount of money you have. It is an absolute outrage and grossly un-
American that the number of years we live in this country is dependent
upon our income. Studies have shown that the top 1 percent of Americans
live 15 years longer than the poorest people in our society. It is not
only the very top as opposed to the very bottom; it is wealthy people
in general versus working-class people. If you got the money, you are
going to live longer in this country than if you do not have the money.
In my view, healthcare is a human right that all Americans,
regardless of income, are entitled to, and all Americans deserve the
best quality healthcare that our country can provide.
Further, as chairman of the Senate Budget Committee, it is not
acceptable to me that we end up spending over twice as much as
virtually every other major country on Earth per capita--twice as much
per capita--while our life expectancy and other healthcare outcomes lag
behind most other countries. This is really quite an amazing thing. We
spend more; yet our results are worse than in other countries,
unbelievably.
According to the Centers for Medicare and Medicaid Services, we are
now spending $12,530 per capita on healthcare. Imagine that--over
$12,000 for every man, woman, and child in this country. This is,
frankly, an outrageous and unsustainable sum of money. In comparison,
the United Kingdom spends just $5,300; France spends $5,400; Canada,
$5,900; Germany, $7,300. We spend over $12,000 per year.
The question that everyone should be asking is, How does it happen
that we spend so much money for healthcare, but we get so little in
return?
Let's be clear. The current debate over healthcare in the United
States really has nothing to do with healthcare. Frankly, it is hard to
defend this dysfunctional system. The healthcare debate has everything
to do with the unquenchable greed of the healthcare industry and their
desire to maintain a system which fails the average American but which
makes the industry huge profits every single year. While ordinary
Americans struggled to pay for healthcare during this pandemic, the six
largest health insurance companies in our country made over $60 billion
in profits last year, led by UnitedHealth Group, which made $24 billion
in 2021.
While millions of Americans cannot afford soaring healthcare costs,
the top executives in the insurance industry receive huge amounts of
compensation. In 2020--remember, 70 million uninsured and underinsured
and 68,000 dying every year because they don't get to a doctor on
time--the CEOs of 178 major healthcare companies collectively made $3.2
billion in total compensation--up 31 percent from the previous year--
all in the midst of the pandemic. People were dying every single day,
and the cost of healthcare was soaring; yet the CEOs saw a 31-percent
increase in their compensation. According to Axios, in 2020, the CEO of
Cigna, David Cordani, took home $79 million in compensation. The CEO of
Centene, Mr. Neidorff, made $59 million. The CEO of UnitedHealth Group,
Mr. Wichmann, received $42 million in total compensation.
But it is not just the health insurance companies that are ripping
off the American people; it is the drug companies as well. In terms of
the pharmaceutical industry, last year, Pfizer, Johnson & Johnson, and
AbbVie--three giant pharmaceutical companies--increased their profits
by over 90 percent to $54 billion. How is it that, in the midst of a
pandemic, during which we lost over a million people and millions and
millions of people have become sick, the profits of the major drug
companies went up by over 90 percent?
The CEO of Moderna got a $926 million golden parachute after his
company received $2.5 billion in taxpayer dollars to develop the
vaccine. We all appreciate the development of the vaccine, which is
saving lives every day. But, really, does the CEO of the company that
received $2.5 billion of taxpayer money deserve a $926 million golden
parachute? That is an indication, a manifestation, of a sick and broken
healthcare system. And while over 330,000 Americans died during the
pandemic because they could not afford to go to a doctor on time, the
CEO of Regeneron Pharmaceuticals made over $450 million in total
compensation.
The current system is failing the American people, and the American
people want change--real change.
In March, a few months ago, I was pleased to introduce Medicare for
All legislation, with 15 Senate cosponsors. Companion legislation in
the House now has 122 cosponsors. This legislation would improve and
expand Medicare to cover, over a 4-year period, healthcare to every
man, woman, and child in this country. In other words, what this
legislation finally does is make sure that the United States joins
every other major country and that we guarantee healthcare to all of
our people.
This legislation is comprehensive, and it would end out-of-pocket
expenses. Unlike the current system, it would provide full freedom of
choice regarding healthcare providers. In other words, under Medicare
for All, there would no longer be insurance premiums, deductibles, or
copayments, and no more networks which deny you your choice of doctors.
And, when I talk about Medicare for All being comprehensive, it would
cover dental care, vision, hearing aids, prescription drugs, and home-
and community-based care. In other words, it would do precisely what
the American people want us to do.
Would a Medicare for All system be expensive? Yes, but while
providing comprehensive care for all, it would be significantly less
expensive than our current dysfunctional system because it would
eliminate an enormous amount of the bureaucracy, profiteering,
administrative costs, and misplaced priorities inherent in our current
for-profit system.
Remember, we currently pay twice as much for healthcare as do the
people of virtually any other country, and all of those countries
manage to provide universal healthcare. So, yes, we can provide quality
care for all at a much, much lower cost per person.
Under Medicare for All, there would no longer be armies of people
billing us, telling us what is covered and what is not covered, and
hounding us to pay our hospital bills. This not only saves substantial
sums of money but will make life a lot easier for the American people,
who would never again have to fight their way through the nightmare of
insurance company bureaucracy. In fact, the Congressional Budget
Office, the CBO, estimated that Medicare for All would save Americans
$650 billion a year.
Now, trust me. I do know the 30-second ads from the insurance and
drug companies that have told us that if Medicare for All becomes law,
your taxes will go up. What they forgot to tell you is that, under
Medicare for All, you will no longer be paying premiums, deductibles,
copayments, and out-of-pocket expenses to private health insurance
companies. What they certainly won't tell you is that Medicare for All
will save--save--the average American family thousands of dollars a
year. In fact, a study by RAND found that moving to a Medicare for All
system would save a family with an income of less than $185,000 about
$3,000 a year on average.
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Now, one might ask, fair enough: If Medicare for All is so good, if
it has so many advantages, if it is what the American people want, why
hasn't it been enacted by now? Why hasn't the United States joined
every other major country in guaranteeing healthcare for all?
That takes us to our corrupt political system and the outrageous way
we fund campaigns. So I would suggest if you want to know why we are
stuck with a dysfunctional healthcare system that fails the American
people but that makes the drug companies and the insurance companies
wildly profitable, follow the money. Follow the money.
Since 1998, in our corrupt political system, the private healthcare
sector has spent more than $10 billion on lobbying. Got that? More than
$10 billion on lobbying since 1998. Over the last 30 years, it has
spent more than $1.7 billion on campaign contributions to maintain the
status quo.
In terms of their lobbying efforts, let's be clear. They are very,
very bipartisan. There are former Democratic Party leaders and former
Republican Party leaders who are working together to represent the
insurance companies and the drug companies.
And, by the way, of course, in terms of the campaign contributions,
the insurance companies and the drug companies are also very
bipartisan. In fact, their contributions go to many Members of both the
Democratic and Republican Parties. It doesn't really matter if you are
a Democrat or a Republican; what matters is you protect the interests
of the drug companies and the insurance companies.
But, you know, what I believe is that maybe, just maybe, now is the
time for Congress to do what the American people want--not what the
lobbyists want, not what the drug companies want, not what the
insurance companies want. And maybe, just maybe, we should have the
courage to take on the powerful special interests that dominate
healthcare in the United States. And maybe, just maybe, now is the time
to provide healthcare to every man, woman, and child as a human right
by passing a Medicare for All, single-payer program.
I yield the floor.
The PRESIDING OFFICER. The Senator from Nebraska.