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Joe Biden on Health Care

Democratic Sr Senator (DE); nominee for Vice President


McCain health plan is ultimate Bridge to Nowhere

Q: Are you interested in defending Sen. McCain's health care plan?

PALIN: He's proposing a $5,000 tax credit for families so they can purchase their own health care coverage. That's budget neutral. That doesn't cost the government anything as opposed t Barack Obama's plan to mandate health care coverage and have a universal government-run program.

BIDEN: McCain's health care plan, you know, it's with one hand you giveth, the other you taketh. You know how John McCain pays for his $5,000 tax credit a family will get? He taxes as income every one of you who has a health care plan through your employer. That's how he raises $3.6 trillion: taxing your health care benefit, which his website points out will go straight to the insurance company. Then you're going to have to replace the plan you get through your employer--on average it costs $12,000--you have to replace a $12,000 plan with a $5,000 check you just give to the insurance company. I call that the "Ultimate Bridge to Nowhere.

Source: 2008 Vice Presidential debate against Gov. Sarah Palin Oct 2, 2008

Modernize, simplify & expand health insurance

His plan for dealing with the healthcare crisis is vague to nonexistent, with references to containing costs by "modernizing" and "simplifying" the system; "expanding" health insurance; and looking at "innovative alternatives" pioneered by the states to "evaluate what works best in providing affordable access to healthcare for all."
Source: The Contenders, by Laura Flanders, p.180 Nov 11, 2007

Help medical students find ways to finance their tuition

You got to help them pay off their education. They start off in the hole. They graduate and have these gigantic bills, 40,000 bucks a year. They graduate hundreds of thousands of dollars in debt. You got to give them ability to write that off if they engage in public service, move into areas where they need doctors, and get the insurance company out of looking over their shoulders & everything. They know the decisions to make and what they should be doing. They should be rewarded for their decisions.
Source: 2007 Democratic debate at Drexel University Oct 30, 2007

Start paying for universal coverage with $100B in redundancy

Q: Do you favor universal coverage for everyone without exception?

A: Yes, I do.

Q: How would you pay for it?

A: I would pay for it by three ways. 1) I start off dealing with going into a prevention-and-treatment mode here that required us to simplify and modernize the system. That could save $100 billion a year in redundancy that goes on right now. 2) I would immediately provide for catastrophic health insurance for all Americans, and I'd immediately move for insuring every single child in America. That would cost less than what the top 1% tax break costs, $85 billion a year. 3) Then what I would do is I would move to insuring everyone through one of two vehicles. Either a system we work out among the stakeholders, an agreement that everyone essentially gets Medicare from the time you're born or a system whereby everyone can buy into the federal system. Those who don't have the means to buy in, then you subsidize them into the system. I would pay for that by direct revenues.

Source: Huffington Post Mash-Up: 2007 Democratic on-line debate Sep 13, 2007

Rethink healthcare by focusing on prevention

Q: Do we need to fundamentally rethink the way we view health care?

A: Absolutely. We have to view it in three ways. Prevention. You know, an ounce of prevention worth a pound of cure is real. We virtually do not have anything that rewards those people who are engaged in their physician's or insurer's companies that emphasize prevention. The second thing we have to do is we have to provide for changing the way we think of it as an employer-based system totally. We have an overwhelming opportunity now to get universal health care, because business needs more than labor or business needs it more than the uninsured. They cannot compete internationally. We have to think about it really differently, but the delivery of health care we have to think about differently, too. The idea we're not going to be opening up little clinics in shopping centers all across America that is going to generate avoidance of operating of emergency rooms is just not reasonable.

Source: Huffington Post Mash-Up: 2007 Democratic on-line debate Sep 13, 2007

Start with catastrophic insurance and insuring all kids

Q: How would you address the millions of uninsured, and the cost for those insured?

A: We need not just 100,000 new cops, but 100,000 new nurses that we fund in order to make things better. We have to be in a position where we don't let the perfect become the enemy of the good. In the first year, I'd insure every single, solitary child in America and make sure catastrophic insurance exists, and for every single person in America, while we move toward a national health care system covering anybody.

Source: 2007 AFL-CIO Democratic primary forum Aug 8, 2007

Got tested for AIDS after blood transfusion; no shame in it

Q: African-Americans, though 17% of all American teenagers, are 69% of the population of teenagers diagnosed with HIV/AIDS. What is the plan to protect these young people from this scourge?

BIDEN: You're asking, how do we prevent these 17-year-olds from getting HIV? All the things that were said here [by the other candidates] are good ideas; but they don't prevent that. There's neglect on the part of the medical and the white community focusing on educating the minority community out there. I spent last summer going through the black sections of my town, trying to get black men to understand it is not unmanly to wear a condom, getting women to understand they can say no, getting people in the position where testing matters. I got tested for AIDS. I know Barack got tested for AIDS. There's no shame in being tested for AIDS.

OBAMA: I got tested with my wife Michelle, in public, when we were in Kenya.

BIDEN: And I got tested to save my life, because I had 13 pints of blood transfusion.

Source: 2007 Democratic Primary Debate at Howard University Jun 28, 2007

Voted NO on means-testing to determine Medicare Part D premium.

CONGRESSIONAL SUMMARY:To require wealthy Medicare beneficiaries to pay a greater share of their Medicare Part D premiums.

SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction. OPPONENT'S ARGUMENT FOR VOTING NO:Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.

Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.

Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56

Reference: Bill S.Amdt.4240 to S.Con.Res.70 ; vote number 08-S063 on Mar 13, 2008

Voted NO on allowing tribal Indians to opt out of federal healthcare.

CONGRESSIONAL SUMMARY:
    TRIBAL MEMBER CHOICE PROGRAM: Members of federally-recognized Indian Tribes shall be provided the opportunity to voluntarily enroll, with a risk-adjusted subsidy for the purchase of qualified health insurance in order to--
  1. improve Indian access to high quality health care services;
  2. provide incentives to Indian patients to seek preventive health care services;
  3. create opportunities for Indians to participate in the health care decision process;
  4. encourage effective use of health care services by Indians; and
  5. allow Indians to make health care coverage & delivery decisions & choices.

SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. COBURN: The underlying legislation, S.1200, does not fix the underlying problems with tribal healthcare. It does not fix rationing. It does not fix waiting lines. It does not fix the inferior quality that is being applied to a lot of Native Americans and Alaskans in this country. It does not fix any of those problems. In fact, it authorizes more services without making sure the money is there to follow it.

Those who say a failure to reauthorize the Indian Health Care Improvement Act is a violation of our trust obligations are correct. However, I believe simply reauthorizing this system with minor modifications is an even greater violation of that commitment.

OPPONENT'S ARGUMENT FOR VOTING NO:Sen. DORGAN: It is not more money necessarily that is only going to solve the problem. But I guarantee you that less money will not solve the problem. If you add another program for other Indians who can go somewhere else and be able to present a card, they have now taken money out of the system and purchased their own insurance--then those who live on the reservation with the current Indian Health Service clinic there has less money. How does that work to help the folks who are stranded with no competition?

LEGISLATIVE OUTCOME:Amendment rejected, 28-67

Reference: Tribal Member Choice Program; Bill SA.4034 to SA.3899 to S.1200 ; vote number 08-S025 on Feb 14, 2008

Voted YES on adding 2 to 4 million children to SCHIP eligibility.

Allows State Children's Health Insurance Programs (SCHIP), that require state legislation to meet additional requirements imposed by this Act, additional time to make required plan changes. Pres. Bush vetoed this bill on Dec. 12, 2007, as well as a version (HR976) from Feb. 2007.

Proponents support voting YES because:

Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:

  1. It terminates the coverage of childless adults.
  2. It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
  3. It contains adequate enforcement to ensure that only US citizens are covered.

Opponents recommend voting NO because:

Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:

Veto message from President Bush:

Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.

Reference: Children's Health Insurance Program Reauthorization Act; Bill H.R. 3963 ; vote number 2007-403 on Nov 1, 2007

Voted YES on requiring negotiated Rx prices for Medicare part D.

Would require negotiating with pharmaceutical manufacturers the prices that may be charged to prescription drug plan sponsors for covered Medicare part D drugs.

Proponents support voting YES because:

This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.

It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.

Opponents support voting NO because:

Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.

Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)

Reference: Medicare Prescription Drug Price Negotiation Act; Bill S.3 & H.R.4 ; vote number 2007-132 on Apr 18, 2007

Voted YES on expanding enrollment period for Medicare Part D.

To provide for necessary beneficiary protections in order to ensure access to coverage under the Medicare part D prescription drug program. Voting YES would extend the 6-month enrollment period for the Prescription Drug Benefit Program to the entire year of 2006 and allows beneficiaries to change plans once in that year, without penalty, after enrollment. Also would fully reimburse pharmacies, states and individuals for cost in 2006 for covered Medicare Part D drugs.
Reference: Medicare Part D Amendment; Bill S Amdt 2730 to HR 4297 ; vote number 2006-005 on Feb 2, 2006

Voted YES on increasing Medicaid rebate for producing generics.

Vote on an amendment that removes an increase in the Medicaid deduction rebate for generic drugs from 11% to 17%. The effect of the amendment, according to its sponsor, is as follows: "This bill eliminates the ability of generic drugs to be sold using Medicaid. Over half the prescription drugs used in Medicaid are generic. Because we have raised the fees so dramatically on what a generic drug company must pay a pharmacy to handle the drug, pharmacies are not going to use the generic. In the long run, that will cost the Medicaid Program billions of dollars. My amendment corrects that situation." A Senator opposing the amendment said: "This bill has in it already very significant incentives for generic utilization through the way we reimburse generics. Brand drugs account for 67% of Medicaid prescriptions, but they also account for 81% of the Medicaid rebates. This is reasonable policy for us, then, to create parity between brand and generic rebates. This amendment would upset that parity."
Reference: Amendment for Medicaid rebates for generic drugs; Bill S Amdt 2348 to S 1932 ; vote number 2005-299 on Nov 3, 2005

Voted YES on negotiating bulk purchases for Medicare prescription drug.

Vote to adopt an amendment that would allow federal government negotiations with prescription drug manufactures for the best possible prescription drug prices. Amendment details: To ensure that any savings associated with legislation that provides the Secretary of Health and Human Services with the authority to participate in the negotiation of contracts with manufacturers of covered part D drugs to achieve the best possible prices for such drugs under Medicare Part D of the Social Security Act, that requires the Secretary to negotiate contracts with manufacturers of such drugs for each fallback prescription drug plan, and that requires the Secretary to participate in the negotiation for a contract for any such drug upon the request of a prescription drug plan or an MA-PD plan, is reserved for reducing expenditures under such part.
Reference: Prescription Drug Amendment; Bill S.Amdt. 214 to S.Con.Res. 18 ; vote number 2005-60 on Mar 17, 2005

Voted YES on $40 billion per year for limited Medicare prescription drug benefit.

S. 1 As Amended; Prescription Drug and Medicare Improvement Act of 2003. Vote to pass a bill that would authorize $400 billion over 10 years to create a prescription drug benefit for Medicare recipients beginning in 2006. Seniors would be allowed to remain within the traditional fee-for-service program or seniors would have the option to switch to a Medicare Advantage program that includes prescription drug coverage. Private insurers would provide prescription drug coverage. Private Insurers would engage in competitive bidding to be awarded two-year regional contracts by the Center for Medicare Choices under the Department of Health and Human Services.Enrolled seniors would pay a $275 deductible and an average monthly premium of $35. Annual drug costs beyond the deductible and up to $4,500 would be divided equally between the beneficiary and the insurer. Beneficiaries with incomes below 160 percent of the poverty level would be eligible for added assistance.
Reference: Medicare Prescription Drug Benefit bill; Bill S.1/H.R.1 ; vote number 2003-262 on Jun 26, 2003

Voted YES on allowing reimportation of Rx drugs from Canada.

S. 812, as amended; Greater Access to Affordable Pharmaceuticals Act of 2002. Vote to pass a bill that would permit a single 30-month stay against Food and Drug Administration approval of a generic drug patent when a brand-name company's patent is challenged. The secretary of Health and Human Services would be authorized to announce regulations allowing pharmacists and wholesalers to import prescription drugs from Canada into the United States. Canadian pharmacies and wholesalers that provide drugs for importation would be required to register with Health and Human Services. Individuals would be allowed to import prescription drugs from Canada. The medication would have to be for an individual use and a supply of less than 90-days.
Reference: Bill S.812 ; vote number 2002-201 on Jul 31, 2002

Voted YES on allowing patients to sue HMOs & collect punitive damages.

Vote to provide federal protections, such as access to specialty and emergency room care, and allow patients to sue health insurers in state and federal courts. Economic damages would not be capped, and punitive damages would be capped at $5 million.
Reference: Bill S1052 ; vote number 2001-220 on Jun 29, 2001

Voted NO on funding GOP version of Medicare prescription drug benefit.

Vote to pass an amendment that would make up to $300 billion available for a Medicare prescription drug benefit for 2002 through 2011. The money would come from the budget's contingency fund. The amendment would also require a Medicare overhaul.
Reference: Bill H Con Res 83 ; vote number 2001-65 on Apr 3, 2001

Voted YES on including prescription drugs under Medicare.

Vote to establish a prescription drug benefit program through the Medicare health insurance program. Among other provisions, Medicare would contribute at least 50% of the cost of prescription drugs and beneficiaries would pay a $250 deductible
Reference: Bill HR.4690 ; vote number 2000-144 on Jun 22, 2000

Voted NO on limiting self-employment health deduction.

The Santorum (R-PA) amdt would effectively kill the Kennedy Amdt (D-MA) which would have allowed self-employed individuals to fully deduct the cost of their health insurance on their federal taxes.
Status: Amdt Agreed to Y)53; N)47
Reference: Santorum Amdt #1234; Bill S. 1344 ; vote number 1999-202 on Jul 13, 1999

Voted YES on increasing tobacco restrictions.

This cloture motion was on a bill which would have increased tobacco restrictions. [YES is an anti-smoking vote].
Status: Cloture Motion Rejected Y)57; N)42; NV)1
Reference: Motion to invoke cloture on a modified committee substitute to S. 1415; Bill S. 1415 ; vote number 1998-161 on Jun 17, 1998

Voted NO on Medicare means-testing.

Approval of means-based testing for Medicare insurance premiums.
Status: Motion to Table Agreed to Y)70; N)20
Reference: Motion to table the Kennedy Amdt #440; Bill S. 947 ; vote number 1997-113 on Jun 24, 1997

Voted YES on blocking medical savings acounts.

Vote to block a plan which would allow tax-deductible medical savings accounts.
Status: Amdt Agreed to Y)52; N)46; NV)2
Reference: Kassebaum Amdt #3677; Bill S. 1028 ; vote number 1996-72 on Apr 18, 1996

Rated 100% by APHA, indicating a pro-public health record.

Biden scores 100% by APHA on health issues

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.

The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.

Source: APHA website 03n-APHA on Dec 31, 2003

Establish a national childhood cancer database.

Biden co-sponsored establishing a national childhood cancer database

Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.

    Authorizes the Secretary to award grants to childhood cancer professional and direct service organizations for the expansion and widespread implementation of:
  1. activities that provide information on treatment protocols to ensure early access to the best available therapies and clinical trials for pediatric cancers;
  2. activities that provide available information on the late effects of pediatric cancer treatment to ensure access to necessary long-term medical and psychological care; and
  3. direct resource services such as educational outreach for parents, information on school reentry and postsecondary education, and resource directories or referral services for financial assistance, psychological counseling, and other support services.
Legislative Outcome: House version H.R.1553; became Public Law 110-285 on 7/29/2008.
Source: Conquer Childhood Cancer Act (S911/HR1553) 07-S911 on Mar 19, 2007

Other candidates on Health Care: Joe Biden on other issues:
DE Gubernatorial:
Jack Markell
Ruth Ann Minner
DE Senatorial:
Christine O`Donnell
Ted Kaufman
Tom Carper


2008 Senate retirements:

Wayne Allard(R,CO)
Larry Craig(R,ID)
Pete Domenici(R,NM)
Chuck Hagel(R,NE)
Trent Lott(R,MS)
Craig Thomas(R,WY)
John Warner(R,VA)

Incoming Obama Administration:

Pres.Barack Obama
V.P.Joe Biden
State:Hillary Clinton
HHS:Tom Daschle
Staff:Rahm Emanuel
DHS:Janet Napolitano
DOC:Bill Richardson
DoD:Robert Gates
A.G.:Eric Holder
Treas.:Tim Geithner
Winners of 2008 Senate Races:
( * if new to the Senate)
AK:*Begich over Stevens
AL:Sessions
AR:Pryor
CO:*Udall
DE:Biden and Kaufman
GA:Chambliss v.Martin (Dec. 2 runoff)
IA:Harkin
ID:*Risch
IL:Durbin
KS:Roberts
KY:McConnell
LA:Landrieu
MA:Kerry
ME:Collins
MI:Levin
MN:Coleman v.Franken (recounting as of Dec.1)
MS4:Wicker
MS6:Cochran
MT:Baucus
NC:*Hagan over Dole
NE:*Johanns
NH:*Shaheen over Sununu
NJ:Lautenberg
NM:*Udall
OK:Inhofe
OR:*Merkley over Smith
RI:Reed
SC:Graham
SD:Johnson
TN:Alexander
TX:Cornyn
VA:*Warner
WV:Rockefeller
WY4:Barrasso
WY6:Enzi
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Page last updated: Dec 02, 2008