• Politics

Clinton and Sanders Offer Competing Visions of Health Care

6 minute read

Hillary Clinton will announce a detailed plan to reduce the cost of prescription drugs and build on President Obama’s Affordable Care Act, as she seeks to head off a strong primary challenge from liberal Vermont Sen. Bernie Sanders.

Clinton will reveal her plan on Tuesday in Iowa, where Sanders is edging her out in some recent polls. Her proposals would more tightly regulate pharmaceutical companies and aim to significantly reduce drug costs, particularly for seniors.

Under the plan, monthly out-of-pocket costs for all patients would be limited at $250 per month for individuals, which her campaign said would help up to one million Americans. She would also require pharmaceutical companies to pay higher rebates to Medicare in exchange for the federal program insuring prescriptions drugs, a measure her campaign says would save the program $100 billion.

The Democratic frontrunner has made controlling healthcare costs a key theme this week and began talking more in depth about costs on Monday during a campaign visit to Baton Rouge, La.

“As your President, I want to build on the progress we’ve made,” Clinton told a group of voters Monday. “I’ll do more to bring down health care costs for families, ease burdens on small businesses, and make sure consumers have the choices they deserve.”

“And frankly, it is finally time for us to deal with the skyrocketing out of pocket health costs, and particularly runaway prescription drug prices,” she added.

Clinton and Sanders both support similar measures to reduce the costs of prescription drugs but have profoundly different visions of healthcare in the United States. The Democratic frontrunner supports continuing to build on the Affordable Care Act with legislation to reduce healthcare costs, while Sanders believes in replacing Obamacare with a single-payer system of the kind common in Canada and Western Europe.

See Bernie Sanders' Career in Photographs

Bernie Sanders - Career in Pictures
Bernie Sanders (R), member of the steering committee, stands next to George Beadle, University of Chicago president, who is speaking at a Committee On Racial Equality meeting on housing sit-ins. 1962.Special Collections Research Center/University of Chicago Library
Bernie Sanders - Career in Pictures
A photo taken on July 22, 2015 of Bernie Sanders and his son is seen in an old clip from an alternative newspaper called the Vermont Freeman in Burlington, VT.The Washington Post/Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders in his office after winning his first election as the mayor of Burlington, Vt. on Sept. 15, 1981.Donna Light—AP
Bernie Sanders - Career in Pictures
Bernie Sanders, right, greeted voters at a Burlington polling place on March 1, 1983 in Burlington, Vt.Donna Light—AP
Bernie Sanders - Career in Pictures
Bernie Sanders and his campaign celebrating after his mayoral re-election circa 1983 in Burlington, Vt.Courtesy of Bernie Sanders Campaign
Bernie Sanders - Career in Pictures
Bernie Sanders recording his singing in a studio Nov. 20, 1987 in Burlington, Vt.Toby Talbot—AP
Bernie Sanders - Career in Pictures
Bernie Sanders and his wife Jane O'Meara in Washington circa 1991.Courtesy of Bernie Sanders Campaign
Bernie Sanders - Career in Pictures
Bernie Sanders, James Jeffords and Patrick Leahy toast to the passing of the Northeast Dairy Compact on June 14, 2006 in Montpelier, Vt.Toby Talbot—AP
Bernie Sanders - Career in Pictures
Bernie Sanders officially announces his candidacy for U.S. Senate on May 19, 2006, at the Unitarian Church in Burlington, Vt. Alden Pelett—AP
Bernie Sanders - Career in Pictures
Bernie Sanders and the other members of the Vermont Congressional delegation at the annual lighting of U.S. Capitol Christmas on Dec. 5, 2007 in Washington.Chip Somodevilla—Getty Images
Bernie Sanders - Career in Pictures
Senate Majority Leader Harry Reid speaks during a rally in support of Social Security with Sen. Tom Harkin and Bernie Sanders on March 28, 2011 in Washington.Chip Somodevilla—Getty Images
Bernie Sanders - Career in Pictures
Rep. Steve Cohen and Bernie Sanders attend a rally near the reflection pool, held by 350.org to protest the amount of money members of Congress receive from the fossil fuel industry on Jan. 24, 2012. Tom Williams—Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders at the signing ceremony of Veterans' Access to Care through Choice, Accountability, and Transparency Act on Aug. 7, 2014 in Belvoir, Va.Alex Wong—Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders waits to speak at a rally to advocate for an increase in pay to $15 USD per hour, as part of a "Fight for $15" labor effort on April 22, 2015 in Washington.Brendan Smialowski—AFP/Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders shakes Colleen Green's hand as he leaves a town hall meeting on May 11, 2015. in Charlottesville, Va.Jay Paul— Reuters
Bernie Sanders - Career in Pictures
Bernie Sanders kisses his wife, Jane O'Meara, before officially announcing his candidacy for the U.S. presidency during an event at Waterfront Park May 26, 2015 in Burlington, Vt. Win McNamee—Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders delivers remarks at a town meeting at the South Church May 27, 2015 in Portsmouth, N.H.Win McNamee—Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders speaks during a news conference to discuss legislation to restore pension guarantees for thousands of retired union workers on June 18, 2015 in Washington.Jim Watson—AFP/Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders kisses his wife Jane O'Meara during a campaign event on Aug. 10, 2015 in Los Angeles.Bloomberg/Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders speaks to a primarily Latino audience during a campaign stop at the Muscatine Boxing Club on Sept. 4, 2015 in Muscatine, Iowa.Bloomberg/Getty Images
Bernie Sanders - Career in Pictures
Bernie Sanders and Jerry Falwell Jr., president of Liberty University, listen to a prayer during a Liberty University Convocation on Sept. 14, 2015 in Lynchburg, Va.Bloomberg/Getty Images
Bernie Sanders - Career in Pictures
Democratic presidential candidate Sen. Bernie Sanders, right, and his wife Jane O’Meara, wave to the crowd as he is announced onstage to speak to supporters during a campaign rally on Sept. 14, 2015 in Manassas, Va.Cliff Owen—AP
Bernie Sanders - Career in Pictures
Bernie Sanders joins Cornell William Brooks in a march with the National Association for the Advancement of Colored People (NAACP) on Sept. 15, 2015 from Selma, Ala. to Washington.Brendan Smialowski—AFP/Getty Images

The Clinton plan would set up stricter controls on advertising by the pharmaceutical industry, which has often been criticized for being misleading and expensive. For example, the United States is one of the few industrialized nations that allows direct-to-consumer advertising of pharmaceutical drugs; a 2004 study by the FDA found that 58 percent of doctors agreed that ads make drugs seem better than they really are. Clinton’s plan would require that companies receiving federal support to invest in research, and it would set up a tighter review process by the FDA of pharmaceutical advertising.

Clinton’s plan would also allow Medicare to negotiate drug prices, using its leverage and purchasing power of more than 40 million enrollees to drive down drug costs. It’s a measure Clinton supported during her 2008 campaign.

Just two days before she announced her plan, Sanders campaigned in New Hampshire on a similar message of reducing healthcare costs, speaking with seniors at the Riverwoods Retirement Community in Exeter, N.H., about the rising costs of prescription drugs.“Today, Americans pay, by far, the highest prices for prescription drugs anywhere in the world,” Sanders said on Sunday.

Read More: Bernie Sanders Brushes Off Clinton Super PAC Attacks

Sanders’ plans to address rising drug costs are similar in important ways to Clinton’s. He has introduced legislation that would also allow Medicare to negotiate with pharmaceutical companies to lower the prices of prescription drugs. Sanders also supports allowing the importation of drugs, and his legislation calls for individuals and pharmacists to import generic versions of prescription drugs from Canada, where drug prices are significantly lower than in the United States.

On Monday, he joined Rep. Elijah Cummings in writing an open letter to Turing Pharmaceuticals, the maker of a drug whose price skyrocketed from $13.50 per tablet to $750 after the company was purchased. The letter came the same day that Clinton tweeted that the drug’s price hike was “outrageous.”

Despite the similarities in the two Democrats’ plans, however, they have a fundamentally different vision of healthcare in the United States.

Clinton has made the defense of Obamacare a key platform of her campaign, vocally supporting of the Affordable Care Act and strongly criticizing Republicans for their calls to repeal it.

Sanders has offered a more radical plan, supporting a single-payer system of the kind common in Western Europe and Canada. Sanders’ proposal would establish healthcare as a right to all U.S. citizens and be paid for through government spending. Under his plan, for-profit health insurance companies would provide only supplemental coverage.

Clinton has stood by the Affordable Care Act, repeatedly praising different aspects of the law, such as a provision that allows young people to stay on their parents’ insurance until they turn 26, an increase in the number of insured Americans and a measure that bars insurance companies from denying coverage for preexisting conditions.

The primary fight foreshadows another argument in the general election with the eventual Republican nominee, which Clinton has already started preparing for. As she announced her plan, Correct the Record, a super PAC supporting her campaign, released a barrage of facts detailing Republicans’ stance on prescription drugs.

Read More: Hillary Clinton Attacks Jeb Bush During Colorado Trip

On Monday, Clinton also criticized Republicans for seeking to repeal Obamacare.

“Well, I’ll tell you, I’m not going to let them rip away the progress we’ve made,” Clinton said. “I’m not going to let them tear up that law, kick 16 million people off their health coverage, and force this country to start the health care debate all over again. Not on my watch.”

Sanders, who voted for the Affordable Care Act, says the legislation made important first steps, but also has said repeatedly he views health care as a human right.

Republicans, meantime, were quick to attack Clinton’s support for the Affordable Care Act.

“Hillary Clinton’s renewed embrace of Obamacare—with its job-killing mandates, higher premiums, and broken promises—shows just how desperate she is to change the subject from her growing email scandal,” said RNC spokesman for Michael Short on Monday. “But by doubling down on a failed law voters have always opposed, Hillary Clinton is once again reminding them how out of step she is with them on the issues.”

See Hillary Clinton's Evolution in 20 Photos

Hillary Rodham Clinton
Teenager: Hillary Rodham poses in her 1965 senior class portrait from Park Ridge East High School in Illinois. AP
Hillary Rodham Clinton
Law School Student: Bill Clinton and Hillary Rodham pose for a snapshot at Yale Law School in 1972. They married in 1975.Clinton Presidential Library
Hillary Rodham Clinton
Mother: Clinton poses with her husband, Bill, then in his first term as governor, with their week-old daughter, Chelsea, on March 5, 1980.Donald R. Broyles—AP
Hillary Rodham Clinton
Campaign Companion: Clinton celebrates her husband's victory in a Democratic runoff in Little Rock, Ark. on June 8, 1982.AP
Hillary Rodham Clinton
Arkansas First Lady: Clinton is seen in her inaugural ball gown in 1985. A. Lynn—AP
Hillary Rodham Clinton
Political Wife: Clinton celebrates her husband's inauguration in Little Rock on Sept. 20, 1991.Danny Johnston—AP
Hillary Rodham Clinton
Dignitary: Clinton receives an honorary law degree from Hendrix College in Conway, Ark., on May 30, 1992.Chris Ocken—AP
Hillary Rodham Clinton
Campaigner: Clinton speaks at a meeting during the presidential campaign for her husband in Buffalo, N.Y., on April 4, 1992.Bill Sikes—AP
Hillary Rodham Clinton
First Lady: Clinton appears at the MTV Inauguration Ball at the Washington Convention Center on Jan. 20, 1993. Shayna Brennan—AP
Hillary Rodham Clinton
Second-Term First Lady: Clinton attends the Inaugural Ball after her husband was sworn in to a second term on Jan. 20, 1997. Brooks Kraft—Corbis
Hillary Rodham Clinton
New York Senator: Clinton speaks at a press conference with female Democratic senators in Washington on June 21, 2006. Brooks Kraft—Corbis
Hillary Rodham Clinton
Committee Member: Clinton listens to the testimony of Lt. General David Petraeus to the Senate Armed Forces Committee at a hearing on Capital Hill in Washington on Jan. 23, 2007. Brooks Kraft—Corbis
Hillary Rodham Clinton
Candidate: Clinton holds a a campaign event in Portsmouth, N.H., while running for the Democratic presidential nomination on Sept. 2, 2007. Brooks Kraft—Corbis
Hillary Rodham Clinton
Campaigner: Clinton speaks at a campaign stop in Cedar Rapids, Iowa on Jan. 2, 2008. Brooks Kraft—Corbis
Hillary Rodham Clinton
Secretary of State: Clinton kisses President Obama at a joint session of Congress in Washington on Feb. 24, 2009. Brooks Kraft—Corbis
Hillary Rodham Clinton
Witness: Clinton joins Chairman of the Joint Chiefs of Staff Admiral Michael Mullen and Secretary of Defense Robert Gates before the Senate Foreign Relations Committee on Dec. 3, 2009. Brooks Kraft—Corbis
Hillary Rodham Clinton
Witness: Clinton testifies before the Senate Foreign Relations Committee hearing on the deadly attack on the U.S. diplomatic mission in Benghazi, Libya, on Jan. 23, 2013.J. Scott Applewhite—AP
Hillary Rodham Clinton
Author: Clinton attends a signing memoir, "Hard Choices," at a Costco in Arlington, Va., on June 14, 2014. Brooks Kraft—Corbis
Hillary Rodham Clinton
Grandmother: Clinton holds her granddaughter Charlotte Clinton Mezvinsky at Lenox Hill Hospital in New York City on Sept. 27, 2014.Office of President Clinton/AP
Hillary Rodham Clinton
Once and Future Candidate: Clinton speaks at Iowa Senator Tom Harkin's annual Steak Fry in Indianola, Iowa, on Sept. 14, 2014. Brooks Kraft—Corbis

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