Tag Archives: health care

Biden Challenges Trump Attempts to Spin Historic Failure to Combat Coronavirus

Vice President Joe Biden is directly challenging Trump’s handling of the coronavirus pandemic accelerating across the United States and world that has produced twin crises in healthcare and the economy, in the form of questions that should be posed at the White House briefings that have become campaign rallies for Trump’s election. (c) Karen Rubin/news-photos-features.com

Vice President Joe Biden is directly challenging Trump’s handling of the coronavirus pandemic accelerating across the United States and world that has produced twin crises in healthcare and the economy, in the form of questions that should be posed at the White House briefings that have become campaign rallies for Trump’s election. Instead of a “whole of government” marshaling of forces to combat the virus, Trump’s “whole of government” is one big political enterprise, while Trump uses that time at the bully pulpit to attack Democrats, particularly Speaker Nancy Pelosi, and call the impeachment yet another “hoax” instead of organizing his administration to make sure all the states and cities have the life-saving equipment and staff needed to save lives, that the nation unites together to curtail social contact, and to make sure businesses and families to have the financial resources necessary to make it through. Instead, Trump has denied re-opening enrollment to Obamacare for those who don’t have health insurance, and his administration has no clue how to actually implement the $2.2 trillion in “relief” money to families and businesses.  This is from the Biden campaign: –Karen Rubin, news-photos-features.com.

As Trump Attempts to Spin Away His Historic Failure to Combat the Coronavirus, Here Are Questions He Needs to Answer at Today’s Press Conference


1.  Why are you refusing to allow Americans who desperately need health insurance in the middle of a pandemic access to the Affordable Care Act’s marketplace? 
 
The Trump administration is refusing to re-open the federal ACA marketplace’s enrollment period — jeopardizing Americans’ access to health insurance in the midst of a global pandemic — despite pleas from a bipartisan coalition of leaders, including the Republican Governor of Arizona, Doug Ducey, to do so.
 
This is yet another step in Trump’s ideological battle against the ACA — no matter the cost to the health care of Americans — which has seen his Administration pursue efforts that would kick tens of millions of Americans off their coverage and roll back protections for Americans with pre-existing conditions
 
About 20 million Americans have received health insurance through the ACA, and it’s given better care and peace of mind to countless others — that’s why Vice President Biden sent a letter to President Trump and Republican leaders demanding that they drop their efforts to jeopardize Americans’ health care. 
 

2.  Why do you continue to mislead Americans about your failure to adequately develop and deploy an effective coronavirus test — a failure that allowed the virus to spread unchecked and explode across our country?
 
In a call with governors on Monday, according to the New York Times, Trump continued to shrug off the coronavirus testing crisis that exploded on his watch, claiming that “I haven’t heard about testing being a problem” and that he hasn’t “heard about testing in weeks” — even though countless Americans are still unable to be tested for the coronavirus, fatally undercutting our response to this crisis?

Trump’s lie was so out of step with reality that it prompted a rebuke from fellow Republicans, with Maryland Governor Larry Hogan saying yesterday that Trump’s claim was “just not true” and that “no state has enough testing” and Ohio Governor Mike DeWine adding that “we know Ohio hasn’t had as much testing as we would have liked. We had to ration the testing.”
 
Similarly, Trump’s assertion in a Monday interview with Fox New that testing failures were the fault of the Obama-Biden administration was demolished by PolitiFact yesterday, which rated Trump’s claim “Pants on Fire” false, and said that that his attack “flies in the face of logic.”
 
Trump’s baseless claims come just days after a bombshell report by the Times showed how his failure to quickly deploy an accurate coronavirus test resulted in a “lost month” that left America blind as it tried to combat the virus’ spread, and that his administration “squandered [America’s] best chance of containing the virus’s spread.”


3.  With new polls showing that Americans don’t approve of your handling of the coronavirus crisis, do you regret not acting sooner to halt the virus’ spread, like other countries did, instead of downplaying its threat for months?
 
Two new polls today show growing numbers of Americans disapprove of Trump’s slow and erratic response to the coronavirus, which has left the United States leading the world in confirmed cases.
 
POLITICO/Morning Consult survey found that by a seven point margin, Americans don’t think the administration is doing enough to combat the coronavirus. Similarly, an Associated Press poll also out today shows that only 44% of Americans approve of Trump’s handling of the pandemic and only 38% approve of the federal government’s response — even as people rally in support of how their state and local officials have handled the crisis. 
 
These sliding poll numbers come as Trump continues to mislead Americans about his slow response to the coronavirus pandemic, bizarrely claiming in Monday’s press briefing that he knew all along how dangerous the virus was, but failing to explain why he didn’t take swift action.
 

4.  GOP State Attorneys General confirmed Monday that they will continue their lawsuit to roll back the Affordable Care Act and kick millions of Americans off their health insurance in the midst of a pandemic. Will you, as Vice President Biden has called for, withdraw your support for this effort?
 
The Daily Beast confirmed on Monday that at least five Republican state Attorneys General plan to continue their lawsuit to overturn the ACA — threatening the health care of millions of Americans in the middle of a pandemic.  
 
Ten years ago, President Obama signed the Affordable Care Act into law, expanding access to quality, affordable health care for millions of Americans. But instead of standing up for Americans’ health care, Donald Trump continues to lead fellow Republicans in efforts to do away with the law and the critical protections it put in place.
 

5.  Why did your administration ignore existing Obama-Biden Administration plans to combat pandemics and why did you take actions that reduced our preparedness for challenges like the coronavirus?
 
POLITICO reports that the Trump administration tossed out an existing “pandemic playbook” from the National Security Council that laid out, in detail, steps to take in the face of a public health emergency like this. 
 
As a result, key problems that the playbook planned for — like the current logistical challenges plaguing our health care system — went unaddressed, slowing down our response. 
 
This is only one in a string of missteps by the Trump administration that left the United States unprepared and vulnerable to a future pandemic. Key positions across the government have been left unfilled, or occupied by unqualified political cronies. Similarly, CDC staff in China was slashed on Trump’s watch, removing important eyes and ears on the ground that could have given us critical early notice of the coronavirus’ spread.


6.  With another round of record unemployment claims showing the economic pain the coronavirus is putting the American people through, do you regret the weeks you spent downplaying the threat it posed and do you agree with your Treasury Secretary who said last week that unemployment numbers are “not relevant”?
 
With 6.6 million Americans filing for unemployment benefits last week, the explosive economic toll of the coronavirus continues to grow.
 
For months, Trump ignored and downplayed the looming threat of the coronavirus and failed to take the necessary steps to prepare us — even as other countries quickly acted. Now, America has more coronavirus cases than any other country in the world and our economy continues to suffer body blows.
 
Throughout, Trump’s administration has shown a cavalier indifference to the unimaginable economic toll of the coronavirus has had on the American workers, with Secretary Mnuchin claiming that last week’s massive unemployment figures were “not relevant” — even as families across the country are struggling to make ends meet.
 
 
7.  Why are you refusing to allow Americans who desperately need health insurance in the middle of a pandemic access to the Affordable Care Act’s marketplace? 
 
The Trump administration is refusing to re-open the federal ACA marketplace — preventing Americans’ access to health insurance in the midst of a global pandemic — despite pleas from a bipartisan coalition of leaders, including the Republican Governor of Arizona, Doug Ducey, to do so.
 
This is yet another step in Trump’s ideological battle against the ACA — no matter the cost to the health of Amercans — which has seen his Administration pursue efforts that would kick tens of millions of Americans off their coverage and roll back protections for Americans with pre-existing conditions
 
About 20 million Americans have received health insurance through the ACA, and it’s given better care and peace of mind to countless others — that’s why Vice President Biden sent a letter to President Trump and Republican leaders demanding that they drop their efforts to jeopardize Americans’ health care.
 

8.  A new report today shows that the U.S. Army was projecting as early as the beginning of February that 150,000 Americans could be killed by the coronavirus. So why did you continue to waste precious weeks downplaying the threat it posed?
 
A shocking report today by the Daily Beast shows that as early as February 3, the U.S. Army had internal projections showing that upwards of 150,000 Americans could die as a result of the coronavirus that was then spreading rapidly around the globe.
 
Instead of joining other countries around the world in taking quick action to prepare for the virus, Trump dismissed and downplayed its threat, telling a campaign rally a week later that “looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away.”
 
Vice President Biden, in contrast, was sounding the alarm — writing a January 27 op-ed in USA Today about the threat it posed and the steps that should be taken, with Jonathan Chait of New York Magazine noting yesterday that Joe Biden “very much did see the coronavirus disaster coming.”
 
 
9.  With new polls showing that Americans don’t approve of your handling of the coronavirus crisis, do you regret not acting sooner to halt the virus’ spread?
 
Two new polls released yesterday show growing numbers of Americans disapprove of Trump’s slow and erratic response to the coronavirus, which has left the United States leading the world in confirmed cases.
 
POLITICO/Morning Consult survey found that by a seven point margin, Americans don’t think the administration is doing enough to combat the coronavirus. Similarly, an Associated Press poll also out today shows that only 44% of Americans approve of Trump’s handling of the pandemic and only 38% approve of the federal government’s response — even as people rally in support of how their state and local officials have handled the crisis.
 
These sliding poll numbers come as Trump continues to mislead Americans about his slow response to the coronavirus pandemic, bizarrely claiming in Monday’s press briefing that he knew all along how dangerous the virus was, but failing to explain why he didn’t take swift action.
 
 
10.  Why do you continue to mislead Americans about your failure to adequately develop and deploy an effective coronavirus test — a failure that allowed the virus to spread unchecked and explode across our country?
 
In a call with governors on Monday, according to the New York Times, Trump continued to shrug off the coronavirus testing crisis that exploded on his watch, claiming that “I haven’t heard about testing being a problem” and that he hasn’t “heard about testing in weeks” — even though countless Americans are still unable to be tested for the coronavirus, fatally undercutting our response to this crisis?
 
Trump’s lie was so out of step with reality that it prompted a rebuke from fellow Republicans, with Maryland Governor Larry Hogan saying Tuesday that Trump’s claim was “just not true” and that “no state has enough testing” and Ohio Governor Mike DeWine adding that “we know Ohio hasn’t had as much testing as we would have liked. We had to ration the testing.”
 
Similarly, Trump’s assertion in a Monday interview with Fox New that testing failures were the fault of the Obama-Biden administration was demolished by PolitiFact yesterday, which rated Trump’s claim “Pants on Fire” false, and said that that his attack “flies in the face of logic.”
 
Trump’s baseless claims come just days after a bombshell report by the Times showed how his failure to quickly deploy an accurate coronavirus test resulted in a “lost month” that left America blind as it tried to combat the virus’ spread, and that his administration “squandered [America’s] best chance of containing the virus’s spread.

Joe Biden: 5 Questions for Donald Trump at Coronavirus Pandemic Briefing

Vice President Joe Biden offers stark difference to Donald Trump in focus and approach to addressing coronavirus pandemic poses five questions to Trump that should be asked at the daily briefing (c) Karen Rubin/news-photos-features.com

The coronavirus pandemic has completely derailed the 2020 presidential campaigns. While Trump has a bully pulpit and turns daily briefings into political rallies, challengers including Vice President Joe Biden cannot compete for visibility or reach. We will do our part, as much as possible, to broadcast their messages so that voters may discern for themselves who should be elected to lead this country. This is from the Joe Biden campaign, which came before Trump, switching focus from the 10 minutes he spent concerned about the spread of the disease and having an adequate health care system, turned again to prioritize the economy, saying he would look to end measures in a matter of weeks (not months) designed to slow the spread of COVID-19 in order to goose the economy. Trump said that the economic impact could become worse than COVID-19 itself. “We cannot let cure be worse than the problem,” causing the medical community to scratch heads.  The desire to prioritize economic health over people is echoed by other Republicans and rightwingers. Texas Lt. Gov. Dan Patrick said lots of grandparents would be willing to die in order to save the economy for their grandchildren. This is from the Biden campaign, in advance of Trump’s March 23 briefing–Karen Rubin, News & Photo Features.

Five Questions for Donald Trump at Today’s Briefing

As Trump Attempts to Spin Away His Historic Failure to Combat the Coronavirus, Here Are Five Questions He Needs to Answer at Today’s Press Conference

1.  Why do you continue to support efforts to roll back the Affordable Care Act and kick tens of millions of Americans off their insurance in the middle of a global pandemic?
 
Ten years ago today, President Obama signed the Affordable Care Act into law, expanding access to quality, affordable health care for millions of Americans. But, even in the midst of a global pandemic, Donald Trump continues to lead fellow Republicans in efforts to do away with the law and the critical protections it put in place.
 
Over 20 million Americans have received health insurance through the ACA, and it’s given better care and peace of mind to countless others — that’s why Vice President Biden sent a letter today to President Trump and Republican leaders demanding that they drop their efforts to jeopardize Americans’ health care.
 
 
2.  Why did you put the profits of big corporations ahead of desperately needed medical supplies for health care workers, first responders, and coronavirus victims?
 
New reporting today from CNN shows that Trump abruptly reversed himself on using the Defense Production Act to speed up the manufacture of critical medical equipment because big businesses aggressively lobbied the White House out of fear of “profit loss.”
 
Trump is continuing to put the bottom lines of his corporate cronies ahead of the safety of first responders and coronavirus victims — even as a bipartisan group of governors and mayors has demanded that he finally use the DPA to help secure life-saving gear.
 
 
3.  Why did you ignore the repeated warnings of your own intelligence officials in January and February about the impending risk of the coronavirus and decide to downplay the threat instead of preparing a response?
 
The Washington Post reported that Trump ignored repeated warnings from top intelligence officials in January and February that the coronavirus was spreading globally and that it posed a dire threat to the safety of the United States, with one official telling the Post that “the system was blinking red.”
 
Instead of preparing for the imminent spread of coronavirus in America, Trump repeatedly ignored experts and downplayed its significance, claiming, “it’s going to disappear. One day — it’s like a miracle — it will disappear.” The result: a “chaotic” response as basic needs for tests and life-saving equipment go unmet, and as Administration officials scramble to cover up for Trump’s lies about the response.
 
While Trump was ignoring the experts and downplayed the threat of the coronavirus, Vice President Biden laid out a clear-eyed vision in January for how we could come together as a country to stop the emerging pandemic and has built on that with a comprehensive plan to combat the coronavirus.
 
 
4.  Why did you take China’s word and praise Xi’s response for weeks as the coronavirus continued to spread, ignoring Vice President Biden’s warning about their misleading statements?
 
Trump wasted critical weeks praising President Xi and China’s response to the coronavirus epidemic — even as Trump’s own intelligence officials warned that the Chinese were providing faulty information. Vice President Biden, on the other hand, clearly warned Trump against trusting information from Xi at face value, insisting instead that America push to get experts on the ground in China.
 
Now Trump has laughably pivoted to criticizing China, attempting to rewrite history and brush aside countless examples of him heaping praise on Xi and the Chinese government. Moreover, is Trump saying that he wasn’t supposed to take steps to protect the American people simply because this virus emerged in another country?
 
 
5.  Why are you supporting a $500 billion slush fund for corporations with no strings attached and no protections for workers?
 
With America’s economy teetering, and with countless families facing financial ruin, Trump continues to back a massive corporate bailout package with almost no conditions, and no restraints on corporations using taxpayer dollars for executive bonuses and stock buybacks.
 
That’s why Vice President Biden has called for workers and families to be put first in any stimulus package — with no blank checks for big corporations — so Americans will have the financial support they need to weather this storm.

On 10th Anniversary of Obamacare, Biden tells Trump, AGs ‘Drop the Lawsuit’ to Strip Millions of Health Insurance, Gut Protections for Pre-Existing Conditions

2017 rally to save Obamacare, Long Island. On the 10th anniversary of President Obama signing the Affordable Care Act into law and expanding access to quality, affordable health care for millions of Americans, Vice President Joe Biden, candidate for President, sent a letter to President Trump, State Attorneys General, and Mississippi Governor Tate Reeves calling on them the drop the lawsuit against the landmark legislation, which would strip millions of their health insurance and gut protections for those with pre-existing conditions—during a global pandemic. © Karen Rubin/news-photos-features.com

Today, on the 10th anniversary of President Obama signing the Affordable Care Act into law and expanding access to quality, affordable health care for millions of Americans, Vice President Joe Biden sent a letter to President Trump, State Attorneys General, and Mississippi Governor Tate Reeves calling on them the drop the lawsuit against the landmark legislation, which would strip millions of their health insurance and gut protections for those with pre-existing conditions—during a global pandemic.  Below is the text of Vice President Biden’s letter:

March 23, 2020

Dear President Trump, State Attorneys General, and Governor Reeves,

All across this nation, Americans are anxious and afraid about the impact the deadly COVID-19 pandemic is already having on their lives, their families, and their ability to pay their bills. Individuals and families are stepping up to do their part––staying home, taking individual precautions and implementing social distancing, and making donations to support food banks and other vital service providers, all to protect those most at-risk from the virus in our communities. Their level of dedication should be matched by their elected leaders.

At a time of national emergency, which is laying bare the existing vulnerabilities in our public health infrastructure, it is unconscionable that you are continuing to pursue a lawsuit designed to strip millions of Americans of their health insurance and protections under the Affordable Care Act (ACA), including the ban on insurers denying coverage or raising premiums due to pre-existing conditions. No American should have the added worry right now that you are in court trying to take away their health care. You are ​letting partisan rancor and politics threaten the lives of your constituents, and that is a dereliction of your sworn duty​. I am therefore calling on each of you to drop your support of litigation to repeal the ACA.

This Monday, March 23, marks 10 years since President Obama signed into law the ACA. It was—and still is—a big deal for our country, because having health insurance isn’t just about being able to access health care when you need it, it’s about the peace of mind that comes from knowing that if your kid gets sick, you will be able to get them the care they need, or that if you have an accident, you won’t have to also worry about how to pay your medical bills. During a public health crisis, it’s part of the assurance that you can seek the treatment you and your loved ones need. I was proud to stand with President Obama every day of our Administration, but no day more so than when he signed the ACA, because of the real security it delivered for every day American families.

Since 2010, 20 million Americans have gained access to health insurance coverage. But the ACA also helps tens of millions more Americans across the country. It is the reason 100 million people with pre-existing conditions—including conditions like asthma and diabetes that make them at higher-risk for adverse health impacts from the—don’t have to worry about being charged more or denied coverage. It is the reason insurance companies can’t tell patients that they’ve hit an annual or lifetime cap on care.

The litigation you are supporting—Texas v. U.S.—jeopardizes every single one of those protections and threatens the peace of mind and access to care for hundreds of millions of Americans. There is no underlying constitutional flaw with the Affordable Care Act. In fact, the Supreme Court twice upheld the constitutionality of the law. The only reason this new case gained traction was because Congressional Republicans decided to amend the law and zero-out the penalty for not being insured, and legal experts from across the ideological spectrum have concluded that this new argument—that this change invalidates the entire law—is legally unsupportable.

The purpose of your suit is to destroy the ACA. Make no mistake: If the ACA did not exist right now, in this public health crisis, tens of millions of people would not have health insurance. 100 million would not have protections for the kind of underlying conditions that make them even more vulnerable to the impact of COVID-19. Insurance companies would be allowed to place caps on care provided to individuals. And if you succeed in killing it next year, you’ll put countless Americans at risk in the next pandemic.

If there was ever a moment to set aside politics, it is now. I have called for making all testing, treatment, and any eventual vaccine free of charge, regardless of whether an individual is insured. That is what is needed to defeat this virus. The last thing we need right now is people avoiding seeking care because they can’t afford it. But people will still have medical needs not directly related to COVID-19, which is why every American needs access to high-quality, affordable health insurance and the pre-existing condition protections that the law guarantees.

You have in your power the ability to make life safer, healthier, and a little bit easier for your constituents. All you have to do is drop your support for this ill-conceived lawsuit, which is even more dangerous and cruel in this moment of national crisis. History will judge all of us by how we respond to this pandemic. The public health imperative we now face is bigger than politics, and it requires all of us to summon the courage to lead and to do what is right for the American people.

Joseph R. Biden, Jr.
47th Vice President of the United States

In Oval Office Speech, Trump Fails to Offer Solutions to Stem Healthcare Crisis Looming With Coronavirus Pandemic or Calm Economic Fears

Trump offers his “historic actions” to address the coronavirus pandemic: payroll tax cut, tax deferral, travel ban from Europe (c) Karen Rubin/news-photos-features.com.
Trump, in an address to the nation from the  Oval Office, tried to calm fears and most importantly (for him) calm the financial markets after the World Health Organization declared the coronavirus a pandemic and chided nations for underplaying the crisis. Trump spent most of the time self-congratulating himself, calling the crisis “unprecedented” (it’s not), and his actions “historic” (hardly). Trump said nothing about making the health care infrastructure work to save Americans from suffering and needless dying, or for bolstering finances for people who have lost their means of earning money, paying bills, caring for children. His solution, to unilaterally ban travel from Europe (not UK) is absurd. Still no idea how many Americans harbor the infection. He used words like “unprecedented” when this is hardly unprecedented (Spanish flu, Swine flu, Ebola, and months of seeing what happened in China, South Korea, Italy). He kept saying that America will get by because we are the strongest, smartest, best nation that ever existed. Trump’s solution is medieval: pull up the drawbridge, build a wall against foreign invasion. Balderdash. And by the way, YOU DIDN’T BUILD THAT: the strong economy was bequeathed by Obama and other predecessors that Trump is frittering away with $1 trillion budget deficits despite (as Trump constantly claims) a historic, strong economy. And what does strong military have to do with coronavirus pandemic? The amount of back-slapping Trump does to himself (“unprecedented steps” which are hardly unprecedented or even dramatic or adequate or on target for the health crisis at hand), and his sychophants, even the “experts” have had to lather praise is disgusting. As for abandoning the partisanship, he means “adore me, go along with whatever I say.” Immediately after, he attacked Nancy Pelosi and Democrats. Here s the speech annotated – Karen Rubin/news-photos-features.com.
REMARKS BY PRESIDENT TRUMP
IN ADDRESS TO THE NATION
 
Oval Office
   
9:02 P.M. EDT
 
THE PRESIDENT:  My fellow Americans: Tonight, I want to speak with you about our nation’s unprecedented response to the coronavirus outbreak that started in China and is now spreading throughout the world.
 
Today, the World Health Organization officially announced that this is a global pandemic.

We have been in frequent contact with our allies, and we are marshalling the full power of the federal government and the private sector to protect the American people.

[And yet the European Union was blindsided by Trump’s sudden ban on travel from Europe but not the UK].
 
This is the most aggressive and comprehensive effort to confront a foreign virus in modern history.  I am confident that by counting and continuing to take these tough measures, we will significantly reduce the threat to our citizens, and we will ultimately and expeditiously defeat this virus.
 
From the beginning of time, nations and people have faced unforeseen challenges, including large-scale and very dangerous health threats.  This is the way it always was and always will be.  It only matters how you respond, and we are responding with great speed and professionalism.

[Hardly ‘unforeseen’ when the outbreak began in December in China and his first response came in March after pooh-poohing.]

Our team is the best anywhere in the world.  At the very start of the outbreak, we instituted sweeping travel restrictions on China and put in place the first federally mandated quarantine in over 50 years.  We declared a public health emergency and issued the highest level of travel warning on other countries as the virus spread its horrible infection. 
 
And taking early intense action, we have seen dramatically fewer cases of the virus in the United States than are now present in Europe. 

  [Except you really don’t know how many Americans are harboring the coronavirus because there hasn’t been adequate testing. And back in January, when Seattle doctor suspected coronavirus, federal agencies refused allowing testing, continued to reject the test kits from W.H.O. and relied on faulty, inadequate tests of its own.]

The European Union failed to take the same precautions and restrict travel from China and other hotspots.  As a result, a large number of new clusters in the United States were seeded by travelers from Europe. 

[That is one of Trump’s ‘blame others’ ‘blame them’ ‘blame Europe’ out of his ass comments. He doesn’t know how the infection came here or where it came from. Those cruise goers didn’t come from Europe.]
 
After consulting with our top government health professionals, I have decided to take several strong but necessary actions to protect the health and wellbeing of all Americans.
 
To keep new cases from entering our shores, we will be suspending all travel from Europe to the United States for the next 30 days.  The new rules will go into effect Friday at midnight.  These restrictions will be adjusted subject to conditions on the ground.
 
There will be exemptions for Americans who have undergone appropriate screenings, and these prohibitions will not only apply to the tremendous amount of trade and cargo, but various other things as we get approval.  Anything coming from Europe to the United States is what we are discussing.  These restrictions will also not apply to the United Kingdom.
 
At the same time, we are monitoring the situation in China and in South Korea.  And, as their situation improves, we will reevaluate the restrictions and warnings that are currently in place for a possible early opening.

  [There is no travel ban on South Korea.]

Earlier this week, I met with the leaders of health insurance industry who have agreed to waive all copayments for coronavirus treatments, extend insurance coverage to these treatments, and to prevent surprise medical billing. 
 
We are cutting massive amounts of red tape to make antiviral therapies available in record time.  These treatments will significantly reduce the impact and reach of the virus.

[Treatment still not likely to be available for a year.]
 
Additionally, last week, I signed into law an $8.3 billion funding bill to help CDC and other government agencies fight the virus and support vaccines, treatments, and distribution of medical supplies.  Testing and testing capabilities are expanding rapidly, day by day.  We are moving very quickly.

[Who will get that money and supplies?  Will Trump steer to “loyal” states and communities like Texas and Florida, and away from places like New York, California, Massachusetts, just as he did with Ukraine’s military aid, George w. Bush did with anti-terror funding after 9/11 and Chris Christie did by shutting down the George Washington bridge to punish Democratic mayors who refused to endorse him?]
 
The vast majority of Americans: The risk is very, very low.  Young and healthy people can expect to recover fully and quickly if they should get the virus.  The highest risk is for elderly population with underlying health conditions.  The elderly population must be very, very careful.

[The problem here is that the ‘young, healthy’ people can transmit the infection to others who are vulnerable.]
 
In particular, we are strongly advising that nursing homes for the elderly suspend all medically unnecessary visits.  In general, older Americans should also avoid nonessential travel in crowded areas. 
 
My administration is coordinating directly with communities with the largest outbreaks, and we have issued guidance on school closures, social distancing, and reducing large gatherings.
 
Smart action today will prevent the spread of the virus tomorrow.
 
Every community faces different risks and it is critical for you to follow the guidelines of your local officials who are working closely with our federal health experts — and they are the best. 

[Here is the key piece: the federal government is failing and useless and has no clue what to do, so Trump needs to rely – and probably blame – state and local officials who are doing their best to keep up with the needs. But key policies need to be made at the federal level. See Nicholas Kristof, “12 Steps to Tackle the Coronavirus” in New York Times of what Trump should have said and done.]
 
For all Americans, it is essential that everyone take extra precautions and practice good hygiene.  Each of us has a role to play in defeating this virus.  Wash your hands, clean often-used surfaces, cover your face and mouth if you sneeze or cough, and most of all, if you are sick or not feeling well, stay home.
 
To ensure that working Americans impacted by the virus can stay home without fear of financial hardship, I will soon be taking emergency action, which is unprecedented, to provide financial relief.  This will be targeted for workers who are ill, quarantined, or caring for others due to coronavirus.
 
I will be asking Congress to take legislative action to extend this relief.
 
Because of the economic policies that we have put into place over the last three years, we have the greatest economy anywhere in the world, by far. 

  [To the extent the US has in fact has greatest economy in the world, it is largely because of his abuse of tariff wars, sanctions, ending aid to undermine other economies.]

Our banks and financial institutions are fully capitalized and incredibly strong. 

[Thanks Obama! And Dodd Frank.]

Our unemployment is at a historic low.  This vast economic prosperity gives us flexibility, reserves, and resources to handle any threat that comes our way.
 
[He neglects to mention the $1 trillion budget deficits he has run despite his ‘historic’ strong economy, low unemployment. The fact that 40% of all Americans don’t have $400 available to cover an emergency.]

This is not a financial crisis, this is just a temporary moment of time that we will overcome together as a nation and as a world.  

[The next morning, the Dow plummeted another 2000 points, more than 7%, down to 21,400 from a high of 29,000 just a couple of weeks earlier. Trump was reported to have leveled a tirade at Federal Reserve Chair Powell for failing to cut interest rates even further than the half-point “emergency” cut a week ago.]

However, to provide extra support for American workers, families, and businesses, tonight I am announcing the following additional actions:  I am instructing the Small Business Administration to exercise available authority to provide capital and liquidity to firms affected by the coronavirus. 
 
Effective immediately, the SBA will begin providing economic loans in affected states and territories. These low-interest loans will help small businesses overcome temporary economic disruptions caused by the virus.  To this end, I am asking Congress to increase funding for this program by an additional $50 billion. 
 
Using emergency authority, I will be instructing the Treasury Department to defer tax payments, without interest or penalties, for certain individuals and businesses negatively impacted.  This action will provide more than $200 billion of additional liquidity to the economy.

  [How are the individuals and businesses chosen? What will this do to the Treasury’s ability to pay bills? How does starving the federal government of resources help the situation]

Finally, I am calling on Congress to provide Americans with immediate payroll tax relief.  Hopefully they will consider this very strongly.

[Payroll tax only helps people who are earning wages, not the people who are laid off or lose their jobs. The amount of money is so miniscule, people don’t even realize. And how does starving Medicare and Social Security of funding help? Instead, should be requiring paid sick leave, unemployment benefits expanded to people with fewer hours and contract workers. See Nicholas Kristof.]
 
We are at a critical time in the fight against the virus.  We made a life-saving move with early action on China.  Now we must take the same action with Europe.  We will not delay.  I will never hesitate to take any necessary steps to protect the lives, health, and safety of the American people.  I will always put the wellbeing of America first.

[Yet another undeserved pat on the back, and misguided focus on putting up walls instead of gearing up for the spreading epidemic in the country. Some 100 million are projected to get the illness; more than 1 million expected to die. Millions will jam emergency rooms and ICUs. There are only 1 million hospital beds and 700,000 of these are already occupied. People will die of heart attacks and other ailments because they cannot be accommodated. Doctors and nurses and health care workers will get sick or become so overworked they can’t function. Who is available to replace? What is Trump doing about that? Is he setting up mobile clinics, like MASH units? Sending out mobile testing vehicles. Doing drive-by testing as in South Korea which is handling 20,000 tests a day?]  

If we are vigilant — and we can reduce the chance of infection, which we will — we will significantly impede the transmission of the virus.  The virus will not have a chance against us. 
 
No nation is more prepared or more resilient than the United States.  We have the best economy, the most advanced healthcare, and the most talented doctors, scientists, and researchers anywhere in the world.

[More jingoism, American Exceptionalism. America First. Balderdash. Basically his argument is, ‘We will defeat this epidemic because we are The Greatest.’ And by the way, YOU DIDN’T BUILD THAT! Obama and predecessors handed Trump a strong economy, rescued from the depths of the Great Recession. Obama created the Affordable Care Act which covered 30 million more people than before, controlled health care costs, enabled more people to become doctors, nurses, health care workers.]
 
We are all in this together.  We must put politics aside, stop the partisanship, and unify together as one nation and one family. 

 [Biggest joke-on-America ever, since Trump, who wears a MAGA hat on CDC tour, and tells Pence not to praise Washington Governor Jay Inslee (“a snake”, and accuses Democrats and Nancy Pelosi of perpetrating a hoax in raising alarm about coronavirus in order to undermine him. As for abandoning the partisanship, what he really means, as Moscow Mitch always means when he uses the term “compromise” is “Do what we say, don’t criticize or point out why we are inept, corrupt, and out only for ourselves.”]


[Trump assailed Democrats hours after he implored lawmakers to “stop the partisanship.” Then the markets cratered, unassuaged by his economic proposals, New York Times reported.]  

As history has proven time and time again, Americans always rise to the challenge and overcome adversity. 
 
Our future remains brighter than anyone can imagine.  Acting with compassion and love, we will heal the sick, care for those in need, help our fellow citizens, and emerge from this challenge stronger and more unified than ever before.

[Such pablum. Trump reads the teleprompter in a monotone, the sentences running one into another. He has no idea what he just said.]
 
God bless you, and God bless America.  Thank you.
 
                         END                 9:12 P.M. EDT

See also:

Cuomo Pleads with CDC to Allow Coronavirus Testing in Private Labs to Better Monitor, Contain Spread

Coronavirus Epidemic: Warren Outlines Decisive Plan to Keep American Families Healthy & Stabilize Economy

Sanders to Trump: Stop Playing Politics with our Health and National Security  

Democratic Race for 2020: Sanders Issues ‘Reproductive Health Care and Justice for All’ Plan

Senator Bernie Sanders has released his “Reproductive Health Care and Justice for All” plan. © Karen Rubin/news-photos-features.com © Karen Rubin/news-photos-features.com

The vigorous contest of Democrats seeking the 2020 presidential nomination has produced excellent policy proposals to address major issues. In what can be described as an love letter to Senator Elizabeth Warren’s supporters, Senator Bernie Sanders has released his “Reproductive Health Care and Justice for All” plan. But you decide how many of these provisions would ever be enacted. This is from the Sanders campaign:

WASHINGTON – Senator Bernie Sanders released a major tenet of his presidential platform: Reproductive Health Care and Justice for All. The latest policy plan builds on the Senator’s wide-ranging agenda for quality and affordable health care for all people. The plan centers on two primary prongs — ensuring universal and affordable access to reproductive health care, and a comprehensive action plan to address the crisis of maternal mortality in communities of color across the country. 

“There has been no time in the history of this country when women, especially Black women, have had the reproductive freedom and justice that they deserve. In my administration, that will finally change,” said Senator Bernie Sanders. “We must once and for all put an end to the unacceptable crisis of Black maternal mortality, and ensure every woman in this country — no matter where they’re from — has the basic right to quality healthcare.”

Sen. Sanders continued, “When I am in the White House, we will fight back against the Republican assault on abortion rights across this country and defend a woman’s fundamental right to control her own body. As President, there will be no doubt that in the United States of America, abortion is a constitutional right. Period.”

The Reproductive Health Care and Justice for All plan reflects the fact that issues of justice must be addressed holistically and intersectionally. The plan will be implemented in tandem with a comprehensive, progressive agenda to end racial disparities in our economic, criminal justice, environmental, education, and health care systems.  

The full and detailed plan can be found here. The following is a summary of key policies and action items as part of Reproductive Health Care and Justice for All.

As President, Bernie Sanders will:

Use executive authority to reverse President Trump’s anti-choice actions.  

Codify Roe v. Wade in legislative statute, require all judicial nominees to support Roe v. Wade as settled law, and require preclearance for state abortion laws to ensure that state laws do not impose undue restrictions and barriers for abortion services.  

Protect and expand funding for Planned Parenthood, and repeal the Hyde and Helms Amendments.  

Ban state Targeted Regulation of Abortion Providers (TRAP) laws that put undue and unnecessary burdens and regulations on doctors who provide abortion services with the goal of restricting access.  

Ensure anti-choice crisis pregnancy centers do not receive federal funds.  

Ensure that all communities have access to nearby abortion care.   

Make birth control available over-the-counter, in addition to free under Medicare for All.  

Ban ineffective abstinence-only sex education.  

Increase access to and funding for reproductive services and facilities in communities of color, eliminate “contraceptive deserts,” and increase funding to hospitals where Black mothers and parents receive care.  

Work with women of color-led community organizations to develop and coordinate policy.    

Educate health care providers and medical school students on providing culturally competent care.  

Ban discrimination by health care providers, and provide a right of action for patients discriminated against.  

Establish standard protocols to rapidly address postpartum hemorrhage, a leading cause of maternal mortality in Black women.  

Require hospitals that receive federal funding to hire culturally competent care liaisons to field complaints, and provide training to all labor and delivery staff, including nurses, doctors, and clerks.
 

Ensure there are sufficient OBGYN physicians, midwives, lactation consultants and doulas in medically underserved communities of color.   

Create and expand programs for Black maternal mortality liaisons, patient advocates, care coordinators, and social workers at hospitals serving at-risk women of color.  

Expand the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program for pregnant mothers, infants, and children.  

Democratic Race for 2020: Biden Issues Plan to End Opioid Crisis, Ensure Access to Treatment and Recovery

Vice President Joe Biden, running for the 2020 Democratic nomination for president, has released his plan for ending the opioid crisis and ensuring access to effective treatment and recovery for substance use disorders. © Karen Rubin/news-photos-features.com

The vigorous contest of Democrats seeking the 2020 presidential nomination has produced excellent policy proposals to address major issues. Vice President Joe Biden has released his plan for ending the opioid crisis and ensuring access to effective treatment and recovery for substance use disorders. This is from the Biden Campaign:

Millions of families are impacted by the opioid crisis. It’s ravaging communities coast to coast, from New Hampshire to California. The challenge of substance use disorders is not limited to opioids. Millions of individuals are affected by misuse of other substances such as alcohol or methamphetamine. Latest estimates indicate that, in 2018, almost 68,000 Americans died from a drug overdose – almost 47,000 of which involved an opioid. And, the impacts of this crisis reverberate in our classrooms and neighborhoods, in small towns and big cities.
 
Biden will tackle this crisis by making sure people have access to high quality health care – including substance use disorder treatment and mental health services. That’s what Obamacare did by designating substance use disorder treatment and mental health services as essential benefits that insurers must cover, and by expanding Medicaid, the nation’s largest payer for mental health services which also plays an increasingly growing role as a payer for substance use disorder services.
 
But President Trump wants to repeal Obamacare, including its Medicaid expansion. Repeal would be disastrous for communities and families combating the opioid crisis. It is not realistic to think that grant money will fill the hole that eliminating Obamacare and its Medicaid expansion would create.
 
Step one of Biden’s plan to tackle the opioid epidemic and substance use disorders is to defeat Trump and then protect and build on Obamacare. And, Biden will pursue a comprehensive, public health approach to deal with opioid and other substance use disorders. His plan will:

Hold accountable big pharmaceutical companies, executives, and others responsible for their role in triggering the opioid crisis.

Make effective prevention, treatment, and recovery services available to all, including through a $125 billion federal investment.

Stop overprescribing while improving access to effective and needed pain management.

Reform the criminal justice system so that no one is incarcerated for drug use alone.

Stem the flow of illicit drugs, like fentanyl and heroin, into the United States – especially from China and Mexico.


HOLD ACCOUNTABLE BIG PHARMA COMPANIES, EXECUTIVES, AND OTHERS RESPONSIBLE FOR THEIR ROLE IN TRIGGERING THE OPIOID CRISIS
 
Biden will demand accountability from pharmaceutical companies and others responsible for the opioid crisis, including manufacturers, distributors, and “pill mill operators.” Pharmaceutical executives should be held personally responsible, including criminally liable where appropriate. Specifically, Biden will:

Direct the U.S. Justice Department to make actions that spurred this crisis a top investigative and, where appropriate, civil and criminal enforcement priority. Biden will make sure the Department has all the necessary resources to complete this work. Building on the efforts of the Obama-Biden Administration, Biden will also ensure the Food and Drug Administration takes action when new information reveals harms from previously approved drugs (including the risk of diversion, or the use of drugs by an individual other than the one to whom the drug was prescribed), ensures compliance with risk mitigation strategies, and punishes drug companies for deceptive practices. And, he will appoint an Opioid Crisis Accountability Coordinator to coordinate efforts across federal agencies and support the enforcement efforts of state and local partners.

Direct the Drug Enforcement Administration (DEA) to step up its efforts to identify suspicious shipments and protect communities. Opioids distributors knowingly shipped millions of pills to towns with hundreds of residents, helping trigger the opioid epidemic. Biden will empower the DEA to stop drug shipments from pharmaceutical companies and their distributors that create risks of diversion and misuse. Biden will work with Congress to allow the DEA to act expeditiously when a pharmaceutical distributor fails to adequately monitor shipments that could pose an “imminent danger” to vulnerable communities and increase penalties for companies that fail to take action to stop suspicious shipments. In addition, Biden will direct the DEA to improve data collection on wholesalers and pharmacies, including prescribing patterns and suspicious order reports, and to disseminate its analysis to distributors to prevent problems before they become disasters.

Ban drug manufacturers from providing payments or incentives to physicians and other prescribers. Pharmaceutical companies work hard to persuade doctors and other medical personnel to prescribe their products. These companies essentially pay providers to prescribe opioids and other drugs by, for example, paying providers to speak at or attend conferences, or consult for their companies. By banning these practices, Biden will ensure that patients’ lives do not take a backseat to doctors’ bottom lines.

Terminating pharmaceutical corporations’ tax break for advertisement spending. Drug corporations spent an estimated $6 billion in 2016 alone on prescription drug advertisements to increase their sales, a more than four-fold increase from just $1.3 billion in 1997. The American Medical Association has even expressed “concerns among physicians about the negative impact of commercially driven promotions, and the role that marketing costs play in fueling escalating drug prices.” Currently, drug corporations may count spending on these ads as a deduction to reduce the amount of taxes they owe. But taxpayers should not have to foot the bill for these ads. As President, Biden will end this tax deduction for all prescription drug ads, as proposed by Senator Jeanne Shaheen.

 
MAKE EFFECTIVE PREVENTION, TREATMENT, AND RECOVERY SERVICES AVAILABLE TO ALL WHO NEED THEM
 
Biden has long recognized and led on efforts to make clear that substance use disorders are diseases, not a lifestyle choice, and that we need to change how we talk about and treat substance use disorders to align with this fact.
 
He knows that the most important step we can take to address substance use disorders is to ensure that Americans have access to affordable, high-quality health care, including treatment for mental illnesses and substance use disorder. That’s why Biden has plan to build on the Affordable Care Act and achieve universal coverage. In addition, Biden will redouble efforts to ensure insurance companies stop discriminating against people with behavioral health conditions and instead provide the coverage for treatment of mental illness and substance use disorders that patients and families need. Congress passed a bipartisan parity law 12 years ago requiring that this discrimination stop, but the enforcement of parity has been insufficient. As Vice President, Biden championed efforts to implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. As President, he will finish the job by appointing officials who will hold insurers accountable, enforcing our parity laws to the fullest extent. He will also direct federal agencies to issue guidance making clear how state officials and the public can file a complaint when their insurers – or Medicaid – are not living up to their parity obligations.
 
In addition, Biden will work to make sure that people experiencing substance use disorders have access to quality facilities and providers. As President, he will ensure that the new public option, Medicare, Medicaid, the Indian Health Service, the Military Health System, and the Veterans Health Administration accelerate integration of substance use disorder care into standard health care practice. Biden will double funding for community health centers and expand the supply of health care providers, for example by growing the National Health Service Corps. And, he will protect rural hospitals from payment cuts, give them the flexibility they need to remain open, and invest in telehealth so people in remote areas can still have access to mental health and substance use disorder specialists.

Finally, Biden will make sure federal funds are specifically targeted at improving access to treatment and recovery for opioid and other substance use disorders, and at preventing these disorders in the first place. As Vice President, Biden championed passage of the 21st Century Cures Act, which included $1 billion in funding for states to address the opioid epidemic. That was a down payment. To deal with the immense scope of the opioid and substance use disorder crisis, Biden will dramatically scale up the resources available, with an unprecedented investment of $125 billion over ten years. Funds will be used to:

Pursue comprehensive strategies to expand access to treatment, particularly in rural and urban communities with high rates of substance use disorders and a lack of access to substance use disorder treatment services. Biden will invest $75 billion in flexible grants to states and localities for prevention, treatment, and recovery efforts. State and local agencies will also be able to use funds to enhance data systems allowing them to better target resources to individuals and communities most in need of support. As a condition for receiving funding, grant recipients will have to provide long-term, comprehensive strategic plans that address the multifaceted nature of the substance use disorder crisis. Funds may be used to:

Invest in evidence-based, cost-effective prevention programs in schools and communities to reduce the development of substance use disorders.

Mitigate harms from opioid and other drug use, including overdoses. Local communities will be able to use the funds to implement evidence-based programs designed to stop the spread of diseases like hepatitis C and HIV, including syringe service programs, or to scale up innovative programs like the safe station initiative started in Manchester, New Hampshire, which allows those seeking help to go to fire stations in order to be connected to treatment and recovery services.

Expand access to ongoing treatment and recovery services. Communities will be able to use funds to increase access to substance use disorder and mental health treatment and other services to support long-term recovery, including peer support networks and recovery coaches, and better integrate primary care and behavioral health. Recognizing the strong evidence that social supports, including family support, may have a positive impact on the treatment of HIV, Biden will support the development of family-centered models for substance use disorder treatment and recovery.

Make Medication Assisted Treatment (MAT) available to all who need it, reaching universal access no later than 2025. MAT (also referred to as MOUD or Medications for Opioid Use Disorder) is regarded as the gold standard of care for individuals with opioid use disorder. Yet, less than 50% of substance use disorder facilities around the country offer even one of the FDA-approved medications. The 21st Century Cures Act, legislation Biden championed as Vice President, provided resources to states designed to expand access to MAT.  Biden will build on this in order to ensure universal access to MAT for all who need it, including by:

Providing $20 billion for grants to dramatically expand capacity to administer MAT across the country, especially in underserved areas, including establishing new facilities and developing training programs to increase the number of professionals able to administer MAT.

Stopping insurance companies from erecting barriers to coverage of MAT. For example, insurers have imposed “fail first” protocols which require prescribers to certify that other therapies were tried before covering MAT. Insurers also may require that physicians obtain “prior authorization” for MAT before prescribing it.   

Removing undue restrictions on prescribing medications for substance use disorder. For example, drugs containing buprenorphine were approved by the FDA in 2002 but a relatively small number of doctors or medical personnel are certified to prescribe them. Biden will ensure that any undue restrictions on prescribing are lifted and review methadone treatment regulations.

Help first responders and community health providers respond to overdoses. Biden will invest $10 billion to provide local communities with the tools needed to prevent overdoses and respond to emergencies emanating from this crisis. 

Ensure local communities have a sufficient supply of overdose prevention drugs. Naloxone (also known as Narcan) is a medication that can reverse an opioid overdose, making it a critical tool in the fight to save lives. Biden will expand grants to states for the purchase of Naloxone to be distributed to local community actors called upon to respond to overdoses, including first responders, public health providers, and the staff at homeless shelters and public libraries.

Demand that drug companies charge a fair price for overdose drugs, including Naloxone. The Biden Administration will aggressively negotiate a reduction in the drug’s price, on behalf of the federal government, and state and local communities.

Support first responders. Police officers and firefighters are often the first on the scene of an overdose. Biden will ensure they are equipped not just with naloxone, but also with the mental health and resilience support anyone would need after being exposed again and again to such trauma.

Invest in community-based prevention programs and a major public education effort to eliminate the stigma surrounding substance use disorder treatment. Biden will invest $5 billion in community-based prevention efforts and public education initiatives including training educators to recognize the signs of mental health problems and substance use disorders and refer them to appropriate services. Funds will also support evidence-based education programs for young people on mental health and substance use disorders.

Expand the pipeline of medical personnel to treat substance use disorders. Building on legislation like the Opioid Workforce Act of 2019, Biden will work with Congress to invest $5 billion to expand medical residencies and access to education and training for medical personnel in substance use disorder diagnosis and treatment. Funding will support training for primary care providers, as well as other members of the health care team, to build an integrated system of care.

Invest in research by doubling funding for the NIH HEAL (Helping to End Addiction Long-Term) Initiative. This $10 billion investment will support efforts to improve treatments for chronic pain.

Provide targeted interventions for particular populations. Biden will invest $10 billion in efforts specifically designed to support populations with unique situations or needs. Biden will ensure a portion of this funding for state and local governments is set aside for Tribal governments. In addition to expanding veterans’ access to substance use disorder and mental health treatment, Biden will direct his Secretary of Veterans Affairs to ensure VA medical personnel are sufficiently trained in safe prescribing practices and pain treatment. Biden will call upon the public health and criminal justice systems to provide evidence-based substance use disorder treatment, including MAT, for people during their incarceration and after their release. Finally, Biden will expand investments to help children suffering from Neonatal Abstinence Syndrome or Neonatal Opioid Withdrawal Syndrome, and to ensure their mothers have access to effective treatment and care.


STOP OVERPRESCRIBING WHILE IMPROVING ACCESS TO EFFECTIVE AND NEEDED PAIN MANAGEMENT
 
An essential part of our national strategy to address the opioid epidemic must be stopping pharmaceutical companies’ practices that lead to overprescribing. Yet at the same time, physicians still must effectively treat pain. Chronic pain is a growing public health challenge with wide-ranging impacts: keeping individuals out of the workforce, negatively affecting their mental and physical health, contributing to suicidal ideation, and otherwise limiting their quality of life. Biden believes we need to pursue two joint goals: eliminate overprescribing of prescription opioids for pain, and improve the effectiveness of and access to alternative treatment for pain. Biden will:

Support development of less addictive pain medications and alternative pain treatments, and improve standards of quality for treatment. We need pain medications that are less addictive and more effective. Biden will invest in NIH research to develop these new medications. By doubling funding for NIH’s HEAL program, Biden will accelerate research regarding alternative treatments and therapies and help providers and patients better understand the options and access alternatives. And, he will direct the FDA to give priority to new pain medications with a documented reduced risk of addiction. 

Expand coverage for alternative pain treatments. As documented in a recent study related to back pain, some non-pharmacological pain interventions (e.g., psychological counseling, acupuncture, physical therapy, or occupational therapy) are not consistently covered or have administrative barriers to coverage (e.g., pre-authorization, visit limits). In accordance with evidence-based medicine, Biden will call for a requirement that Medicare, Medicaid, his proposed new public option, and private insurance companies consistently and transparently cover alternatives to opioids for chronic pain, without barriers such as prior authorization or high levels of cost-sharing.

Crack down on misleading advertising regarding substance use disorder treatment facilities with no basis in evidence. Biden will ensure that the Federal Trade Commission and the FDA act when companies try to mislead. He will appoint leaders of both agencies who will make this a key priority.

Provide training to medical personnel in pain management and substance use disorder treatment. Building on the Obama-Biden Administration’s prior efforts, Biden will direct the U.S. Department of Health and Human Services to work with the medical community to support research and the development of curricula and training regarding pain management. He will ensure that the systematic study of pain management and substance use disorder is a mandatory part of the curricula and material on which doctors and other medical personnel are tested. Those seeking a federal DEA license to prescribe controlled substances will be required to receive training on proper prescribing guidelines and pain management.

Expand the effectiveness of monitoring programs designed to prevent inappropriate overprescribing of opioids. Prescription Drug Monitoring Programs (PDMPs) are electronic databases designed to prevent drug abuse. For example, a provider can check the database before prescribing in order to determine whether his or her patient has been getting the same prescription from multiple providers. In order to receive any of the $125 billion in new grants under the Biden Administration, states will have to institute a requirement that every prescriber checks the database every time they write a new opioid prescription. Biden will also set aside some of these grant dollars to ensure states improve Prescription Drug Monitoring Programs data-sharing across state lines.

Ensure regular updating of the Centers for Disease the Control and Prevention (CDC) prescriber guideline based on the best available evidence. The CDC has issued a guideline to help prescribers make evidence-based decisions regarding when and how to prescribe opioids in order to minimize the risk of abuse while also effectively treating pain. Biden will ask the CDC to commit to regularly updating these guidelines as new evidence emerges regarding opioid abuse risk factors and alternative pain treatments. And, he will partner with health care providers and states to maximize providers’ awareness and use of the guideline.

 
REFORM THE CRIMINAL JUSTICE SYSTEM SO THAT NO ONE IS INCARCERATED FOR DRUG USE ALONE
 
Biden has released a criminal justice plan that will strengthen America’s commitment to justice and reform our criminal justice system by building a system focused on redemption and rehabilitation. Biden believes that no one should be incarcerated for drug use alone, and as President he will treat drug use as a disease rather than a crime. Specifically, Biden will:

End all incarceration for drug use alone and instead divert individuals to drug courts and treatment. Biden will require federal courts to divert these individuals to drug courts so they receive appropriate treatment and services. He’ll incentivize states to put the same requirements in place. And, he’ll expand funding for federal, state, and local drug courts and other programs that divert individuals who commit crimes as a result of or in furtherance of substance use disorders to treatment rather than incarceration. 

Get people who should be supported with social services – instead of in our prisons  – connected to the help they need. Too often, those in need of mental health care or treatment for a substance use disorder do not get the care that they need. Instead, they end up having interactions with law enforcement that lead to incarceration. To change the nature of these interactions, the Biden Administration will fund initiatives to partner mental health and substance use disorder experts, social workers, and disability advocates with police departments. These service providers will respond to calls with police officers so individuals who should not be in the criminal justice system are diverted to treatment for substance use disorder or mental illness, when appropriate, or are provided with the housing or other social services they may need.

Read more about Biden’s plan to reform the criminal justice system at https://joebiden.com/justice/.
 
STEM THE FLOW OF ILLICIT DRUGS LIKE FENTANYL, ESPECIALLY FROM CHINA AND MEXICO
 
As part of a comprehensive agenda that prioritizes prevention, treatment, recovery, and harm reduction, Biden believes that part of the solution to the opioid crisis involves preventing bad actors from smuggling opioids and other illicit drugs into our country. Specifically, Biden will:

Make fentanyl a top priority in our dealings with China. The Treasury Department has already sanctioned a small number of Chinese nationals in connection with fentanyl – it’s a good start, but going after individuals will not alter Beijing’s thinking long-term. Biden will pressure Beijing to crack down on illicit fentanyl production in China and stem the flow of the drug into the United States. Biden will also develop regional strategies in the Asia-Pacific and the Americas to deal with shifts in the routes and sources of fentanyl in response to a Chinese crackdown.

Enhance cooperation with Mexican authorities to disrupt the movement of heroin and fentanyl across the U.S.-Mexico border.  Chinese fentanyl is frequently transshipped through Mexico, and then smuggled across the border in pure form or combined with heroin. As China takes steps to police fentanyl and its precursors, production and distribution will increasingly shift to Mexico. Biden will pursue strong, sustained cooperation with Mexican authorities to disrupt suppliers and supply routes, including the importation of precursor chemicals from China. The Biden Administration will also provide technical assistance to enhance the Mexican Post Service’s (SEPOMEX) ability to detect and electronically track shipments of fentanyl and precursors that come through Mexico. As President, Biden will repair the damage to U.S.-Mexico ties inflicted by Donald Trump and develop a common agenda with Mexico that looks beyond our shared border to promote our shared prosperity and protect U.S. national security interests.

Enforce sanctions on international actors engaged in the trafficking of illicit drugs like heroin and fentanyl. Biden’s Treasury Department sanctions team will map the financial institutions and networks that facilitate the distribution of fentanyl and key precursors and develop sanctions packages based on that evidence and task the Office of the Director of National Intelligence to support these efforts with a focus on illicit finance.

Increase cooperation among global law enforcement agencies. Biden will direct U.S. law enforcement agencies to work closely with foreign counterparts, share threat information, and use technology to assist in tracking and seizing illicit shipments.

Ensure federal agencies have the tools and resources they need to stop the flow of fentanyl from abroad. Fentanyl producers have exploited gaps in monitoring through the U.S. Postal Service (USPS) to flood the U.S. with the deadly product. Biden will give the USPS the tools and resources it needs to carry out that mandate and disrupt the large supplies of fentanyl that are sent through the mail system, working with U.S. Customs and Border Protection. In addition, the vast majority of opioids and fentanyl are shipped through legal ports of entry—not in between them. Rather than waste resources building a wall or tearing families apart, Biden will direct resources to the ports of entry to interdict opioid shipments there.

Combating the Opioid Epidemic and Substance Use Disorders, Paid for By Making Sure Pharma Pays Its Fair Share
 
Biden’s $125 billion investment in a comprehensive response to the opioid epidemic and substance use disorders is paid for by raising taxes on the profits of pharmaceutical corporations.

Democratic Candidates for 2020: Warren Releases Plan to Reduce Health Care Costs and Transition to Medicare for All

Senator Elizabeth Warren provided more detail about how she would introduce universal health care, reduce health care costs and transition to Medicare for All © Karen Rubin/news-photos-features.com

The vigorous contest of Democrats seeking the 2020 presidential nomination has produced excellent policy proposals to address major issues. Clearly responding to the backlash against her radical plan to finance Medicare for All, Senator Elizabeth Warren released details of how she would reduce health care costs in America, eliminate profiteering from the health care system, and complete a full transition to Medicare for All in her first term. Warren has already released her plan to fully finance Medicare for All when it’s up and running without raising taxes on the middle class by one penny.

 “Medicare for All is the best way to guarantee health care to all Americans at the lowest cost. I have a plan to pay for it without raising taxes on middle class families, and the transition I’ve outlined here will get us there within my first term as president. Together, along with additional reforms like my plans to reduce black maternal mortality rates, ensure rural health care, protect reproductive rights, support the Indian Health Service, take care of our veterans, and secure LGBTQ+ equality, we will ensure that no family will ever go broke again from a medical diagnosis – and that every American gets the excellent health care they deserve. “

This is from the Warren campaign:

On Day One, Elizabeth will use her executive authority to:

Reverse Donald Trump’s sabotage of Obamacare 

Improve the Affordable Care Act, Medicare, and Medicaid.

Protect people with pre-existing conditions

Drastically lower pharmaceutical costs for millions of families for drugs including Insulin, EpiPens, and drugs that save people from opioid overdoses.

The first bill Elizabeth will pass is her comprehensive set of anti-corruption reforms which include ending lobbying as we know it and knocking back the influence of Big Pharma and insurance companies. 

And in her first 100 days, Elizabeth will use a fast-track legislative process called budget reconciliation to create a true Medicare for All option that will: 

Include all the health care benefits of Medicare for All described in the Medicare for All Act.

Be immediately free for nearly half of all Americans, including: 

Children under the age of 18

Families making at or below 200% of the federal poverty level (about $51,000 for a family of four)

Give every American over the age of 50 the choice to enter a substantially improved Medicare program.

Consumer costs will automatically decline, so eventually coverage under this plan will be free to everyone

Throughout her first term, she will fight for additional health system reforms to save money and save lives–including a boost of $100 billion in guaranteed, mandatory spending for new NIH research.  

And no later than her third year in office, she will pass legislation to complete the transition to Medicare for All: guaranteed comprehensive health care for every American, long-term care, vision, dental, and hearing, with a single payer to reduce costs and produce better health outcomes. 

Elizabeth’s plan can deliver an $11 trillion boost to families who will never pay another premium, deductible, or co-pay. 

And her plan will protect unions and make sure that there’s support for workers affected by these changes.

Read more about her plan here and below: 

My First Term Plan for Reducing Health Care Costs in America and Transitioning to Medicare for All

I spent my career studying why families went broke. I rang the alarm bells as the costs for necessities skyrocketed while wages remained basically flat. And instead of helping, our government has become more tilted in favor of the wealthy and the well-connected. 

The squeeze on America’s families started long before the election of Donald Trump, and I’m not running for president just to beat him. I’m running for president to fix what’s broken in our economy and our democracy. I have serious plans to raise wages for Americans. And I have serious plans to reduce costs that are crushing our families, costs like child careeducationhousing – and health care

The Affordable Care Act made massive strides in expanding access to health insurance coverage, and we must defend Medicaid and the Affordable Care Act against Republican attempts to rip health coverage away from people. But it’s time for the next step.

The need is clear. Last year, 37 million American adults didn’t fill a prescription because of costs. 36 million people skipped a recommended test, treatment, or follow-up because of costs. 40 million people didn’t go to a doctor to check out a health problem because of costs. 57 million people had trouble covering their medical bills. An average family of four with employer-sponsored insurance spent $12,378 on employee premium contributions and out-of-pocket costs in 2018. And 87 million Americans are either uninsured or underinsured.

Meanwhile, America spends about twice as much per person on health care than the average among our peer countries while delivering worse health outcomes than many of them. America is home to the best health care providers in the world, and yet tens of millions of people can’t get care because of cost, forcing families into impossible decisions. Whether to sell the house or skip a round of chemo. Whether to cut up pills to save money or buy groceries for the week. The way we pay for health care in the United States is broken – and America’s families bear the burden. 

We can fix this system. Medicare for All is the best way to cover every person in America at the lowest possible cost because it eliminates profiteering from our health care and leverages the power of the federal government to rein in spending. Medicare for All will finally ensure that Americans have access to all of the coverage they need – not just what for-profit insurance companies are willing to cover – including vision, dental, coverage for mental health and addiction services, physical therapy, and long-term care for themselves and their loved ones. Medicare for All will mean that health care is once again between patients and the doctors and nurses they trust–without an insurance company in the middle to say “no” to access to the care they need. I have put out a plan to fully finance Medicare for All when it’s up and running without raising taxes on the middle class by one penny.

But how do we get there? 

Every serious proposal for Medicare for All contemplates a significant transition period. Today, I’m announcing my plan to expand public health care coverage, reduce costs, and improve the quality of care for every family in America. My plan will be completed in my first term. It includes dramatic actions to lower drug prices, a Medicare for All option available to everyone that is more generous than any plan proposed by any other presidential candidate, critical health system reforms to save money and save lives, and a full transition to Medicare for All.  

Here’s what I’ll do in my first 100 days:

I’ll pursue comprehensive anti-corruption reforms to rein in health insurers and drug companies – reforms that are essential to make any meaningful health care changes in Washington.

I’ll use the tools of the presidency to start improving coverage and lowering costs – immediately. I’ll reverse Donald Trump’s sabotage of health care, protect individuals with pre-existing conditions, take on the big pharmaceutical companies to lower costs of key drugs for millions of Americans, and improve the Affordable Care Act, Medicare, and Medicaid. 

I will fight to pass fast-track budget reconciliation legislation to create a true Medicare for All option that’s free for tens of millions. I won’t hand Mitch McConnell a veto over my health care agenda. Instead, I’ll give every American over the age of 50 the choice to enter an improved Medicare program, and I’ll give every person in America the choice to get coverage through a true Medicare for All option. Coverage under the new Medicare for All option will be immediately free for children under the age of 18 and for families making at or below 200% of the federal poverty level (about $51,000 for a family of four). For all others, the cost will be modest, and eventually, coverage under this plan will be free for everyone.

By the end of my first 100 days, we will have opened the door for tens of millions of Americans to get high-quality Medicare for All coverage at little or no cost. But I won’t stop there. Throughout my term, I’ll fight for additional health system reforms to save money and save lives – including a boost of $100 billion in guaranteed, mandatory spending for new NIH research over the next ten years to radically improve basic medical science and the development of new medical miracles for patients.

And finally, no later than my third year in office, I will fight to pass legislation that would complete the transition to full Medicare for All. By this point, the American people will have experienced the full benefits of a true Medicare for All option, and they can see for themselves how that experience stacks up against high-priced care that requires them to fight tooth-and-nail against their insurance company. Per the terms of the Medicare for All Act, supplemental private insurance that doesn’t duplicate the benefits of Medicare for All would still be available. But by avoiding duplicative insurance and integrating every American into the new program, the American people would save trillions of dollars on health costs.

I will pursue each of these efforts in consultation with key stakeholders, including patients, health care professionals, unions, individuals with private insurance, hospitals, seniors currently on Medicare, individuals with disabilities and other patients who use Medicaid, Tribal Nations, and private insurance employees. 

And at each step of my plan, millions more Americans will pay less for health care. Millions more Americans will see the quality of their current health coverage improve. And millions more Americans will have the choice to ditch their private insurance and enter a high-quality public plan. And, at each step, the changes in our health care system will be fully paid for without raising taxes one penny on middle class families.

Every step in the coming fight to improve American health care – like every other fight to improve American health care – will be opposed by those powerful industries who profit from our broken system.  

But I’ll fight my heart out at each step of this process, for one simple reason: I spent a lifetime learning about families going broke from the high cost of health care. I’ve seen up close and personal how the impact of a medical diagnosis can be devastating and how the resulting medical bills can turn people’s lives upside down. When I’m President of the United States, I’m going to do everything in my power to make sure that never happens to another person again.

The First 100 Days of a Warren Administration

Donald Trump has spent nearly every day of his administration trying to rip health coverage away from tens of millions of Americans – first by legislation, then by regulation, and now by lawsuit. When I take office, I will immediately work to reverse the damage he has done. 

But I’ll do much more than that. 

In my first 100 days, I will pick up every tool Donald Trump has used to undermine Americans’ health care and do the opposite. While Republicans tried to use fast-track budget reconciliation legislation to rip away health insurance from millions of people with just 50 votes in the Senate, I’ll use that tool in reverse – to improve our existing public insurance programs, including by giving everyone 50 and older the option to join the current Medicare program, and to create a true Medicare for All option that’s free for millions and available to everyone.   

But first, we must act to rein in Washington corruption. 

Anti-Corruption Reforms to Rein in Health Industry Influence.

In Washington, money talks – and nowhere is that more obvious than when it comes to health care. The health care industry spent $4.7 billion lobbying over the last decade. And health insurance and pharmaceutical executives have been active in fundraising and donating to candidates in the 2020 Democratic primary campaign as well. 

Today, the principal lobbying groups for the drug companies, health insurers, and hospitals have teamed up with dozens of other health industry groups to create the Partnership for America’s Health Care Future – a front group whose members spent a combined $143 million on lobbying in 2018 and aims to torpedo Medicare for All in this election. The Partnership has made clear that “whether it’s called Medicare for All, Medicare buy-in, or the public option, one-size-fits-all health care will never allow us to achieve [our] goals.” 

Let’s not kid ourselves: every Democratic plan for expanding public health care coverage is a challenge to these industries’ bottom lines – and every one of these plans is already being drowned in money to make sure it never happens. Any candidate who believes more modest reforms will avoid the wrath of industry is not paying attention. 

If the next president has any intention of winning any health care fight, they must start by reforming Washington. That’s why I’ve released the biggest set of anti-corruption reforms since Watergate – and why enacting these reforms is my top priority as president. Here are some of the ways my plan would rein in the health care industry:

Close the revolving door. My plan will close the revolving door between health care lobbyists and government, and end the practice of large pharmaceutical companies like Novartis, United Health, Roche, Pfizer, and Merck vacuuming up senior government officials to try and monopolize government expertise, relationships, and influence during a fight for health care reform.

Tax excessive lobbying. My plan will also implement an excessive lobbying tax on companies that spend more than $500,000 per year peddling influence – like Pfizer, Amgen, Eli Lilly, Novartis, and Johnson & Johnson. Money from the tax would be used to strengthen congressional support agencies, establish an office to help the public participate in the rule-making process, and give our government additional resources to fight back against an avalanche of corporate lobbying spending.

End lobbyist bribery. My campaign finance plan will ban all lobbyists – including health insurance and pharma lobbyists – from trying to buy off politicians by donating or fundraising for their campaigns. This will shut down the flow of millions of dollars in contributions.

Limit corporate spending to influence elections. My plan bans all election-related spending from big corporations with a significant portion of ownership from foreign entities. That would block major industry players like UnitedHealthAnthemHumanaCVS HealthPfizer, AmgenAbbVieEli LillyGilead, and Novartis – along with any trade associations that receive money from them – from spending to influence elections. 

Crowd out corporate contributions with small dollar donations. I support a constitutional amendment to get big money out of politics. But until we enact it, my plan would institute a public financing program that matches every dollar from small donations with six more dollars so that congressional candidates are answering to the people who need health care and affordable prescription drugs, rather than health insurance and pharmaceutical companies.

Passing these reforms will not be easy. But we should enact as much of this agenda as possible, as quickly as possible. I will also use my executive authority to begin implementing them wherever possible – including through prioritizing DOJ and FEC enforcement against the corrupt influence-peddling game. And I will voluntarily hold my administration to the standards that I set in my anti-corruption plan so that all our federal agencies, including those involved in health care, serve only the interests of the people. 

Money slithers through Washington like a snake. Any candidate that cannot or will not identify this problem, call it out, and pledge to make fixing it a top priority will not succeed in delivering any public expansion of health care coverage – or any other major priority. 

Immediate Executive Actions to Reduce Costs and Expand Public Health Coverage.

There are a number of immediate steps a president can take entirely by herself to lower drug prices, reduce costs, and improve Medicare, Medicaid, and ACA access and affordability. I intend to take these steps within my first 100 days. 

Dramatically Lower Key Drug Prices

As drug companies benefit from taxpayer-funded R&D and rake in billions of dollars in profits, Americans are stuck footing the bill. The average American spends roughly $1,220 per year on pharmaceuticals – more than any comparable country. As president, I will act immediately to lower the cost of prescription drugs, using every available tool to bring pressure on the big drug companies. I’ll start by taking immediate advantage of existing legal authorities to lower the cost of several specific drugs that tens of millions of Americans rely on. 

Some drug prices are high because pharmaceutical companies jack up prices on single-source brand-name drugs, taking advantage of government-granted patents and exclusivity periods to generate eye-popping profits. Pharma giant Gilead, for example, launched its Hepatitis C treatment Harvoni at $94,500-per-twelve week treatment – leaving as many as 85 percent of more than 3 million Americans with Hepatitis C struggling to afford life-saving treatments. 

The government has two existing tools to combat price-gouging by brand-name drug companies, in addition to tough antitrust enforcement against companies that abuse our patent system and use every trick in the book to avoid competition. First, the government can bypass patents (while providing “reasonable and entire compensation” to patent holders) using “compulsory licensing authority.” The Defense Department has used this authority as recently as 2014. Second, under the march-in provisions of the Bayh-Dole Act, the government can require re-licensing of certain patents developed with government involvement when the contractor was not alleviating health or safety needs. Just in this decade, federal research investments have contributed to the development of hundreds of drugs – all of which could be subject to this authority.

But new drugs aren’t the only unaffordable drugs on the market. Even older, off-patent drugs can be expensive and inaccessible. Lack of generic competition allows bad actors like Martin Shkreli to boost the prices of decades-old drugs. Some of the biggest generic drug companies in the country are now being sued by forty-four states for price-fixing to keep profits high. Limited competition and other market failures can also lead to drug shortages. Fortunately, the government can also act to fix our broken generic drug market by stepping in to publicly manufacture generic drugs, stopping price gouging in its tracks and bringing down costs.. 

On the first day of my presidency, I will use these tools to drastically lower drug costs for essential medications – drugs with high costs or limited supply that address critical public health needs. And during my administration, we will use these tools to make other drugs affordable as well.

Insulin was discovered nearly 100 years ago as a treatment for diabetes – but today the drug is still unaffordable for too many Americans. Eli Lilly’s brand-name insulin prices increased over 1,200% since the 1990s. Insulin costs are too high because three drug companies – Novo Nordisk, Sanofi, and Eli Lilly – dominate the market, jacking up prices. Americans with diabetes are rationing insulin, and taxpayers are spending billions on it through Medicare and Medicaid. It’s obscene. No American should die because they can’t afford a century-old drug that can be profitably developed for $72 a year. I will use existing authorities to contract for manufacture of affordable insulin for all Americans. 

EpiPens deliver life-saving doses of epinephrine, a drug that reverses severe allergic reactions to things like peanuts and bee stings. Though epinephrine has been around for over a century, the pens that deliver it are protected by a patent that limits competition. In 2016, this lack of competition allowed Mylan, EpiPen’s manufacturer, to jack up EpiPen prices by 400%, leaving families unable to afford this life-saving medication. Though cheaper versions have recently entered the market, prices remain out of reach for many American families. As president, I will use existing authorities to produce affordable epinephrine injectors for Americans (and especially children) who need it.

Naloxone can reverse the effects of an opioid overdose. In 2017, more than 70,000 people died from a drug overdose in the United States, with the majority due to opioids. The opioid epidemic cost Americans nearly $200 billion in 2018, including more than $60 billion in health care costs. Health officials agree that naloxone is “critical” to curb the epidemic – but easy-to-use naloxone products like ADAPT Pharma’s Narcan nasal spray and Kaléo’s Evzio auto-injector are outageously expensive, and the approval of a generic naloxone nasal spray is tied up in litigation. Kaléo spiked the price of Evzio by over 550% to “capitalize on the opportunity” of the opioid crisis, costing taxpayers more than $142 million over four years. It doesn’t have to be this way: in 2016, it cost Kaléo just 4% of what it charged to actually make Evzio, and naloxone can be as cheap as five cents a dose. Both products benefited from government support or funds in the development of naloxone. My administration will use its compulsory licensing authority to facilitate production of low-cost naloxone products so first responders and community members can save lives.

Humira is a drug with anti-inflammatory effects used to treat diseases like arthritispsoriasis, and Crohn’s disease. It is the best-selling prescription drug in the world, treating millions. AbbVie, Humira’s manufacturer, has doubled the price of Humira to more than $38,000 a year. In 2017, Medicaid and Medicare spent over $4.2 billion on it – while AbbVie, its manufacturer, developed a “patent thicket” to shield itself from biosimilar competition. In May 2019, the company entered into a legal settlement preventing a competitor from entering the U.S. market until 2023 – probably because prices went down by up to 80% once biosimilars entered in Europe. My administration will pursue antitrust action against AbbVie and other drug companies that pursue blatantly anti-competitive behavior, and, if necessary, use compulsory licensing authority to facilitate production, saving taxpayers billions. 

Hepatitis C drugs like Harvoni are part of a class described as “miracle” drugs. Harvoni’s price tag – $94,500-per-treatment – left 85% of the more than 3 million Americans living with Hepatitis C without a lifesaving medication, while taxpayers foot a $3.8 billion bill. Although the price has come down in recent years, it is still expensive for too many. One estimate suggests that by using compulsory licensing, the federal government could treat all Americans with Hepatitis C for $4.5 billion – just 2% of the $234 billion it would otherwise cost. That is exactly what I will do.

Truvada is a drug that – until recently – was the only FDA-approved form of pre-exposure prophylaxis, which can reduce the risk of HIV from sexual activity by up to 99%. Truvada’s manufacturer, Gilead, relied on $50 million in federal grants to develop it, but today they rake in multi-billion dollar profits while Americans struggle to afford it. The CDC estimates a million Americans could benefit from Truvada, though only a fraction do today – largely due to to its $2,000-a-month price tag, which is nearly thirty times what it costs in other countries. My administration will facilitate the production of an affordable version – reducing HIV infections and saving taxpayers billions of dollars each year.  

Antibiotics provide critical protection from bacterial and fungal infections, and we are in desperate need of new antibiotics to combat resistant infections. Every year, nearly three million Americans contract antibiotic-resistant infections – and more than 35,000 people die. But antibiotics don’t generate much money, discouraging pharmaceutical investment, causing shortages, and contributing to price hikes. Earlier this year, one biotech firm filed for bankruptcy after marketing a new antibiotic, Zemdri, for less than a year. My administration will identify antibiotics with high prices or limited supply and help produce them to combat resistance and provide patients with the treatments they need.

Drug shortages leave doctors and patients scrambling to access the treatments they need, forcing many to ration medications and use inferior substitutes. Our nation’s hospitals, for example, are currently experiencing a shortage of vincristine – an off-patent drug that is the “backbone” of childhood cancer treatment. The vincristine shortage began when Teva, one of its two suppliers, made the “business decision” to stop manufacturing the drug. When I am president, the government will track drugs in consistent shortage, like vincristine, and I will use our administrative authority to ensure we have sufficient production.

Finally, I will also direct the government to study whether other essential medicines, including breakthrough drugs for cancer or high-cost drugs for rare diseases, might also be subject to these interventions because they are being sold at prices that inappropriately limit patient access.  

Make Mental Health and Substance Use Treatment A Reality 

The law currently requires health insurers to provide mental health and substance use disorder benefits in parity with physical health benefits. But in 2018, less than half of people with mental illness received treatment and less than a fifth of people who needed substance use treatment actually received it. As president, I will launch a full-scale effort to enforce these requirements – with coordinated actions by the IRS, Centers for Medicare and Medicaid Services, and Department of Labor to make sure health plans actually provide mental health treatment in the same way they provide other treatment. 

Reverse Trump’s Sabotage 

I will reverse the Trump administration’s actions that have undermined health care in America. Key steps include:

Protecting coverage for people with pre-existing conditions. The Trump administration has abandoned its duty to defend current laws in court, cheering on efforts to destroy protections for pre-existing conditions, insurance coverage for dependents until they’re 26, and the other critical Affordable Care Act benefits. In a Warren administration, the Department of Justice will defend this law. And we will close the loopholes created by the Trump administration, using 1332 waivers, that could allow states to steer healthy people toward parallel, unregulated markets for junk health plans. This will shut down a stealth attack on people with pre-existing conditions who would see their premiums substantially increase as healthier people leave the marketplace.   

Banning junk health plans. The Trump administration has expanded the use of junk health insurance plans as an alternative to comprehensive health plans that meet the standards of the ACA. These plans cover few benefits, discriminate against people with pre-existing conditions, and increase costs for everyone else. And in some cases they direct as much as 50 percent of patient premiums to administrative expenses or profit. I will ban junk plans.

Expanding ACA enrollment. I’ll re-fund the Affordable Care Act programs that help people enroll in ACA coverage, programs that have been gutted by the Trump administration.

Expanding premium tax credits. I will reverse the Trump administration rule that artificially reduced premium tax credits for many people, making coverage less affordable – and instead will expand these credits.

Rolling back Trump’s sabotage of Medicaid. I’ll reverse the Trump administration’s harmful Medicaid policies that take coverage away from low-income individuals and families. I’ll prohibit restrictive and ineffective policies like work requirements – which have already booted 18,000 people in Arkansas out of the program – as well as enrollment caps, premiums, drug testing, and limits on retroactive eligibility that can prevent bankruptcy.

Restoring non-discrimination protections in health care. I will immediately reverse the Trump administration’s terrible proposed rule permitting health plans and health providers to discriminate against women, LGBTQ+ people, individuals with limited English proficiency, and others.

Ending the Trump administration’s assault on reproductive care. I’ll roll back the Trump administration’s domestic and global gag rules, which deny Title X and USAID funding to health care providers who provide abortion care or even explain where and how patients can access safe, legal abortions. And I will overturn the Trump administration’s embattled proposed rule to roll back mandatory contraceptive coverage. 

Strengthen the Affordable Care Act 

As president I will use administrative tools to strengthen the ACA to reduce costs for families and expand eligibility. Key steps include:

Stop families from being kicked out of affordable coverage. Because of something called the “family glitch,” an entire family can lose access to tax credits that would help them buy health coverage if one parent is offered individual coverage with a premium less than 9.86% of their family income. I’ll work to make sure that a family’s access to tax credits is based on the affordability of coverage for the whole family – not just one individual – so families who don’t actually have access to affordable alternatives don’t lose their ACA tax credits.

Expand eligibility to all legally present individuals. I’ll also work to extend eligibility for ACA tax credits to all people who are legally present, including those eligible for the Deferred Action for Childhood Arrivals program.

Put money back in workers’ pockets. The Affordable Care Act requires insurance companies to spend at least 80 percent of total premium contributions on health care claims (and, in many cases, at least 85 percent), leaving the rest to be spent on plan administration, marketing, and profit. Insurers who waste money must issue rebates – but too often, these are returned to employers who don’t pass on the savings to their employees. Insurance companies are expected to pay out $1.3 billion in rebates in 2019, with employers in the small-group market receiving an average rebate of $1,190 and employers in the large-group market receiving an average rebate of $10,660. My plan will require employers to pass along the full value of the rebate directly to employees. 

Strengthen Medicare 

As president I will use administrative tools to strengthen Medicare:

Expand Dental Benefits. The Medicare statute prohibits coverage of dental care that is unrelated to other medical care, unless it is medically necessary. This has been interpreted to largely exclude any oral health care. As a result, almost two-thirds of Medicare beneficiaries, or nearly 37 million people, lack access to dental benefits. I will use my administrative authority to clearly expand the medically necessary dental services Medicare can provide, improving the health of millions of Medicare beneficiaries.

Stop private Medicare Advantage plans from bilking taxpayers. Roughly one-third of Medicare beneficiaries get coverage through a private Medicare Advantage plan. Medicare payments to these plans for each enrollee are supposed to reflect the cost of covering that person through traditional Medicare, but overwhelming evidence shows that these private plans make their enrollees appear sicker on paper than they actually are to earn inflated payments at the expense of taxpayers. Some suggest that this adds $100 billion or more to Medicare spending over ten years. My administration will put an end to this fraud.

Strengthen Medicaid 

As president I will use administrative tools to strengthen Medicaid and potentially allow millions more to access the program.

Use waiver authority to increase Medicaid eligibility. With the approval of the federal government, states can use Section 1115 demonstration waivers to expand coverage to people who aren’t otherwise eligible for Medicaid. Currently, however, states can only obtain these waivers if projected federal spending under the new program will not be higher than without the waiver. While I pursue legislative reforms to expand coverage, I’ll also change this administrative restriction to allow these demonstrations to fulfill their promise of providing affordable health coverage, including working with states that want to expand Medicaid to uninsured individuals and families above the statutory upper limit of Medicaid (138% of the poverty level). Any state that chooses to expand in this way will not be penalized for doing so when full Medicare for All comes online.

Streamlining eligibility and enrollment. Far too many people miss out on Medicaid coverage because of red tape. Some states take coverage away if someone misses just one piece of mail or forgets to notify the state within 10 days of a change in income. These kinds of harsh policies help explain why more than a million children “disappeared” from the Medicaid and CHIP programs in the past year. I will eliminate these kinds of unfair practices, and instead work with states to make it easier for everyone – families, children, and people with disabilities – to maintain this essential coverage.

Ensuring access to care for beneficiaries in managed care plans. I’ll roll back the Trump administration’s proposed changes to rules regulating Medicaid managed care plans, which would dilute important standards, such as requiring health plans to maintain adequate provider networks guaranteeing access to care for Medicaid enrollees. 

Antitrust Enforcement for Hospitals and Health Systems 

For years, both horizontal mergers (where hospitals purchase other hospitals) and vertical mergers (where hospitals acquire physician practices) have produced greater hospital and health system consolidation, contributing to the skyrocketing costs of health care. Today, “not a single highly competitive hospital market remains in any region of the United States.” Study after study shows that mergers mean higher prices, lower quality, and increased inequality due to the growing wage gap between hospital CEOs and everyone else. Bringing down the cost of health care means enforcing competition in these markets. 

As president, I will appoint aggressive antitrust enforcers who recognize the problems with hospital and health system consolidation to the Department of Justice and Federal Trade Commission. My administration will also conduct retrospective reviews of significant new mergers, and break up mergers that should never have taken place. 

Bringing Health Records into the 21st Century 

Congress spent $36 billion to get every doctor in America using electronic health records, but we still do not have adequate digital information flow in health care – in part because two big companies make up about 85% of the market for medical records at big hospitals. As they attempt to capture more of the market, these companies are making it harder for systems to communicate with each other. My administration will ramp up the enforcement against information blocking by big hospital systems and health IT companies, and I will appoint leaders to the FTC and DOJ who will conduct a rigorous antitrust investigation of the health records market, especially in the hospital space.

Elevating the Voices of Workers in the Transition to Medicare for All

The fundamental goal of my presidency will be returning power to working people. Medicare for All accomplishes that by giving every American high-quality coverage and freeing them from relying on the whims of their employers or private insurance companies for the health care they need. My plan to transition to Medicare for All will also put working people first, and elevate their voices at each stage of the process. 

My plan seeks to build on the achievements of generations of working people and their unions who have fought for and won health care. I view good health plans negotiated through collective bargaining as a positive achievement for working people, and I will seek as part of the first phase of my plan the elimination of the excise tax on those plans.

In my first weeks in office, I will issue an Executive Order creating a commission of workers (including health care workers), union representatives, and union benefit managers that I will consult at every stage of the transition process. The commission will be responsible for providing advice on each element of the transition to Medicare for All, including, at a minimum:

Ensuring workforce readiness and adequate access to care across all provider types.

Determining national standards of coverage and benefits, including long-term care.

Learning from successful existing non-profit health care administrators and integrating them into the new Medicare for All system.

Ensuring a living wage for all health care workers and that savings generated within the new system by hospitals and other health care employers are shared fairly with all of the workers in the health care system.

Ensuring that workers are able to use the collective bargaining process during the transition period and under the new Medicare for All system to ensure both effective health outcomes and to ensure that savings generated by the new system are fairly shared with workers.

In administering the Medicare for All system, my administration will also rely on unions’ expertise on designing good benefits for workers and helping workers navigate our health care system. During the transition to Medicare for All – and even when we ultimately reach a full Medicare for All system – my administration will seek to partner with collectively bargained non-profit health care administrators. For example, we will draw upon their expertise in helping workers choose providers, and look for opportunities to enter into contracts with the administrators of unions’ collectively bargained health plans to provide these services. And my plan will guarantee that union-sponsored clinics are included within the Medicare for All system and will continue serving their members. 

Finally, Medicare for All will be an enormous boost to the economy, lifting a weight off of both workers and businesses and creating good new jobs, including in administering health care benefits. Still, the Medicare for All legislation includes billions of dollars to provide assistance to workers who may be affected by the transition to Medicare for All, and I plan on consulting with the new worker commission and other affected parties to ensure that money is spent as effectively as possible. In the past, transition assistance programs have been underfunded and have not been as responsive as they should have been to the actual needs of workers. That will not be the case in my administration. No worker will be left behind.

Legislation to Expand Medicare and Create a True Medicare for All Option 

In 2017, Senate Republicans came within one vote of shredding the Affordable Care Act and taking health care coverage away from more than 20 million people. How did they get so close? By using a fast-track legislative process called budget reconciliation, which only requires 50 votes in the Senate to pass laws with major budgetary impacts. President Obama also used this process to secure final passage of the Affordable Care Act. 

I am a strong supporter of eliminating the filibuster, which I believe is essential to preventing right-wing Senators who function as wholly owned subsidiaries of major American industries from blocking real legislative change in America. Any candidate for president who does not support this change should acknowledge the extreme difficulty of enacting their preferred legislative agenda. But I’m not going to wait for this to happen to start improving health care – and I’m not going to give Mitch McConnell or the Republicans a veto over my entire health care agenda.

That’s why, within my first 100 days, I will pass my own fast-track budget reconciliation legislation to enact a substantial portion of my Medicare for All agenda – including establishing a true Medicare for All option that’s free for millions and affordable for everyone. 

A True Medicare for All Option. There are many proposals that call themselves a Medicare for All “public option” – but most of them lack the financing to actually allow everyone in America to choose true Medicare for All coverage. As a result, these proposals create the illusion of choice, when in reality they offer tens of millions of Americans the decision between unaffordable private insurance and unaffordable public insurance. A choice between two bad options isn’t a choice at all.

My approach is different. 

Because I have identified trillions in revenue to finance a fully functioning Medicare for All system – without raising taxes on the middle class by one penny – I can also fund a true Medicare for All option. The plan will be administered by Medicare and offered on ACA exchanges. Here are its key features: 

Benefits. Unlike public option plans, the benefits of the true Medicare for All option will match those in the Medicare for All Act. This includes truly comprehensive coverage for primary and preventive services, pediatric care, emergency services and transportation, vision, dental, audio, long-term care, mental health and substance use, and physical therapy. 

Immediate Free Coverage for Millions. This plan will immediately offer coverage at no cost to every kid under the age of 18 and anybody making at or below 200% of the federal poverty level (about $51,000 for a family of four) – including individuals who would currently be on Medicaid, but live in states that refused to expand their programs.

Free, Identical Coverage for Medicaid Beneficiaries. States will be encouraged to begin paying a maintenance-of-effort to the Medicare for All option in exchange for moving their Medicaid populations into this plan and getting out of the business of administering health insurance. For states that elect to maintain their Medicaid programs, Medicaid premiums and cost sharing will be eliminated, and we will provide wraparound benefits for any Medicare for All option benefits not covered by a state’s program to ensure that these individuals have the same free coverage as Medicaid-eligible people in the Medicare for All option. 

Eventual Free Coverage for Everyone. This plan will begin as high-quality public insurance that covers 90% of costs and allows people to utilize improved ACA subsidies to purchase coverage and reduce cost sharing. There will be no premiums for kids under 18 and people at or below 200% of the federal poverty level. For individuals above 200% FPL, premiums will gradually scale as a percentage of income and are capped at 5.0% of their income. Starting in year one, the plan will not have a deductible — meaning everyone gets first dollar coverage, and cost sharing will be zero for people at or below 200% FPL. Cost sharing will scale modestly for individuals at or above that level, with caps on out-of-pocket costs. In subsequent years, premiums and cost sharing for all participants in this plan will gradually decrease to zero. 

Reducing Drug Prices. The Medicare for All option will have the ability to negotiate for prescription drugs using the mechanisms I’ve previously outlined, helping to drive down costs for patients. 

Automatic Enrollment. Anyone who is uninsured or eligible for free insurance on day one, excluding individuals who are over 50 and eligible for expanded coverage under existing Medicare, will be automatically enrolled in the Medicare for All option. Individuals who prefer other coverage can decline enrollment.

Employee Choice. Workers with employer coverage can opt into the Medicare for All option, at which point their employer will pay an appropriate fee to the government to maintain their responsibility for providing employee coverage. In addition, unions can negotiate to include a move to the Medicare for All option via collective bargaining during the transition period, with unionized employers paying a discounted contribution to the extent that they pass the savings on to workers in the form of increased wages, pensions, or other collectively-bargained benefits. This will support unions and ensure that the savings from Medicare for All are passed on to workers in full, not pocketed by the employer.

Provider Reimbursement and Cost Control. I have identified cost reforms that would save our health system trillions of dollars when implemented in a full Medicare for All system. The more limited leverage of a Medicare for All option plan will accordingly limit its ability to achieve these savings – but as more individuals join, this leverage will increase and costs will go down. Provider reimbursement for this plan will start above current Medicare rates for all providers, and be reduced every year as providers’ administrative and delivery costs decrease until they begin to approach the targets in my Medicare for All plan. The size of these adjustments will be governed by overall plan size and the progress of provider adjustment to new, lower rates. 

Expand and Improve Existing Medicare for Everyone Over 50. In addition to the Medicare for All option, any person over the age of 50 will be eligible for expanded coverage under the existing Medicare program, whose infrastructure will allow it to absorb new beneficiaries more quickly. The expanded Medicare program will be improved in the following ways: 

Benefits. To the greatest extent possible, critical benefits like audio, vision, full dental coverage, and long-term care benefits will be added to Medicare, and we will legislate full parity for mental health and substance use services. 

Eventual Free Coverage for Everyone. Identical to the Medicare program, enrollees will pay premiums in Part B and D, with a $300 cap on drug costs in Part D. Plugging a huge hole in the current Medicare program, out-of-pocket costs will be capped at $1,500 per year across Parts A, B, and D, eliminating deductibles and reducing cost sharing. In subsequent years, premiums and cost sharing will gradually decrease to zero. 

Employee Choice. Identical to the Medicare for All option, workers 50-64 can opt into expanded Medicare, at which point their employer will pay an appropriate fee to the government to maintain their responsibility for providing employee coverage. 

Reducing Drug Prices. The expanded Medicare program will receive the ability to negotiate for prescription drugs using the mechanisms I’ve previously outlined, helping to drive down costs for patients. And we will create a publicly run prescription drug plan that is benchmarked off the best current Part D plan. 

Automatic Enrollment. Every person without health insurance over the age of 50 will be automatically enrolled in the expanded existing Medicare program. 

Provider Reimbursement and Cost Control. Provider reimbursement for new beneficiaries will start above current Medicare rates for all providers, and be reduced every year as providers’ administrative and delivery costs decrease until they begin to approach the targets in my Medicare for All plan. It will be a new condition of participation that providers who take Medicare or other federally subsidized insurance also take the Medicare for All option. We will also adopt common sense reforms to bring down bloated reimbursement rates, including reforms around post-acute care, bundled payments, and site neutral payments.

Improving the Affordable Care Act. My reforms will also strengthen Affordable Care Act plans – including the new Medicare for All option – by making the following changes:

Expand Tax Credit Eligibility. We will lift the upper limit on eligibility for Premium Tax Credits, allowing people over 400% of the federal poverty level to purchase subsidized coverage and greatly increasing the number of people who receive subsidies. 

Employee Choice. We will allow any person or family to receive ACA tax credits and opt into ACA coverage, regardless of whether they have an offer of employer coverage. If an individual currently enrolled in qualifying employer coverage moves into an ACA plan, their employer will pay an appropriate fee to the government to maintain their responsibility for providing employee coverage.

Lower Costs. Right now, people may pay up to 9.86% of their income before they get subsidies. Under my plan, this cap would be lowered – and to make sure those tax credits cover more, we will benchmark them to more generous “gold” plans in the Marketplace. And we will increase eligibility for cost sharing reductions, ensuring that more individuals can get into an affordable exchange plan immediately.

Eliminate the Penalty for Getting a Raise. Right now, if someone’s income goes up, they can be forced to repay thousands of dollars in back premiums. We will change this and base tax credits on the previous year’s income. And if someone’s income goes down, they will get the higher subsidy for that year.

State Single-Payer Innovation Waivers. To help states try out different payer arrangements and pilot programs, we will allow states to receive passthrough funding to expand or improve coverage via the ACA’s Section 1332 waivers. Combined with Medicaid waivers, these changes will allow interested states to start experimenting immediately with consolidating public payers and move towards a single-payer system.
 

Additional Financing. My plan to pay for Medicare for All identifies $20.5 trillion in new revenue, including an Employer Medicare Contribution, which will cover the long-term, steady-state cost of a fully functioning Medicare for All system. The cost of this intermediate proposal will be lower. Any revenue needed to meet the requirements of fast-track budget reconciliation will be enacted as part of this legislation from the financing options that I have already proposed.

Additional Health System Reforms to Save Money and Lives

After pursuing administrative changes, expanding existing Medicare, and creating a true Medicare for All option, every person in the United States will be able to choose free or low-cost public insurance. Tens of millions will likely do so. But we can’t stop there. We must pursue additional reforms to our health system to save money and save lives. Some of my priorities include:

Investing in Medical Miracles. Many medical breakthroughs stem from federal investments in science – but in 2018, 43,763 out of 54,834 research project grant applications to the National Institutes of Health (NIH) were rejected. We will boost medical research by investing an additional $100 billion in guaranteed, mandatory spending in the NIH over ten years, split between basic science and the creation of a new National Institute for Drug Development that will help take the basic research from the other parts of NIH and turn it into real drugs that patients can use. We will prioritize treatments that are uninteresting to big pharmaceutical companies but could save millions of American dollars and lives. Any drugs that come out of this research and to American consumers can be sold abroad, with the proceeds reinvested to fund future breakthrough drug development. And by enacting my Affordable Drug Manufacturing Act, the government can manufacture generic drugs that are not available due to cost or shortage. 

Ending the Opioid Epidemic. The opioid epidemic is a public health emergency. In 2017, life expectancy in the United States dropped for the third year in a row, driven in large part by deaths from drug overdoses. We will enact my legislation, the CARE Act, to invest $100 billion in federal funding over the next ten years in states and communities to fight this crisis – providing resources directly to first responders, public health departments, and communities on the front lines of this crisis. 

Improved Administration. To cut down on time wasted on paperwork, we will create single standardized forms for things like prior authorizations and appeals processes to be used by all insurers (private and public), and we will establish uniform medical billing for insurers and doctors.

All-Payer Claims Database. Right now, there are so many middlemen in health care that no one knows for certain how much we pay for different services across the whole system. A centralized repository of de-identified claims data will help the government, researchers, and the market better understand exactly what we pay for health care and what kind of quality it gets us. Demystifying what we pay for what we get will be a critical part of ensuring fair reimbursement under Medicare for All.

Antitrust Enforcement. In addition to administrative actions to rein in anti-competitive hospital and electronic medical record practices, we’ll also ban non-compete and no-poach agreements and class action waivers across the board, while making it easier for private parties to sue to prevent anti-competitive actions. I’ll work with states to repeal Certificate of Public Advantage, or COPA, statutes that shield health care organizations from federal antitrust review and can lead to the creation of large monopolies with little to no oversight. And I’ll also push to ensure our antitrust laws apply to all health care mergers.

Ending Surprise Billing. Imagine being a woman who schedules her baby’s delivery with her obstetrician at an in-network hospital, but it turns out that the anesthesiologist administering the epidural isn’t in-network. Even though she had no choice – and probably had no idea that doctor was out-of-network – under the current system she gets hit with a huge bill. We will end the practice of surprise billing by requiring that services from out-of-network doctors within in-network hospitals, in addition to ambulances or out-of-network hospitals during emergency care, be treated as in-network and paid either prevailing in-network rates or 125% of the Medicare reimbursement rate, whichever is lower.

Preventing Provider Shortages. With more people seeking the care they need, it will be essential to increase the number of providers. I will make these critical investments in our clinicians, including by dramatically scaling up apprenticeship programs to build a health care workforce rooted in the community. I will lift the cap on residency placements, allowing 15,000 new clinicians to enter the workforce. I will expand the National Health Service Corps and Indian Health Service loan repayment program to allow more health professionals – including physicians, physician assistants, registered nurses, nurse practitioners, and other licensed practitioners – to practice in underserved communities. I will also provide grants to states that expand scope-of-practice to allow more non-physicians to practice primary care. And I will push to close the mental health provider gap in schools.

Completing the Transition to Medicare For All

By pursuing these changes, we will provide every person in America with the option of choosing public coverage that matches the full benefits of Medicare for All. Given the quality of the public alternatives, millions are likely to move out of private insurance as quickly as possible. 

No later than my third year in office, at which point the number of individuals voluntarily remaining in private insurance would likely be quite low, I will fight to pass legislation to complete the transition to the Medicare for All system defined by the Medicare for All Act by the end of my first term in office. 

Moving to this system would mean integrating everyone into a unified system with zero premiums, copays, and deductibles. Senator Sanders’s Medicare for All Act allows for supplemental private insurance to cover services that are not duplicative of the coverage in Medicare for All; for unions that seek specialized wraparound coverage and individuals with specialized needs, a private market could still exist. In addition, we can allow private employer coverage that reflects the outcome of a collective bargaining agreement to be grandfathered into the new system to ensure that these workers receive the full benefit of their bargain before moving to the new system. But the point of Medicare for All is to cut out the middleman.

Every successful effort to move the United States to create and expand new social programs – like Social Security and Medicare and Medicaid – has required multiple steps. In fact, every credible Medicare for All proposal has a significant, multi-step transition built in. That’s why it’s important to have both short-term goals and long-term goals to guide the process and to deliver concrete improvements to people’s lives at every stage.

I believe the next president must do everything she can within one presidential term to complete the transition to Medicare for All. My plan will reduce the financial and political power of the insurance companies – as well as their ability to frighten the American people – by implementing reforms immediately and demonstrating at each phase that true Medicare for All coverage is better than their private options. I believe this approach gives us our best chance to succeed.

Why do we need to transition to Medicare for All if a robust Medicare for All option is available to everyone? The answer is simple and blunt: cost and outcomes. Today, up to 30% of current health spending is driven by the costs of filling out different insurance forms and following different claims processes and fighting with insurance companies over what is and is not covered. I have demonstrated how a full Medicare for All system can use its leverage to wring trillions of dollars in waste out of our system while delivering smarter care – and I’ve made clear exactly how I would do it. The experience of other countries shows that this system is the cheapest and most efficient way to deliver high-quality health care. As long as duplicative private coverage exists, we will limit our ability to make health care delivery more effective and affordable – and the ability of private middlemen to abuse patients will remain. 

Medicare for All will deliver an $11 trillion boost to American families who will never pay another premium, co-pay, or deductible. That’s like giving the average working family in America a $12,000 raise. This final legislation will put a choice before Congress – maintain a two-tiered system where private insurers can continue to profit from being the middlemen between patients and doctors, getting rich by denying care – or give everybody Medicare for All to capture the full value of trillions of dollars in savings in health care spending. I believe that the American people will demand Congress make the right choice.

Read Senator Warren’s plan here

Watch explainer video here

Democratic Candidates for 2020: Senator Amy Klobuchar Advances Plan for Universal Coverage, Lower Health Care Costs

Senator Amy Klobuchar,left, on stage in Houston for the third Democratic Debate, hosted by ABC News.

Senator Amy Klobuchar had her best moments in the third Democratic Debate, Sept. 12, in addressing health care and drawing the distinction between Senator Bernie Sanders’ Medicare-for-All solution in the quest, shared by all the Democratic candidates, of universal health care at an affordable cost, health care as a right, not a privilege.

This is from the Klobuchar campaign:

MINNEAPOLIS, MN — Senator Amy Klobuchar has been a leader in the Senate to lower the cost of prescription drugs, expand access to affordable health care and protect reproductive rights. She was the first candidate in this race to release a comprehensive plan to combat addiction and prioritize mental health — two issues she’s championed her entire career. 

Senator Klobuchar supports: 

Universal health care for all Americans, and she believes the quickest way to get there is through a public option that expands Medicare or Medicaid.

Changes to the Affordable Care Act to help bring down costs to consumers including providing cost-sharing reductions, making it easier for states to put reinsurance in place, and continuing to implement delivery system reform.

Lifting the ban on Medicare negotiations for prescription drugs, allowing personal importation of safe drugs from countries like Canada, and stopping pharmaceutical companies from blocking less-expensive generics.

Taking on mental health and addiction by launching new prevention and early intervention initiatives, expanding access to treatment, and giving Americans a path to sustainable recovery because she believes everyone has the right — and the opportunity — to receive effective, professional treatment and help.

Stopping the concerted attack to undermine and eliminate a woman’s right to make her own health care decisions. She believes recent bans in states are dangerous, they are unconstitutional, and they are out of step with the majority of Americans. Amy will continue working to protect the health and lives of women across the country.

In her first 100 days as president, Senator Klobuchar will take the following actions:

Immediately suspend the Trump Administration’s efforts to eliminate the Affordable Care Act’s protections for people with pre-existing conditions. 

Immediately allow for the safe importation of prescription drugs from countries like Canada. 

Expand VA health benefits for women veterans and their babies. 

Prioritize mental health and addiction. 

End “pay for delay” agreements that increase the cost of prescription drugs. 

Propose legislation to get us to universal health care.

Develop best models of care to address disparities in maternal and infant mortality and address the shortage of maternity care health professional in underserved rural and urban areas. 

Stop Trump sabotage of the ACA by ending workarounds that allow states to raise premiums for sicker people and shift ACA premium subsidies away from lower-income enrollees. 

End the sale of junk insurance policies that eliminate existing protections for consumers. 

End anticompetitive practices that increase the price of prescription drugs.  

Encourage reinsurance programs. 

Expand Medicaid reimbursement for people receiving mental health or substance use treatment. 

Ensure funding for Planned Parenthood, end the gag rule, and restore the Title X program

Expand investments in veterans telehealth services. 

Invest in the Veterans Health Administration. 

Reassess the granting of Medicaid waivers, including states that have privatized Medicaid. 

Direct the Department of Defense and VA to track servicemembers and veterans exposed to toxic chemicals.

Direct the Department of Health and Human Services to consider VHA facilities when designating Health Professional Shortage Areas. 

Strengthen the National Science Foundation and the National Institutes of Health.

Invest in Alzheimer’s research. 

Prioritize health care delivery system reform to reduce health care costs.

Expand the open enrollment period for health insurance under the Affordable Care Act so more people can get insurance coverage.

Bernie Sanders Defends Medicare-for-All, Attacks Insurance Companies, Big Pharma for Dysfunctional, High-Cost Healthcare

Bernie Sanders, seen at a Brooklyn rally, is defending his signature plan, Medicare-for-All, and blaming the greed of the insurance and pharmaceutical industries as the reason for dysfunctional, high cost health care system that causes 30,000 premature deaths a year and bankrupts 530,000 Americans a year. © Karen Rubin/news-photos-features.com

WASHINGTON – U.S. Senator Bernie Sanders, running to be the Democratic nominee for president, on July 17 delivered a major address on Medicare for All, coinciding with the 54th anniversary of Medicare being signed into law. In his remarks, Sanders outlined his plan to make health care a human right for all Americans. Here is highlighted transcript of remarks as they were prepared for delivery: – Karen Rubin, News & Photo Features

Thank you all very much for being here to discuss one of the major crises facing our country.  Let me also thank the dozens of organizations throughout America who support Medicare for All and the tens of thousands of doctors, nurses and other health professionals who support my legislation.  Let me thank the 14 Senate co-sponsors that we have on this legislation and the 118 Members of the House who support similar legislation.  And mostly, let me thank the American people who by the millions understand, as I do, that health care is a human right, not a privilege.

Together, we will end the international embarrassment of the United States being the only major country on earth that does not guarantee health care to all of its citizens.  

It is not acceptable to me, nor to the American people, that some 87 million people today are either uninsured or underinsured.

It is not acceptable to me that we end up spending almost twice as much as any other major country on health care, while our life expectancy continues to decline and our healthcare outcomes lag behind many other countries.

Frankly, I am sick and tired of talking to doctors who tell me about the patients who died because they were uninsured or underinsured, and walked into the doctor’s office when it was too late.  And we are talking about over 30,000 Americans who die every year because they are uninsured or under-insured.  What a tragedy. 

I am sick and tired of seeing working class families and small businesses pay far more for healthcare than they can afford, and 530,000 Americans declare bankruptcy each year because they cannot pay off the outrageous cost of a medical emergency or a hospital stay.  Families should not be driven into financial ruin because someone in the family became seriously ill.  How insane is that?

I am sick and tired of hearing from Americans who lost loved ones because they could not afford the unbelievably high cost of prescription drugs, or hearing from constituents who are forced to cut their pills in half due to the cost. 

In fact, later this month, I will be travelling from Detroit, Michigan to Windsor, Ontario with a busload of Americans who have diabetes in order to purchase insulin in Canada at one-tenth of the price that they pay in America.

I am sick and tired of talking with people who are struggling with mental illness but cannot afford the mental health counseling they desperately need. 

I am tired of talking to people who have teeth that are rotting in their mouths, but cannot afford the high cost of dental care

Let me be very honest and tell you that, in my view, the current debate over Medicare for All really has nothing to do with healthcare.  It has everything to do with greed and the desire of the healthcare industry to maintain a system which fails the average American, but which makes the industry tens and tens of billions of dollars every year in profit. 

It is about whether we maintain a dysfunctional system which allows the big drug and health insurance companies to make over $100 billion in profits last year, while the top CEOs in that industry made $2.6 billion in total compensation – all the while 1 out of 5 Americans cannot afford the prescription drugs their doctors prescribe.

It’s about whether we maintain a system in which the CEO of the Aetna insurance company, Mr. Mark Bertolini, received a golden parachute worth nearly $500 million after his company merged with CVS Health, while elderly people lack the resources to purchase a hearing aid.

It’s about whether we maintain a system that allows the former CEO from Gilead (John Martin) to become a billionaire by charging $1,000 a pill for a hepatitis c drug called Sovaldi that costs a dollar to manufacture.

Let us make no mistake about it.  The struggle that we are now undertaking, to guarantee health care to all Americans as a right and to substantially lower the cost of prescription drugs, will be opposed by some of the most powerful forces in America – entities that have unlimited amounts of money.  We’re talking about the insurance companies, the drug companies, private hospitals, medical equipment suppliers, Wall Street and other powerful entities.  

Let me make a prediction. In order to defeat the Medicare for All movement, powerful special interests will be spending millions on 30 second television ads, full page magazine ads, and corporate-sponsored “studies” to frighten the American people about Medicare for All – which is exactly what happened before the passage of Medicare in the 1960s. They failed then and they’re going to fail now.

And let me give you an example of the kind of money and power we are talking about. 

Over the last 20 years, the insurance industry and pharmaceutical companies have spent more than $330 million in campaign contributions and over $4 billion in lobbying to get Congress to do its bidding. 

The pharmaceutical industry alone has hired some 1,200 lobbyists – including the former leadership of both political parties.

I find it quite interesting that Billy Tauzin, the Republican Congressman who wrote the bill to prevent Medicare from negotiating for lower drug prices and then went on to become the President and CEO of Pharma, received over $11.6 million in compensation in 2010.

That’s how business is done in Washington.  Well, I have a different vision of what a rational healthcare system is all about.  Instead of massive profits for the drug companies, the insurance companies and Wall Street, we must provide a healthcare system that provides quality healthcare to all in a cost effective way.

And that is exactly what Medicare for All does.

Under this legislation, every family in America would receive comprehensive coverage, and middle-class families would save thousands of dollars a year by eliminating their private insurance costs as we move to a publicly funded program.

The transition to the Medicare for All program would take place over four years. In the first year, benefits to older people would be expanded to include dental care, vision coverage and hearing aids, and the eligibility age for Medicare would be lowered to 55. All children under the age of 18 would also be covered. In the second year, the eligibility age would be lowered to 45 and in the third year to 35. By the fourth year, every man, woman and child in the country would be covered by Medicare for All.

Medicare for All will reduce – let me repeat, reduce — overall health care spending while lowering the number of uninsured and underinsured people in this country to zero.   

We accomplish this because Medicare for All creates a system of health care insurance that isn’t designed to generate profits for insurance and drug companies — it will be a system focused on delivering actual health care. It will save lives, save money, and end the frustration of endless paperwork, denials, and desperate fights with an insurance company to cover medically-necessary medications and procedures.

Medicare for All will fully eliminate health insurance premiums, deductibles and co-payments. Make no mistake about it: These are nothing less than taxes on the middle class. 

And when we do that, the average middle class family will save an estimated $3,000 each and every year.

Further, unlike the current dysfunctional system, Medicare for All allows people the freedom to choose any doctor, clinic, and hospital without worrying about whether their provider is in-network or not.  People will be able to make the health care choices that are best for themselves and their families without some insurance bureaucrat telling them which providers they can see or not see. Medicare for All is at the end of the day empowering patients and health care providers. 

In addition, a Medicare for All system will allow us to address the serious problem of medically underserved areas. 

Just to demonstrate how absurd our health care system is, I was in Philadelphia two days ago rallying with the people of that city to try to stop the closure of Hahnemann University Hospital, an important, safety net hospital in that community.  Why do the owners want to close this hospital? Because they can make more money redeveloping that property into condominiums and hotels.

Let me address some of the half-truths, misinformation, and, in some cases, outright lies that people may be hearing about Medicare for All.  

Medicare for All critics tell us that Americans just love their private health insurance companies. We heard this most recently from UnitedHealth CEO David Wichmann, who by the way, made $83 million in 2017 and who said Medicare for All would “destabilize the nation’s health system.” 

But let’s remember: the current system is already disrupting and destabilizing millions of people’s lives. In the current system, 50 million Americans every year lose their existing health insurance when their employer changes insurer, when they change jobs, or when they cannot afford their current plan. For many of them, they will no longer be able to see the doctor they have relied on for years.  For others, important treatments for long-term conditions or disabilities will be changed or stopped altogether.  

Here is the simple truth. The American people do not like their private health insurance companies. In fact private health insurance companies are quite unpopular.  What the American people do like are their doctors, nurses and other health care providers. 

While our opponents claim that Medicare for All is too expensive, the reality is that it is much more cost effective than our current system.

The Center for Medicare and Medicaid Services estimates that, if we do not change the system, this country will be spending $50 trillion over the next ten years –19.4 percent of our nation’s GDP.  This is unsustainable and will be incredibly harmful to the people of our country, to the business community, and to the entire economy.

And the reason why we spend so much is obvious.  It is not just the huge profits in the insurance industry and the pharmaceutical industry, but it is the incredible and wasteful bureaucratic maze developed by thousands of different healthcare plans.  Today, hospitals and doctors must deal with patients who have different deductibles, different co-payments, different networks of coverage, and different coverage for pharmaceuticals, or no insurance at all.  All of this is not only driving doctors and nurses and hospital administrators to distraction, but it is wasting up to $500 billion a year on unnecessary administrative costs.

Unlike our current system, there is broad consensus – from conservative to progressive economists – that Medicare for All would result in substantial savings to the American people.  Two of the most recent studies on this issue have estimated that Medicare for All would save the American people between $2 trillion and $5 trillion over a 10-year period.

Let us be clear, the fight against Medicare for All today is not a new development.  Powerful special interests have always opposed healthcare programs that work for the people and not for corporate interests.

Let us not forget that when President Harry Truman first proposed a program guaranteeing health care to seniors that idea was billed as radical, “un-American,” and an attack on basic freedom. And because of that assault, the idea stalled in Congress for years — until voters made their voices heard.

In 1960, America elected John F. Kennedy after he campaigned in support of Truman’s idea. That election prompted serious work on universal health care bill, and Kennedy at the time noted that “what we are now talking about doing, most of the countries of Europe did years ago.”

Finally, following the 1964 Democratic election landslide, the new Congress was able to pass what is now known as Medicare despite intense opposition from the health insurance industry and the pharmaceutical companies.

More than a half-century after that achievement, the time is now to go forward.  The time is now to expand Medicare to every man, woman and child in this country. 

Let us be very clear.  When it comes to health care, the insurance and drug industries have been able to control the political process.  

If we are going to break the stranglehold of corporate interests over the health care needs of the American people, we have got to confront a Washington culture that is corrupt, that puts profits before people.

That is why I am calling on every Democratic candidate in this election to join me in rejecting money from the insurance and drug industries. That means not accepting donations over $200 from health insurance or pharmaceutical company PACs, lobbyists or executives. Candidates who are not willing to take that pledge should explain to the American people why those corporate interests believe their campaigns are a good investment.

Of course, President Trump should do the same but I am not going to even waste my breath suggesting that he will.  His efforts to throw 32 million people off their health insurance to have it replaced with junk insurance shows exactly what side he is on.

Finally, let me say, eliminating health insurance and drug company money from the Democratic primary won’t solve all the problems, but it is an important step forward. Now is the time to tell the health care industry that your profits are not more important than the lives of the American people.

See also: Biden Plan for Universal Healthcare: Protect, Build on Obamacare

May Days: Trump’s Many Ironic Proclamations, From Law Day to Memorial Day, with Mothers Day in the Middle

May finishes with Memorial Day. Trump will no doubt issue a proclamation honoring those who have made the ultimate sacrifice to preserve American freedoms and values, while doing everything to undermine them © Karen Rubin/news-photos-features.com

 

By Karen Rubin, News & Photo Features

Normally rote proclamations take on a sardonic, sarcastic, ironic tone when signed by Donald J. Trump.

It may surprise people that May 1 (in many places called May Day) is proclaimed Law Day – particularly ironic as Trump, insisting he doesn’t have to answer to the investigation into possible Russian collusion with his campaign and obstruction of justice while in office, is nothing but undermining the Rule of Law and the concept that “No Man is Above the Law.” He has said as much, in such statements echoing Nixon’s “When the President does it, well, that means it’s not illegal”. Or in his echo of Louis XIV’s “L’etat s’est moi” – when he decried the “raid” on his lawyer Michael Cohen as an attack on the nation (what does he make of sending his goons to raid his Dr. Bornstein’s office without any kind of warrant and steal his medical records over his pique at being outed for using a hair-growth prescription? That press shill Sarah Huckabee Sanders said was “routine” when someone becomes president? Does anyone recall any other president raiding their doctor’s office to seize records? ).

Here’s what Trump signed (and clearly did not write and likely never read):

     On Law Day, we celebrate our Nation’s heritage of liberty, justice, and equality under the law.  This heritage is embodied most powerfully in our Constitution, the longest surviving document of its kind.  The Constitution established a unique structure of government that has ensured to our country the blessings of liberty through law for nearly 229 years.

     The Framers of our Constitution created a government with distinct and independent branches — the Legislative, the Executive, and the Judicial — because they recognized the risks of concentrating power in one authority.  As James Madison wrote, “the accumulation of all powers, legislative, executive, and judiciary, in the same hands . . . may justly be pronounced the very definition of tyranny.”  By separating the powers of government into three co-equal branches and giving each branch certain powers to check the others, the Constitution provides a framework in which the rule of law has flourished.

     The importance of the rule of law can be seen throughout our Nation’s history.

It is not really a coincidence that May 1 (May Day, a celebration of Workers rights around the world, including in the US of A where May Day began), is also designated as Loyalty Day – a McCarthy-era direct assault on Communism (but apparently, not on Russia, which is no longer communist but fascist and Trump’s best bud).

Loyalty Day, just like National Prayer Day, is actually a violation of what this nation holds dear. In America, we are not supposed to be required to pledge allegiance, certainly not to swear “under God”. No doubt, Trump signed the proclamation, thinking that Loyalty Day meant to swear loyalty to himself, the Dear Leader. I have no doubt he actually read the proclamation:

     On Loyalty Day, we reflect with humility and gratitude upon the freedoms we hold dear, and we reaffirm our allegiance to our Nation and its founding principles.  We cherish our system of self-government, whereby each American citizen is free to exercise their God-given and inalienable rights to life, liberty, and the pursuit of happiness.  We honor and defend our Constitution, which constrains the power of government and allows us freely to exercise these rights.  We also recognize the great responsibility that accompanies a free people and vow to preserve our hard-won liberty.  For we know, as President Ronald Reagan once said, that “freedom is never more than one generation away from extinction.”

     This Loyalty Day, we remember and honor the thousands of Americans who have laid down their lives to protect and defend our Nation’s beautiful flag.

May is also when this government has decided to hold the National Prayer Breakfast – another action (along with “In God We Trust” as a motto on money) to institutionalize the violation of the Constitution’s separation of church and state.

Instead, Trump went a step beyond what even George W. Bush did in setting up the Office of Faith Based Initiatives, to sign his own Faith-Based Initiative.

The nexus of Capitalism and Christian Zealotry came during the McCarthy era, when the notion of Christian charity was replaced by the Puritan concept that you got what you deserved, so rich people were rich because they deserved it; poor people were impoverished because they deserved it. Such zealotry was used to justify slavery as well as prohibiting abortion to rape victims.

Much of today’s malevolent political climate can be traced to the McCarthy era, including Trump’s own mentor, Roy Cohn, who was McCarthy’s own counsel, and taught Donnie everything he knows about attacking in order to evade legal or moral accountability.

And of course, May features Mothers Day… Trump’s proclamation for May 13, 2018 begins this way:

     Mother’s Day is a very special occasion and opportunity to express our endless gratitude to the women who give their unyielding love and devotion to their families, and their unending sacrifices to guide, protect, and nurture the success of their children.  Our country has long appreciated and benefited from the contributions women have made to empowering and inspiring not only those under their roofs, but those in our schools, communities, governments, and businesses…

     Today, and every day, let us express our utmost respect, admiration, and appreciation for our mothers who have given us the sacred gifts of life and unconditional love.  In all that they do, mothers influence their families, their communities, our Nation, and our world.  Whether we became their children through birth, adoption, or foster care, we know the unmatched power of the love, dedication, devotion, and wisdom of our mothers.

Certainly, Trump cherishes motherhood so much, he had an affair with Stormy Daniels, among others, while Melania was still nursing 4-month old Barron.

This is the man who directs his administration to terrorize undocumented mothers, that they will be forced to abandon their American-citizen children, who pulls away parents who are the major breadwinners for their families, who have lived in the United States for decades and are contributing to their communities.

The precious sentiment of his Mothers Day proclamation is belied by the cruelty the Trump Administration has shown to refugees claiming asylum, purposefully separating children, even infants, from their parents in order to discourage people fleeing violence from attempting to find refuge in the United States.

“There is no law enforcement or other legitimate basis for separating children from their parents at the border,” Congressman Adam Schiff tweeted. “It is simply cruel. Imagine the terror of a young child in a strange land, pried away from his or her parents. Whatever happened to compassion or family values?”

“Arresting and ripping apart parents and children is a new low in demagoguery. It’s another reminder of President Trump’s failure to craft a genuine set of border laws and his inhumane outlook,” the San Francisco Chronicle wrote.

“It’s a chilling but predictable new low for an administration that reacts blindly and harshly to any mention of immigrants. Families may be fleeing persecution, seeking a better life or trying to find relatives already in the U.S.”

It doesn’t stop there.  The Republicans, which just passed a tax scam that shifts $1.5 trillion in wealth from working people to the richest and adds that much to the national debt,so Trump is clawing back $7 billion in spending from the Children’s Health Insurance Program (CHIP), and  $252 million from a fund that earmarked to combat the Ebola outbreak.

Trump also is advocating for a Republican-pushed Farm Bill which cuts SNAP – the food stamp program that helps 40 million people, the majority who are children, seniors and disabled – by $20 billion,  literally taking food from babes’ mouths. Attaching new work requirements to qualify for the very benefits that are necessary because wages have not kept pace, despite record corporate profits and now $1.5 trillion in tax windfall for the richest.

He also sheds crocodile tears for how devastating the opioid crisis has been. But what has Trump actually done to address the opioid crisis? And for that matter, what has he or the Republican majority done to solve the life/death problem of access to affordable health care, instead, making impossible demands for the very people most desperate for health care to access Medicaid.

Indeed, he chose Mother’s Day to proclaim the start of National Women’s Health Week the guy who is doing everything possible to shut down Planned Parenthood, to sabotage access to affordable health care, who would make being a woman a “pre-existing condition”, who appears to care less that the US is facing a maternal mortality crisis, that up to 900 women die from pregnancy or childbirth complications each year with Black women are 3 to 4 times more likely to die than white women from those complications, not to mention that a woman who suffers a miscarriage may well be jailed for infanticide. (See: Virginia Woman Given a Jail Sentence for “Concealing a Dead Body” After Her Stillbirth)

Trump proclaims:

This is an opportunity to honor the importance of women across America and renew our pledge to support their health and well being.

One of the most LOL ironic among the May proclamations was the one Trump issued as a nod to his wife, Melania, who after  a year and a half as First Lady, finally declared her “agenda” branded as “Be Best” (which turns out to be copied from an Obama handbook on social media and bullying), declaring May 7,  “Be Best  Day”.

Trump’s remarks at this heralded event in which he followed up by signing a proclamation of “Be Best Day” did not speak at all to the essence of anti-bullying. No, not at all. It was all praise for Melania.

     America is truly blessed to have a First Lady who is so devoted to our country and to our children.

     On Be Best Day, we encourage and promote the well-being of children everywhere.  In an increasingly complex and inter‑connected world, nothing is more important than raising the next generation of Americans to be healthy, happy, productive, and morally responsible adults.  This begins with educating our children about the many critical issues they must confront in our modern world that affect their ability to lead balanced and fulfilled lives.

Our Nation’s children deserve certain knowledge that they are safe to grow, learn, and make mistakes.  Adults must provide them with the tools they need to make positive contributions in their schools, with their friends, and in their communities.

It will surprise people that May is also Jewish American Heritage Month, and here we can recall Trump’s varied and many dogwhistles to bigotry and hate and his tacit encouragement of White Supremacists.

      Jewish Americans have helped guide the moral character of our Nation… The contributions of the Jewish people to American society are innumerable, strengthening our Nation and making it more prosperous.

Lumping other minorities together in the same month’s celebrations, May is also Asian Americans and Pacific Islander Heritage Month, as a gratuitous nod to an appreciation of “diversity”:

       Americans of Asian and Pacific Islander descent have contributed immeasurably to our Nation’s development and diversity as a people.

It’s also Older Americans Month, as Trump declared:

      Our country and our communities are strong today because of the care and dedication of our elders.  Their unique perspectives and experiences have endowed us with valuable wisdom and guidance, and we commit to learning from them and ensuring their safety and comfort.

       My Administration is focused on the priorities of our Nation’s seniors. The Department of Justice, for example, is focused on protecting seniors from fraud and abuse.  My Administration is also committed to protecting the Social Security system so that seniors who have contributed to the system can receive benefits from it.  We are also dedicated to improving healthcare, including by increasing the quality of care our veterans receive through the Department of Veterans Affairs and by lowering prescription drug prices for millions of Americans.

Except that everything Trump’s administration has done goes against seniors, including rolling back the Consumer Financial Protection Board which helps seniors (and everyone else) address predatory tactics by financial industry, including Obama-era rules reining in PayDay lenders; has exploded the budget deficit in order to justify pulling billions out of Medicare and Social Security, is determined to narrow Medicaid, has sabotaged the Affordable Care Act resulting in higher premiums, and is risking the Veterans Administration’s ability to provide the specialized health care veterans require by its intent to privatize and put in charge Dr. Ronny with absolutely no experience whatsoever. And let’s examine again what this administration has not done to address opioid addiction or skyrocketing cost of prescription medication. What exactly has this administration done for seniors?

And now Republicans are taking $800 million out of Medicare and standing by as drug costs continue to skyrocket.

Of course, May finishes with Memorial Day, and Trump will no doubt pull out one of the proclamations that express such appreciation for those who have made the ultimate sacrifice to preserve America’s liberty and freedoms – 660,000 have died in all America’s wars since the Revolution (when 4,435 died), including 1,000 in the Indian Wars (1817-1898), 225,000 in the Civil War (140,414 for the Union, 74,524 Confederates); 53,402 in World War I, 291,557 in World War II, 33,739 in the Korean War, 47,434 in Vietnam and 6915 in the Global War on Terror (2001 to present).

Millions more have returned home, some with lifelong injuries both physical and mental. Trump’s answer to these Veterans isn’t the same as during Michelle Obama and Jill Biden’s Joining Forces campaign, or the efforts taken to improve access to health care and other services including a new GI Bill. Trump is moving forward with plans to privatize the Veterans Administration which is opposed by most veterans.

On the same day as Trump proclaimed “Military Spouse Day,” he adds to the list of military spouses deported, as well as veterans who had been promised citizenship in exchange for their military service.

      We ask so much of our military spouses:  frequent moves; heartbreaking separations; parenting alone; incomplete celebrations; and weeks, months, and sometimes years of waiting for a loved one’s safe return from harm’s way.  Time and time again, however, military spouses respond with resilience that defies explanation.  Our service members are often praised as national heroes, but their spouses are equally worthy of that distinction.

     My Administration is committed to taking care of our Armed Forces and ensuring that our military is equipped to defend our country and protect our way of life.  This mission also includes caring for the unique needs of military spouses, whose service to our Nation cannot be overstated.

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