Joe Biden on Health Care Democratic Sr Senator (DE); Vice President-Elect

McCain health plan is ultimate Bridge to Nowhere

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.

Modernize, simplify & expand health insurance

Help medical students find ways to finance their tuition

Start paying for universal coverage with $100B in redundancy

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.

Rethink healthcare by focusing on prevention

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.

Start with catastrophic insurance and insuring all kids

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.

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

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.

Survived two aneurysms in the 1990s

Running is a horrible strain, and those with long memories will recall that Biden survived two aneurysms more than a decade ago. Racing to Iowa every spare second to go to farm breakfasts at 5:30 a.m., making calls every minute begging for money, flying commercial (coach, no less) day after day, gets old awfully fast if you don't have that fire in your belly.

Voted YES on overriding veto on expansion of Medicare.

• Extends Medicare to cover additional preventive services.
• Includes body mass index and end-of-life planning among initial preventive physical examinations.
• Eliminates by 2014 [the currently higher] copayment rates for Medicare psychiatric services.

I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong. This bill is objectionable, and I am vetoing it because:
• It would harm beneficiaries by taking private health plan options away from them.
• It would undermine the Medicare prescription drug program.
• It is fiscally irresponsible, and it would imperil the long-term fiscal soundness of Medicare by using short-term budget gimmicks that do not solve the problem.

Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.

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

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

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

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

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

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:

• On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
• On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
• On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.

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.

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

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)

Voted YES on expanding enrollment period for Medicare Part D.

Voted YES on increasing Medicaid rebate for producing generics.

Voted YES on negotiating bulk purchases for Medicare prescription drug.

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

Voted YES on allowing reimportation of Rx drugs from Canada.

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

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

Voted YES on including prescription drugs under Medicare.

Voted NO on limiting self-employment health deduction.

Voted YES on increasing tobacco restrictions.

Voted NO on Medicare means-testing.

Voted YES on blocking medical savings acounts.

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

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.

Establish 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.