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During the seemingly endless 2021 congressional negotiations over the Build Back Better Act, Senator Bernie Sanders introduced legislation that would have given Medicare the opportunity to pay for drugs through a competitive bidding process. He envisioned using the hundreds of billions of dollars in savings to provide deficit-neutral financing for new vision, hearing and dental benefits for regular Medicare enrollees.
“You’ve got senior citizens whose teeth are rotting in their mouth. Older people who can’t talk to their grandchildren because they can’t hear them because they can’t afford a hearing aid. And people who can’t read a newspaper because they can’t afford glasses,” Sanders told NBC News in May 2021. “So to say that dental care, hearing aids and eyeglasses should be a part of Medicare makes all the sense in the world.”
Cutting pharmaceutical prices and expanding Medicare coverage both polled above 70% and were among the most popular items in the sprawling Build Back Better package. They were also politically strategic: Older voters are disproportionately concentrated in swing states — Pennsylvania, Michigan, Wisconsin, Arizona and Florida — that will play a key role in deciding the 2024 presidential race and, perhaps, the future of the republic.
Sanders’ grand plan died in the House Energy and Commerce Committee in September 2021 when three conservative Democrats joined Republicans in refusing to allow Medicare to negotiate drug prices. Progressives howled at three pharma-friendly turncoats — Kathleen Rice (D-NY), Scott Peters (D-CA) and Kurt Schrader (D-O) — who tanked the measure. But, neither the Biden administration nor leading congressional Democrats had shown much enthusiasm for Sanders’ plan to make Big Pharma pay for hearing aids, eyeglasses and a trip to the dentist for millions of eldely Americans.
It would have rankled Big Pharma, which is a lucrative source of campaign donations for both parties. It also would have displeased the private health insurance industry, another major source of campaign cash. Adding vision, hearing and dental as benefits to regular Medicare would have undermined a key part of private insurers’ Medicare Advantage business model — dangling much-needed benefits in front of regular Medicare enrollees who are invited to gamble on whether they will experience more dire medical problems that require more costly treatments that a Medicare Advantage provider may ration or deny them altogether.
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