During remarks on the Senate floor Tuesday, Sen. Bernie Sanders (I-VT) debated Sen. Mike Crapo (R-ID) on a bill that would cap the price that Medicare pays for prescription drugs.
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NewsTranscript
00:00Thank you Mr. President. Mr. President, my office and I suspect all Senate offices are
00:11getting a whole lot of calls from senior citizens who are experiencing a great deal of fear
00:19and anxiety as to all of the confusion and chaos that is currently going on here in Washington.
00:29When we have the President and my Republican colleagues talking about cutting Medicaid
00:38by some $880 billion, let us be clear, they are not just talking about throwing millions
00:46of children and others off of the health insurance they have. They are also talking about cuts
00:56to community health centers, which receive about 43% of their funding from Medicaid,
01:02and where millions of seniors go to get their primary care. So cutting Medicaid impacts
01:08primary care. At a time when we have a major crisis in nursing home availability, I know
01:15that's true in Vermont, I expect it's true in almost every state in the country, let
01:21us understand that Medicaid provides approximately 2 out of 3 seniors with the funding they
01:30need to live in nursing homes. Make drastic cuts in Medicaid, it's going to be harder
01:37for your mom, your dad, to get into a nursing home or to stay in a nursing home. Cuts in
01:45Medicaid would be a disaster for seniors in nursing homes. But it's not just Medicaid
01:51cuts that worry seniors. At a time when the Social Security Administration is already
01:58understaffed, and again, for years, I have been hearing in my office, I expect other
02:04senators have been hearing in their offices, from seniors, who tell us they're calling
02:09up Social Security, they've got a problem, they are not getting a response, and the result
02:15of that is that some 30,000 people a year die, die waiting for their Social Security
02:24disability benefits. And in the midst of all that, in the midst of a crisis, where Social
02:30Security is understaffed, where our response should be to significantly increase staffing
02:37so that Social Security can better respond to the needs of our constituents, we have
02:41Elon Musk and his minions at Doge cutting some 2,500 of Social Security staff, and
02:50incredibly, they are now threatening to cut up, cut up to half of Social Security Administration
02:58staffing. And then on top of all that, you have Mr. Musk claiming that Social Security,
03:05which has paid out every benefit owed to every eligible American for over 80 years,
03:13claiming that it is a Ponzi scheme. Social Security is not a Ponzi scheme. Paid out every
03:21benefit owed to every eligible American for over 80 years. And then you have the President
03:28of the United States, State of the Union, lying about millions of people, millions of
03:33people, 200 years of age, 300 years of age, imagine that, getting Social Security benefits.
03:41Seniors understand what all of that is about. They know that Musk and Trump want us to lose
03:47faith in Social Security, and that over a period of time, they want to give that indispensable
03:54program over to Wall Street.
03:57Mr. President, let us be clear. In America today, 22% of Americans living, who are 65
04:07years of age, are trying to survive on an income of less than $15,000 a year. Think
04:16about that. Twenty-two percent seniors in America trying to survive on $15,000 a year
04:23or less. Half of seniors are trying to get by on $30,000 a year or less. Everybody, frankly,
04:35I don't know how any senior living on $15,000, $20,000 survives. I don't know. High cost
04:43of prescription drugs, food, housing, keeping warm in the winter, I don't know how they
04:48can do that. According to the Organization for Economic Cooperation and Development,
04:53we now have the dubious distinction of having one of the highest rates of senior poverty
04:59compared to other wealthy nations. In America today, according to the latest OECD estimates,
05:0623% of seniors are living in poverty compared to just 4% in Norway, 6% in France, and 11.5%
05:14in Canada. Yeah, we have more nuclear weapons than any other country. We have more billionaires
05:20than any other country, but we also have one of the highest rates of senior poverty of
05:25any country on Earth. We might want to get our priorities right. Now, Mr. President,
05:30while my Republican colleagues would like to make massive cuts to Medicaid in order
05:36to provide more tax breaks to billionaires, some of us have a better idea. We have to
05:43we think that it makes more sense to substantially improve the lives of our nation's seniors
05:53by expanding Medicare to cover dental, vision, and hearing benefits. In 1965, President Lyndon
06:01Johnson signed Medicare, one of the most popular and successful government programs in our
06:06nation's history, into law. Before the enactment, this is really quite interesting, before the
06:11enactment of Medicare, about half of our seniors were uninsured. Today, everyone in
06:18America age 65 or older is guaranteed health care benefits through Medicare regardless
06:26of their income or medical condition. That is the good news. The bad news is that since
06:34its inception 60 years ago, Medicare has failed to cover such basic health care needs as hearing
06:42dental care and vision. The result, millions of senior citizens have teeth that are rotting
06:49in their mouths. They are unable to hear what their children say or unable to read a newspaper
06:57because of failing eyesight. Mr. President, this is the United States of America. We are
07:05the wealthiest country in the history of the world. Senior citizens should not be walking
07:11around with no teeth in their mouth. They should not be unable to hear conversations.
07:19They should not be unable to afford glasses so they can read a newspaper. The need to
07:25expand Medicare to cover dental, hearing, and eyeglasses is absolutely critical. Nobody
07:32denies that oral health, hearing, and vision are essential parts of health care. We cannot
07:41continue to deny seniors these basic health care benefits. Mr. President, we can no longer
07:49tolerate the fact that 26 million seniors and people with disabilities in America have
07:54no dental insurance and no idea how they will be able to pay for the very expensive dental
08:02procedures that they need. The results have been tragic. Nearly one out of five seniors
08:09in America have lost all of their natural teeth. Twenty percent seniors in America have
08:14no natural teeth in their mouths. Disgracefully, 60 percent of our nation's seniors have untreated
08:21gum disease, which can increase the risk of cardiovascular disease, diabetes, and rheumatoid
08:27arthritis. Further, it is not acceptable that while nearly two-thirds of seniors over
08:33the age of 70 experience hearing loss, less than 30 percent of seniors above this age
08:41have ever used a hearing aid, primarily because hearing aids are too expensive. In my view,
08:48no senior in America should face isolation from their families and friends simply because
08:53they cannot afford the extremely high price of a hearing aid. In addition, we cannot continue
09:00to allow seniors with poor vision to go without routine eye exams or properly prescribed glasses.
09:06Poor vision can lead to injury, cognitive impairment, and depression. Mr. President,
09:13adding dental, vision, and hearing benefits to Medicare is not just good public policy.
09:20It will not only ease human suffering and improve the health of our nation's seniors.
09:25It is precisely what the overwhelming majority of the American people want. Poll after poll
09:34tells us exactly that. According to a poll conducted by Data for Progress last year,
09:40it found that 92 percent of the American people support expanding Medicare to provide dental,
09:46vision, and hearing benefits. And that is why, Mr. President, I have introduced legislation
09:51today with Senators Warren, Booker, Welch, Markey, Duckworth, Merkley, Blumenthal, and
09:58Blumenthal to do just that. Congressman Lloyd Doggett in the House has introduced similar
10:05legislation which has more than 110 co-sponsors. Now, I am sure that some of my Republican
10:13colleagues may say, well, you know, it's an interesting idea, it's a good idea, but you
10:17know, how are you going to pay for it? So let me tell you how we're going to pay for
10:21it. We are going to pay for it by requiring Medicare to pay no more for prescription drugs
10:28than the VA. Right now, we pay the highest prices in the world for prescription drugs,
10:35and that means significantly increased expenses for Medicare. By making sure that Medicare
10:41pays no more than the VA, which has for years, for decades, negotiated prices with the
10:47pharmaceutical industry, we could not only cut the price of prescription drugs for our
10:52seniors in half, we will save over $800 billion over the next decade, which would more, more
11:00than pay for this legislation. Lower the cost of prescription drugs and get the revenue
11:06we need to cover dental, vision, and hearing for seniors. Now, some of my Republican friends
11:13may also argue that this bill is not needed. Some Medicare Advantage plans already offer
11:20dental, vision, and hearing benefits. Yes, but what my Republican friends may not tell
11:25you is, one, seniors still pay thousands of dollars out of pocket because these private
11:31Medicare Advantage benefits are totally inadequate. Further, the nonpartisan Medicare Payment
11:37Advisory Commission has estimated that Medicare Advantage plans overcharge the federal government
11:44by $83 billion a year. In other words, Mr. President, if we are serious about waste,
11:52fraud, and abuse, hear a lot about that, we may want to take a look at the massive waste
11:57and fraud that is taking place with private Medicare Advantage plans. Those savings would
12:03also more than fully pay for this legislation. Therefore, Mr. President, as if in legislative
12:12session, I ask unanimous consent that the Senate proceed to the immediate consideration
12:18of S. 939, which was introduced earlier today, that the bill be considered read three times
12:25and passed, and that the motion to reconsider be considered, made and laid upon the table.
12:31Is there an objection?
12:33Mr. President, reserving the right to object. Thank you, Mr. President. I share my colleagues'
12:42frustration with the Medicare system that far too often fails our seniors. Medicare's
12:48coverage and reimbursement paradigms routinely prioritize treating the symptoms instead of
12:54the underlying causes of chronic stress and disease. Research shows that patients with
13:01diminished vision, hearing, or oral health are more likely to suffer chronic conditions
13:07like kidneys, Alzheimer's, and heart disease. We should modernize Medicare to focus on prevention
13:15and maintenance interventions. Patients should have access to a full spectrum of specialized
13:22providers working together as a team, from nutritionists to dentists to psychologists
13:29and surgeons. However, we must tackle these reforms without increasing the cost for patients
13:36or taxpayers. My colleagues' proposal would increase the deficit by tens of billions of
13:42dollars and risk spiking seniors' premiums. After years of record inflation, we cannot
13:49rush to enact a policy that has not been carefully considered and appropriately integrated
13:54into Medicare. This bill was just introduced today. It hasn't even been looked at by the
14:01Finance Committee. No hearing has been held, and no evaluation of how to effectively integrate
14:08these types of policies has been made. I welcome the opportunity to work with my colleague
14:14to enact meaningful improvements to Medicare that deliver better outcomes for Americans.
14:20However, simply introducing a bill and then moving to have it passed on the floor of the
14:25Senate before there has been any consideration is not the way to proceed. We must proceed
14:33within the committee and floor process, within the regular order that this Senate requires.
14:38And for these reasons, Mr. President, I object to the request.
14:43President, objection is heard.
14:45I ask my colleague, my friend, the Chairman of the Finance Committee, a question. I hear
14:49what you're saying. Do I hear you correctly that you are prepared to discuss this legislation
14:57in committee?
14:58I'm prepared to discuss the issue. I'm not telling you that I will limit the discussion
15:02to this piece of legislation. But, yes, we are prepared to discuss significant approaches
15:08to how we improve and expand proper health care treatment in America.
15:13Look, I understand that this bill would bring forth serious debate and discussion, but I
15:19would appreciate if we could have a starting point. This bill is pretty simple. It says
15:25let's – and I hear you saying that you need – am I hearing you correctly to say that
15:29the idea of covering dental vision and hearing is something that you entertain, that you
15:34think is a good idea? Or am I not hearing that?
15:36I do think that that idea is – that outcome is a good outcome to seek to achieve. I can't
15:41say that I want to have your legislation or even my legislation.
15:44Okay, fair enough.
15:45I don't have it developed.
15:46That's fair enough. But what I would like to do – and I appreciate – you know, I
15:50think you and I can agree that we don't use the committee structure here in the Senate
15:55as effectively as we might. That is the place to have serious debate and discussion, correct?
16:00Correct.
16:01Okay. I would hope, in one way or another, I would appreciate it if we could start off
16:06with my bill. You can come in and tell me what you don't like about it. We can go
16:10from there. But this is a crisis situation. I think you and I agree that too many of our
16:16seniors are suffering because of lack of dental hearing and vision. I look forward to hearing
16:22what you have to say. Let's debate it. But can we get this into the committee and have
16:26a serious discussion on it?
16:28I assume that this bill will be referred to the Finance Committee.
16:32It will be.
16:33If this bill is referred to the Finance Committee, then it, like all other legislation in this
16:37area that is referred to the Finance Committee, will be reviewed by us. I can't tell you
16:42that it will have a specific hearing. I can't tell you exactly how that will work. We will
16:47look at developing a very significant and, I hope, broad and successful approach to reducing
16:55the cost of our health care system and increasing the focus and successes in our health care
17:00system. I look forward to working with you on that.
17:03Thank you, Mr. Chairman. Thank you, Mr. President.