Elon Musk, the billionaire whom Trump has nominated to head the Department of Government Efficiency (DOGE) in his administration, asked on X why Americans are not getting their money’s worth from our health care system. Congresswoman Pramila Jayapal and Senator Bernie Sanders have an answer: If we want a cost-effective system, we need single-payer, one government-administered health care system for everyone. It’s that simple.
Tag: Bernie Sanders
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How can Pharma defend drug prices in US?
The Biden administration and Congress are concerned about drug prices, they claim. Really? It would be so easy to lower drug prices quickly, simply by opening our borders to drugs from verified pharmacies abroad. Instead, for the first time, the US is negotiating drug prices for ten drugs, and those prices will only be available to Medicare. Noah Weiland and Rebecca Robbins report for The New York Times on a recent Senate HELP Committee hearing.
The Senate HELP Committee held a hearing on drug prices last week. The heads of three pharmaceutical companies had to defend their prices at the hearing. There was lots of talk and little action about why every other wealthy nation pays less for their prescription drugs than we do.
CEOs at Johnson & Johnson, Merck and Bristol Myers Squibb admitted that we pay more for our drugs in the US than people in other wealthy countries. In exchange, they claim that we get new drugs sooner. Clearly some spin doctor advised that they praise this “patient choice” in the US. What was left unsaid is that “choice” is only available to the wealthy. Countless Americans cannot afford their drugs even with health insurance because the copays are so high.
Senator Bernie Sanders, for reasons that I have never understood, is constantly comparing drug prices in the US with those in Canada and sometimes arguing that Americans should be able to import drugs from Canada. Canada has the second highest drug prices in the world. Why not France and England, which have far lower prices?
Sanders was looking for the CEOs to voluntarily agree to lowering their prices to the same level as Canada. How could they possibly agree to reduce their revenue and profits voluntarily? In fact, they have filed lawsuits against the federal government (which they are so far losing), claiming that negotiated prices for ten drugs through the Inflation Reduction Act is unconstitutional!
Republicans on the HELP Committee appear to believe that the pharmaceutical market is working. In fact, Congress affords pharmaceutical companies lengthy patent rights and ways to extend them. The pharmaceutical market is fixed to give pharmaceutical companies monopoly pricing power for lengthy periods.
Senator Romney would like you to believe that the pharmaceutical market works like the automobile market. Not at all. With cars, there’s competition based on lots of known information, including the costs and benefits of the automobile. With drugs, people often don’t know their value. Moreover, the price is rigged by the manufacturers, the pharmacy benefit managers and the health insurers.
We are paying about three times more than people in other countries for our drugs. Shame on Congress.
Here’s more from Just Care:
- Drug prices continue to be around three times higher in the US than other wealthy nations
- FDA allows Florida to import lower-cost drugs from Canada
- Six tips for keeping your drug costs down if you have Medicare
- Importing drugs from abroad should be legal
- Case study: Costco saves one couple hundreds of dollars over Medicare Part D
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Senator Sanders wants greater US investment in community health centers
Sen. Bernie Sanders, Chair of the Senate HELP Committee, is focused on expanding the number of primary care physicians in the US. His recent bill would put $100 billion into community health centers, sometimes called Federally Qualified Health Centers or “FQHCs” in the next five years to train physicians, nurses and other health professionals. If you do not have a primary care doctor or simply need good primary care, consider contacting your local FQHC.
Today, millions of Americans cannot see a primary care doctor without a long wait. Not only can a long wait jeopardize their health, it can cost our health care system more. Without prompt primary care to treat a variety of conditions, people can end up needing costly emergency room or hospital care.
No question that primary care doctors are in short supply. The Association of American Medical Colleges says that ten years from now we will face a shortage of as many as 48,000 primary care doctors.
Kaiser Health News reports that as many as 100 million people live in areas where it can be hard to find a primary care physician. One physician who heads a center on primary care at Harvard Medical School reports that lack of access to PCPs can shorten your life expectancy by as much as a year.
Around 70 million adults in the US–more than one in four adults–say they have no go-to doctor they can turn to when they need treatment or guidance with their health. They must use the emergency room at their hospital. In 2010, more people had primary care physicians than today, even though today more people have health insurance.
For sure, some of the adults who don’t have primary care physicians arguably have not needed them. Many men in their 20s, for example, might have no reason to see a primary care physician if they are healthy. But, even if you take them out of the equation, 47 million adults have no primary care physician to see.
People sometimes see nurse practitioners for primary care. If you include nurse practitioners in the mix of primary care providers, there is arguably less of a shortage than Senator Sanders claims, but the shortage is still meaningful in some parts of the country. The US needs to invest more in primary care.
Here’s more from Just Care:
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Senator Sanders wants a commitment from President Biden to lower drug prices
Senator Bernie Sanders is refusing to join with President Joe Biden and fellow Democrats to support the president’s nominee to head the National Institutes of Health. The Washington Post reports that Sanders, who heads the Senate HELP committee, first wants a commitment from President Biden to lower drug prices.
We need “a very clear” government strategy on how to bring down prescription drug prices, says Sanders. Americans pay many times more than people in other countries for our drugs. And, not only is that insane, it is unconscionable. High drug prices are literally killing people, keeping them from taking heart and cancer medications they need to stay alive. High prices are also driving up federal health care spending.
As chair of the Senate HELP committee, Senator Sanders decides whether to confirm nominees for positions at the Department of Health and Human Services. He hopes to pressure the administration to establish a plan for lowering drug prices. He’s gotten media attention, but will he get Biden to act?
President Biden says he is concerned about the price of prescription drugs. He signed the Inflation Reduction Act, which allows Medicare to negotiate some drug prices. But, that’s only for people with Medicare and only covers a small number of drugs.
A recent report from the Department of Health and Human Services found that in the year between 2021 and 2022, the price of more than 1,200 medications rose more than 31 percent. The pharmaceutical industry blames Pharmacy Benefits Managers (PBMs) for high drug prices. They are to blame, and so are pharmaceutical companies. PBMs pocket most of the savings they secure from bulk purchasing of drugs rather than using the savings to reduce drug costs appreciably. Pharmaceutical companies charge high prices.
Senator Sanders’ team just issued a report finding that even when taxpayer dollars go to funding pharmaceutical company research that leads to the development of new drugs, Americans pay a lot more than people in other countries for those drugs. Americans pay for those drugs to be developed and are then expected to pay again in spades for them when they need them.
Senator Sanders wants all drugs created with taxpayer dollars through the NIH to come with a “reasonable pricing clause.” He doesn’t spell out what that means. It should mean a price equal to if not lower than what any other wealthy country pays for those drugs. That’s only reasonable since we’ve paid for their development.
The easiest way to bring down prescription drug prices quickly is to open our borders to drug importation from verified pharmacies and require insurers to cover their cost. But, no one is yet calling for that. Sanders’ goal is to change government policy with regard to the pharmaceutical industry and demand that prescription drug costs in the US drop considerably. Good luck!
Here’s more from Just Care:
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Bernie Sanders blasts drug manufacturers for the “unconscionable” price of Alzheimer’s drug
CNBC.com reports that Senate HELP committee chair, Bernie Sanders, is blasting drug manufacturers Eisai and Biogen for setting the price of its Alzheimer’s drug at a level that will prevent people with Medicare from being able to get it. He wants the US Department of Health and Human Services to lower the price of Leqembi down from its “unconscionable” current price of $26,500 a year.
Like Aduhelm, Leqembi is a prescription drug administered by a physician and therefore covered under Medicare Part B. Medicare covers 80 percent of the cost, and individuals must pay 20 percent coinsurance. People’s annual out-of-pocket costs for Leqembi alone would be more than $5,000, unless they have Medicare supplemental coverage.
Right now, the price of Leqembi will drive up Medicare spending significantly, along with Medicare Part B premiums. It will also contribute to the erosion of the Medicare Trust Fund. Medicare will be spending more than it spent on the three most costliest Part B drugs in 2021. And, though the government has the right to negotiate drug prices for the Part B and D drugs it spends the most on, it will not be able to negotiate the price of Leqembi for 13 years, given restrictions on drug price negotiation in the Inflation Reduction Act.
As I wrote earlier this year when the FDA approved Leqembi, “Keep in mind that after the FDA approved Aduhelm, the government adjusted the Medicare Part B premium up $11 a month! Its list price was $56,000 a year, and the government assumed hundreds of thousands of people would take it.” (Thankfully, Medicare did not end up covering Aduhelm because of health risks associated with taking it and only minor benefits at best.) “This year, the standard Part B monthly premium is down $5.20 because the government adjusted it to account for the fact that Medicare is not covering Aduhelm.”
Sanders wants manufacturers to voluntarily reduce Leqembi’s price. If not, he wants the US Department of Health and Human Services to use its authority to break the drug’s patent in order to drive competition in the market. Sanders also suggests that the Centers for Medicare and Medicaid Services (CMS) has the authority to pay less for Leqembi. It is possible, though not likely, that a similar Eli Lilly drug, donanemab, that has not yet gone to market will help drive down Leqembi’s price.
How many people with Medicare would get Leqembi? We don’t yet know how many people with Medicare will take Leqembi. Medicare is covering it for “patients with mild cognitive impairment or mild dementia with confirmed amyloid plaques,” which could be a large cohort of the 6.7 million people with Alzheimer’s disease. The Kaiser Family Foundation estimates that if one in 20 people with Medicare take it, it would cost the Medicare Part B Trust Fund $8.9 billion annually.
About half of people with Medicare have an annual income under $30,000. They would be hard-pressed to afford coinsurance of more than $5,000. Even if they have Medicare supplemental coverage to pick up the coinsurance, the cost of their supplemental coverage is likely to rise significantly, given the cost of Leqembi and the number of people with Medicare who might take it.
What is the fair price for Leqembi? The Institute for Clinical and Economic Review suggests that the fair price for Leqembi could be as low as $8,900 a year. Even at that price, it would mean nearly $1,800 a year in out-of-pocket costs for people taking it.
Here’s more from Just Care:
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Senator Sanders pushes for greater investment in community health centers
Daniel Payne and Burgess Everett report for Politico on Bernie Sanders latest big push on the health care front. As Chair of the Senate HELP committee, Sanders is moving to put $190 billion more into our health care system over five years. The money is sorely needed.
Senator Sanders’ plan includes $130 billion for the federally qualified health centers (FQHCs), often referred to as community health centers. You can find these community health centers throughout the country. If you are not familiar with FQHCs, they offer free and low-cost primary care services, sometimes even vision and dental services. And, FQHCs are known for their high quality care.
Sanders would put another $60 billion into expanding our health care workforce, including $15 billion for graduate medical education initiatives. His goal is to increase access to primary care.
Of late, FQHCs have not had adequate funding. And the health care workforce has been shrinking to the point where there are staff shortages throughout the country.
The question is whether Bernie Sanders can bring along other Democrats and Republicans to address health care inadequacies in the US, especially the shortage of primary care providers, dentists and nurses. Unfortunately, it’s not likely in this Congress. Other Sanders’ priorities include lowering the price of prescription drugs and increasing the minimum wage.
The HELP Republican leader, Bill Cassidy, says he wants a “reasonable solution” for addressing these health care issues. He sees the money Sanders proposes for the FQHCs as too much and unrealistic. The Republican-led House Energy and Commerce Health Subcommittee is working on legislation to keep FQHC funding at current levels for the next five years. That’s a lot lower than what Senator Sanders is proposing.
Here’s more from Just Care:
- The benefits available at your local community health center
- Do you know about these free and low-cost benefits?
- The choice between traditional Medicare and Medicare Advantage: It’s a sham
- How to get free or low-cost dental care
- Free local resources to help older adults
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HELP committee focuses on Moderna pricing of COVID vaccines
Now that the COVID-19 public health emergency is coming to an end and the government will stop covering the cost of COVID-19 vaccines and booster shots, Moderna is planning to raise the price of its vaccines significantly. Senator Bernie Sanders’ HELP Committee is holding a hearing on Moderna’s pricing of these vaccines.
Make no mistake, COVID-19 vaccines cost almost nothing to manufacture, about $3 a vaccine. The big cost of tbe vaccjnes is for the research and development. And, while there are ongoing costs as the virus mutates, to date, taxpayers have funded a significant share of the research and development costs.
Over the last few years, mRNA COVID vaccines have saved millions of lives. Not only did our government fund a large share of their development costs, it paid for them at a bulk price so that Americans who wanted the vaccine did not face financial barriers. Now, with the end of the public health emergency, Americans will be forced to pay for these vaccines outright or through higher insurance premiums and copays.
Moderna says it will raise the price of its COVID vaccines to as high as $130, a price that will be unaffordable for millions of Americans. Many Americans will die or get very sick as a result.
Moderna claims higher vaccine prices support ongoing research and development costs, which are several billion dollars. It says its patient assistance program will cover costs for those who can’t afford the vaccine. But, a patient assistance program is no substitute for a fairly priced vaccine. Most people are not able to navigate through the administrative hurdles these programs pose.
For sure, the COVID-19 vaccines have value. But, that is no justification for hiking the price of a drug every American needs to protect themselves from the sometimes deadly consequences of the COVID-19 virus. Moreover, government scientists and taxpayers contributed billions of dollars to the development of these vaccines.
Moderna contributed to the vaccine’s research and development, but it was hardly the sole inventor. Moderna has tried to bury the fact that researchers at the National Institutes of Health invented a critical part of the vaccine.
Moderna’s CEO and other executives are now billionaires, and Moderna has raked in tens of billions of dollars in profits from the COVID vaccines. Now, Moderna plans to hike prices, which is its right under the law. It’s due time our government ended that right and set fair drug prices in the US, as governments do in virtually every other wealthy country.
Congress should not allow pharmaceutical companies to set prices for any drugs, let alone life-saving drugs. By so doing, Congress discriminates against Americans with low incomes who desperately need these drugs. Until Congress takes charge of drug pricing, our government should continue buying vaccines for Americans and providing them free of charge to ensure everyone has access to them.
Here’s more from Just Care:
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Bernie Sanders’ HELP committee priorities
Jonathan Cohn reports for the Huffington Post on Bernie Sanders’ move to chair the Senate Health, Education, Labor and Pensions (HELP) committee. Under Sanders’ leadership, the HELP Committee will have several new priorities.
Sanders has been a senator from Vermont for 17 years. Before that, he served as a Congressman in the House of Representatives for 13 years. And, he started his political career as the mayor of Burlington, Vermont.
Sanders was able to focus significant attention on the need for Medicare for all in the US beginning with his run for president in 2016. As of now, Sanders does not intend to make Medicare for all a top priority for the HELP Committee because most Senators do not yet support it.
Committing additional funding to Federally Qualified Health Centers (FQHCs) or “community health centers” is one Sanders priority for the HELP committee. FQHCs provide primary care at low cost throughout the nation to some 30 million people. They are run by the government and physicians employed by the government.
FQHCs serve primarily lower-income individuals, although they must take all comers. Almost 50 percent of them are located in rural areas. They serve about 20 percent of rural Americans.
You can find out the closest FQHC to you by clicking here. You might be able to get low-cost dental care and prescription drugs at your FQHC. Some also offer wellness classes.
Republicans have traditionally supported FQHCs because they offer direct medical services. The government is not funding insurance coverage. And, there is recent precedent for bipartisan health care legislation–a mental health care bill sponsored by Senators Stabenow and Blunt.
Senator Sanders will also make the cost of prescription drugs a top priority. He would like prices in the US linked to prices in other wealthy nations. He plans to hold hearings that expose the high profits, high prices and bad acts of the pharmaceutical industry.
Here’s more from Just Care:
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Sen. Bernie Sanders will focus on high health care costs as head of the HELP committee
Next month, Senator Bernie Sanders will become chair of the Senate Health Education Labor and Pensions (HELP) committee. HealthcareDive reports that, in that role, among other things, Sanders will focus on high health care and prescription drug costs as well as elder care.
In a recent video, Senator Sanders spoke of the huge profits in the pharmaceutical industry at the same time that Americans are going without critical drugs because they are unaffordable; many are dying. The Inflation Reduction Act is a first step towards reining in high drug costs for people with Medicare. It gives the government some power to negotiate drug prices for the 60 most expensive drugs over the next several years, beginning in 2026.
But, Senator Sanders points out that the government’s prescription drug negotiating power is quite weak and explains that Congress has a lot more to do to rein in drug prices. As I see it, Congress should immediately open its borders to drug importation from verified pharmacies around the world and require insurers to cover imported drugs prescribed by treating physicians. That is not a long-term solution to high drug prices, but it is a likely way to put downward pressure on drug prices quickly and help ensure that Americans can afford their medicines. Americans usually pay many times what residents of other wealthy countries pay for prescription medicines.
The Inflation Reduction Act also caps annual out-of-pocket drug costs for people with Medicare at $2,000 beginning in 2025.
Senator Sanders said the HELP committee would hold many hearings with health care and pharmaceutical company executives. Senator Wyden, as chair of the Finance Committee, has focused on the pharmaceutical industries’ failure to pay corporate taxes through international tax law shenanigans.
Here’s more from Just Care:
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Biden-Sanders Unity Task Force recommends incremental health reforms
The Biden-Sanders Unity Task Force recently released its recommendations for health care reform. Unfortunately, the three Sanders’ appointees on the health care task force were not able to move the Biden appointees to support reforms that will guarantee health care to all Americans, much less get us meaningfully closer to Medicare for all. Rather, the Task Force’s proposed reforms are small and not likely to help most Americans.
Vice-President Joe Biden wants to “build upon our bedrock health care programs, including the Affordable Care Act, Medicare, Medicaid, and the Veterans Affairs system.” In his view, building means adding a “public option” and lowering the age of Medicare eligibility to 60. It’s unclear what exactly a public option would mean or how it would help guarantee Americans access to good affordable health care.
Here’s what we know: Joe Biden believes that if Americans had the choice of enrolling in a “public health plan”–health insurance provided directly by the federal government–in the state health insurance exchanges, private health insurers would engage in “real competition” and have a financial incentive to deliver quality affordable care. But, the evidence suggests otherwise.
We know that private Medicare Advantage plans do not engage in real competition with the public Medicare plan. Rather, they game the system, market to healthy people, create barriers to care for their members who need it and drive up costs. There is no reason to believe that private health plans would behave any differently for people under 65 if a public option were available.
What’s more, the Unity Task Force has in mind the possibility of more than one public plan choice, but it does not explain why there would need to be more than one choice. It says that at least one choice would not have a deductible and would be administered by traditional Medicare, not a private health insurance company. For reasons that are not explained, the government administrator of the new public plan would engage in its own negotiations with doctors and hospitals over prices rather than piggyback off of Medicare rates.
Anyone with employer coverage or coverage through the ACA would be free to enroll in the public plan. One special feature of this public plan is that people who are not eligible for Medicaid but whose incomes are low would automatically be enrolled in the public plan. People living in states that have not expanded Medicaid could also enroll in this public plan. They would not pay a premium for it and could opt out of it if they chose.
In addition to creating a public plan option, the Unity Task Force recommends that, at age 60, anyone could choose to enroll in Medicare. But, it does not recommend an out-of-pocket cap on traditional Medicare or other reforms that would improve Medicare benefits and make it easy to enroll in traditional Medicare.
Of course, with many options available, it will be easy for marketers to confuse people about what health plan is best for them. Inevitably, plenty of health plans will not meet people’s needs. For example, they might inappropriately delay and deny care, have narrow networks without high-value health care providers, or high copays. To help people distinguish among plans, the Unity Task Force supports appropriating money to let people know about their options and enroll them. But, assistance is of little help if there are no good options available. And, information that would shed helpful insight into which are better than others–such as which don’t have high denial rates–is not available.
The Unity Task Force recommends giving states the right to come up with their own health plans. Many advocates and states want that right. Still, the likelihood of success on the part of states to guarantee residents affordable health care is slim given financial constraints and their lack of resources to take on the private health insurance industry. States have never been able to serve Americans well on the health insurance coverage front and there is no evidence that they will do so in the future.
The Unity Task Force sees its recommendations as meeting the needs of people who are recently unemployed as a result of the pandemic along with people who have been uninsured for a long while. But, it’s unclear why. With health care costs continuing to rise and little focus on reining them in, it’s hard to imagine the public option–the Task Force’s chief way of improving health insurance–will be affordable to most people without substantial federal subsidies.
If you can’t afford health insurance as a result of these health care reforms, you might want to get care at community health centers, sometimes known as Federally Qualified Health Centers, and rural health centers. The Task Force recommends greater and more predictable funding for these health centers.
To address shortages of health care providers, particularly primary care nurses and dentists and mental health counselors, the Unity Task Force recommends a larger National Health Service Corps.
Here’s more from Just Care:
- Congress must protect our community health centers
- Programs that lower your costs if you have Medicare
- What are the major differences between Medicare for all and a public option?
- How would lowering the Medicare eligibility age to 60 help?
- If you want easy health care access and good quality care, you probably want traditional Medicare