Floor Speech

Date: Sept. 13, 2022
Location: Washington, DC


Mr. SANDERS. Madam President, I understand that there is a lot that is going on in the world today. We are worried about climate change and what that is doing to our planet. We are worried about the terrible war in Ukraine and all of the destruction taking place there. We are worried about inflation and the fact that wages are not keeping up with the prices that people are paying. We are worried about the massive level of income and wealth inequality that exists in our country and the increased concentration of ownership that we see in the United States, among many, many other things that are on people's minds. But to my mind, Madam President, the American people remain and always are deeply concerned about an issue that, by definition, touches each and every one of us, and that is our collapsing and dysfunctional healthcare system.

While it is not discussed much in the corporate media or here in the Halls of Congress, we have today in the United States the most inefficient, bureaucratic, and expensive healthcare system in the world. And that is not just what I believe; that is what the American people know to be true because of their lived experience with the healthcare system.

Madam President, I would hope that all Members of Congress take a hard look at a poll that was published yesterday by the Associated Press-NORC Center for Public Affairs Research, and this is some of what the poll disclosed.

At a time when I hear many of my colleagues tell us that we have the best healthcare system in the world, it turns out that, according to this poll, just 12 percent of the American people believe that healthcare in general is handled very well or extremely well in the United States. Twelve percent.

At a time when we pay the highest prices in the world for prescription drugs, only 6 percent of the American people believe that prescription drug costs in the United States are being handled well or extremely well. Six percent.

At a time when COVID has exacerbated the crisis, only 5 percent of the American people believe that the mental health care system in the United States is being handled well or extremely well. Five percent.

When so many older Americans have died unnecessarily in nursing homes and when so many cannot even find the nursing home bed that they need, just 6 percent of Americans believe that the quality of care at nursing homes in the United States is very good or exceptional. Six percent.

Madam President, the American people increasingly understand, as I do, that healthcare is a human right, not a privilege, and that we must end the international embarrassment of the United States of America being the only major country on Earth that does not guarantee healthcare to all of its citizens. Again, that is not just Bernie Sanders talking; that is what the overwhelming majority of the American people believe.

According to yesterday's AP poll, 66 percent of the American people believe it is the Federal Government's responsibility to make sure that all Americans have health insurance coverage. Sixty-six percent.

Over 86 percent of the American people believe that it is absurd that millions of senior citizens lack dental care, hearing aids, and vision care, and they believe that Medicare should be expanded to cover these basic healthcare needs. It happens to be an issue I have been working on for several years. Eighty-six percent of the American people believe that Medicare should cover dental care, hearing aids, and vision care. Eighty-six percent.

At a time when our long-term healthcare system is in shambles, 81 percent of the American people believe that Medicare should cover the outrageous cost of long-term healthcare for senior citizens and people with disabilities. Eighty-one percent.


Mr. SANDERS. Madam President, it is hard for me to imagine how anyone could defend a healthcare system in which over 70 million people today are either uninsured or underinsured. As we speak, this moment, there are millions of Americans who would like to go to a doctor, who need to go to a doctor, but cannot afford to go to a doctor because of the outrageous cost of medical care in this country.

Frankly, I am tired of talking to physicians who tell me about the patients who died--who died--because they were uninsured or underinsured and who walked into the doctor's office when it was too late. Time and time again, I hear from doctors who tell me about a patient who walked in, and they said to the patient: Why didn't you come in when you first noticed your symptoms?

The patient responded: I don't have the money; I can't afford the copayment; or I have no insurance at all.

Madam President, we are talking about--and I know we don't talk about it much, and maybe we should--we are talking about some 68,000 Americans who die every single year because they are uninsured or underinsured and don't get the medical care that they need. This is the United States, the wealthiest country in the history of the world; 68,000 Americans should not die every year unnecessarily.

I am tired of seeing working-class families and small businesses pay far more for healthcare than they can afford, which results in more than 500,000 Americans every year declaring bankruptcy because of medically related expenses. Half a million Americans declare bankruptcy because of outrageous healthcare bills they simply cannot afford to pay. Families in America should not be driven into financial ruin because someone in that family became seriously ill. Sickness should not be a cause of financial ruin.

I am tired of hearing from Americans who lost loved ones because they could not afford the unbelievably high cost of prescription drugs, and I am tired of hearing from constituents who are forced to cut their pills in half due to the cost. Today, unbelievably, almost one out of four patients cannot afford the prescription drugs their doctors prescribe.

When you want to talk about an irrational and dysfunctional healthcare system, think about a system in which people go to a doctor, they get diagnosed as to their healthcare problem, they get a prescription drug prescribed to them, but they can't afford to buy the drug the doctor prescribes. So what ends up happening? They end up getting sicker. Maybe they end up in the emergency room at an outrageous cost. Maybe because they couldn't afford the prescription drugs in the first place, they end up in the hospital at a very high cost. Maybe they die. That is an irrational and absurd healthcare system.

I am tired of talking to people and families of people who are struggling with mental illness but cannot afford the mental health counseling they desperately need. Last year, as you know, a recordbreaking 100,000 Americans died of drug overdoses. And I will tell you that in my office--and I am sure that in every other Senate office--we get desperate calls from family members looking for affordable mental health counseling. Far too often, that care simply is not there in the community.

People are struggling with husbands, wives, kids who are on the verge of doing something terrible to themselves, to others, and yet, in this country, despite spending far more for healthcare than any other country, we don't have the capability of helping those people. It is not there. The mental health counseling, the help that people need is not there because in this system, geared toward the profits of the insurance companies rather than the needs of the American people, we don't have enough psychologists, counselors, or social workers.

Unbelievably, despite spending far more per capita on healthcare than any other nation, we don't even have enough doctors. We are facing a major doctor shortage in America now, which will only get worse in the years to come if we don't address it. We don't have enough nurses. We don't have enough dentists. We don't have enough medical providers in general. We have, however, more than enough people who bill us and more than enough debt collectors who hound us to pay for a bill we cannot afford, but we just don't have enough people to provide the healthcare that we desperately need.

By the way, the crisis of lack of healthcare providers is only going to get worse as our society continues to age.

At a time of declining life expectancy in the wealthiest country on Earth, your health and your longevity should not be dependent on the amount of money you have. It is an absolute outrage and grossly un- American that the number of years we live in this country is dependent upon our income. Studies have shown that the top 1 percent of Americans live 15 years longer than the poorest people in our society. It is not only the very top as opposed to the very bottom; it is wealthy people in general versus working-class people. If you got the money, you are going to live longer in this country than if you do not have the money.

In my view, healthcare is a human right that all Americans, regardless of income, are entitled to, and all Americans deserve the best quality healthcare that our country can provide.

Further, as chairman of the Senate Budget Committee, it is not acceptable to me that we end up spending over twice as much as virtually every other major country on Earth per capita--twice as much per capita--while our life expectancy and other healthcare outcomes lag behind most other countries. This is really quite an amazing thing. We spend more; yet our results are worse than in other countries, unbelievably.

According to the Centers for Medicare and Medicaid Services, we are now spending $12,530 per capita on healthcare. Imagine that--over $12,000 for every man, woman, and child in this country. This is, frankly, an outrageous and unsustainable sum of money. In comparison, the United Kingdom spends just $5,300; France spends $5,400; Canada, $5,900; Germany, $7,300. We spend over $12,000 per year.

The question that everyone should be asking is, How does it happen that we spend so much money for healthcare, but we get so little in return?

Let's be clear. The current debate over healthcare in the United States really has nothing to do with healthcare. Frankly, it is hard to defend this dysfunctional system. The healthcare debate has everything to do with the unquenchable greed of the healthcare industry and their desire to maintain a system which fails the average American but which makes the industry huge profits every single year. While ordinary Americans struggled to pay for healthcare during this pandemic, the six largest health insurance companies in our country made over $60 billion in profits last year, led by UnitedHealth Group, which made $24 billion in 2021.

While millions of Americans cannot afford soaring healthcare costs, the top executives in the insurance industry receive huge amounts of compensation. In 2020--remember, 70 million uninsured and underinsured and 68,000 dying every year because they don't get to a doctor on time--the CEOs of 178 major healthcare companies collectively made $3.2 billion in total compensation--up 31 percent from the previous year-- all in the midst of the pandemic. People were dying every single day, and the cost of healthcare was soaring; yet the CEOs saw a 31-percent increase in their compensation. According to Axios, in 2020, the CEO of Cigna, David Cordani, took home $79 million in compensation. The CEO of Centene, Mr. Neidorff, made $59 million. The CEO of UnitedHealth Group, Mr. Wichmann, received $42 million in total compensation.

But it is not just the health insurance companies that are ripping off the American people; it is the drug companies as well. In terms of the pharmaceutical industry, last year, Pfizer, Johnson & Johnson, and AbbVie--three giant pharmaceutical companies--increased their profits by over 90 percent to $54 billion. How is it that, in the midst of a pandemic, during which we lost over a million people and millions and millions of people have become sick, the profits of the major drug companies went up by over 90 percent?

The CEO of Moderna got a $926 million golden parachute after his company received $2.5 billion in taxpayer dollars to develop the vaccine. We all appreciate the development of the vaccine, which is saving lives every day. But, really, does the CEO of the company that received $2.5 billion of taxpayer money deserve a $926 million golden parachute? That is an indication, a manifestation, of a sick and broken healthcare system. And while over 330,000 Americans died during the pandemic because they could not afford to go to a doctor on time, the CEO of Regeneron Pharmaceuticals made over $450 million in total compensation.

The current system is failing the American people, and the American people want change--real change.

In March, a few months ago, I was pleased to introduce Medicare for All legislation, with 15 Senate cosponsors. Companion legislation in the House now has 122 cosponsors. This legislation would improve and expand Medicare to cover, over a 4-year period, healthcare to every man, woman, and child in this country. In other words, what this legislation finally does is make sure that the United States joins every other major country and that we guarantee healthcare to all of our people.

This legislation is comprehensive, and it would end out-of-pocket expenses. Unlike the current system, it would provide full freedom of choice regarding healthcare providers. In other words, under Medicare for All, there would no longer be insurance premiums, deductibles, or copayments, and no more networks which deny you your choice of doctors. And, when I talk about Medicare for All being comprehensive, it would cover dental care, vision, hearing aids, prescription drugs, and home- and community-based care. In other words, it would do precisely what the American people want us to do.

Would a Medicare for All system be expensive? Yes, but while providing comprehensive care for all, it would be significantly less expensive than our current dysfunctional system because it would eliminate an enormous amount of the bureaucracy, profiteering, administrative costs, and misplaced priorities inherent in our current for-profit system.

Remember, we currently pay twice as much for healthcare as do the people of virtually any other country, and all of those countries manage to provide universal healthcare. So, yes, we can provide quality care for all at a much, much lower cost per person.

Under Medicare for All, there would no longer be armies of people billing us, telling us what is covered and what is not covered, and hounding us to pay our hospital bills. This not only saves substantial sums of money but will make life a lot easier for the American people, who would never again have to fight their way through the nightmare of insurance company bureaucracy. In fact, the Congressional Budget Office, the CBO, estimated that Medicare for All would save Americans $650 billion a year.

Now, trust me. I do know the 30-second ads from the insurance and drug companies that have told us that if Medicare for All becomes law, your taxes will go up. What they forgot to tell you is that, under Medicare for All, you will no longer be paying premiums, deductibles, copayments, and out-of-pocket expenses to private health insurance companies. What they certainly won't tell you is that Medicare for All will save--save--the average American family thousands of dollars a year. In fact, a study by RAND found that moving to a Medicare for All system would save a family with an income of less than $185,000 about $3,000 a year on average.

Now, one might ask, fair enough: If Medicare for All is so good, if it has so many advantages, if it is what the American people want, why hasn't it been enacted by now? Why hasn't the United States joined every other major country in guaranteeing healthcare for all?

That takes us to our corrupt political system and the outrageous way we fund campaigns. So I would suggest if you want to know why we are stuck with a dysfunctional healthcare system that fails the American people but that makes the drug companies and the insurance companies wildly profitable, follow the money. Follow the money.

Since 1998, in our corrupt political system, the private healthcare sector has spent more than $10 billion on lobbying. Got that? More than $10 billion on lobbying since 1998. Over the last 30 years, it has spent more than $1.7 billion on campaign contributions to maintain the status quo.

In terms of their lobbying efforts, let's be clear. They are very, very bipartisan. There are former Democratic Party leaders and former Republican Party leaders who are working together to represent the insurance companies and the drug companies.

And, by the way, of course, in terms of the campaign contributions, the insurance companies and the drug companies are also very bipartisan. In fact, their contributions go to many Members of both the Democratic and Republican Parties. It doesn't really matter if you are a Democrat or a Republican; what matters is you protect the interests of the drug companies and the insurance companies.

But, you know, what I believe is that maybe, just maybe, now is the time for Congress to do what the American people want--not what the lobbyists want, not what the drug companies want, not what the insurance companies want. And maybe, just maybe, we should have the courage to take on the powerful special interests that dominate healthcare in the United States. And maybe, just maybe, now is the time to provide healthcare to every man, woman, and child as a human right by passing a Medicare for All, single-payer program.