Medicare for All

Congressman Kucinich, along with Congressman John Conyers (D-MI), introduced HR 676, Medicare for All, a bill to provide high-quality health care to every American. This bill would provide all Americans the health care they need, from any doctor they choose, at a universal, high standard of quality. Americans would not be burdened with co-payments, premiums or deductibles. Rather, they would be guaranteed access to medically necessary health care, including inpatient and outpatient care, dental care, vision care, pharmaceuticals, and other treatments that a patient’s doctor would deem necessary.

Medicare for All would cost the same amount of money that is now spent on health care costs.  Funds would be provided by savings from a vast reduction of paperwork, existing government spending on healthcare, savings from rational bulk procurement of medications, a tax on the top 5 percent of income earners, a small tax on stock and bond transfers, and a phased-in payroll tax that is less than what employers currently pay on average for less complete employee health coverage.

The Conyers/Kucinich bill is the signature national health insurance bill currently before Congress. The bill has more co-sponsors than ever before. HR 676 had 93 co-sponsors in the 110th Congress. The list of 93 cosponsors includes 8 Chairs of full committees and 37 Chairs of subcommittees.

The bill is the centerpiece for a growing national movement. Its supporters include 14,000 physicians, several thousand nurses, former Surgeons General, former Editors of the New England Journal of Medicine, over 461 union organizations in 49 states including 114 Central Labor Councils and Area Labor Federations and 39 state AFL-CIOs, Ohio and Cleveland AFL-CIO, Kentucky State Senate, and dozens of cities.  The American College of Physicians, the National Presbyterian Church and the US Conference of Mayors have also endorsed single-payer.
When Congress considered the budget resolution, H.R. 676 was included as part of the Progressive Caucus’ Alternative Budget resolution.

On May 1, 2001, Congressman Kucinich, on behalf of the Progressive Caucus, hosted a Universal Health Care Briefing in collaboration with the Congressional Black Caucus and Hispanic Caucus. Congressman Kucinich brought together 12 members of Congress, former Secretary of Labor Robert Reich, Marcia Angell, former editor of the New England Journal of Medicine, as well as numerous other doctors, nurses, health care advocates, and patients. As part of the briefing, the Physicians for a National Health Program presented a proposal of a national, single-payer health plan.

Click here to watch, listen or read the Webcast of the Health Care Briefing

Summit on the Future of Medicare 

Congressman Kucinich hosted a Senior Summit on the Future of Medicare at a packed Parma Senior Center on October 19, 2007, with more than 400 attendees. The event was a follow up to the 13 town hall meetings Kucinich hosted in 2005 during the Social Security privatization debate. Kucinich detailed the consequences of the Medicare prescription drug program known as “Part D” and the Medicare Advantage program.  He gave highlights of the House Government Reform Committee report, which he requested along with other Members of Congress. He explained how high administrative costs, profits, and overpayments are placing Medicare finances at great risk. Many in the Parma audience shared moving personal experiences about inadequate, costly health coverage for senior citizens and the disabled. Others emphasized the need to continue to speak out and organize around the issue. Congressman Kucinich connected many audience members in need of assistance with his staff who have extensive experience in helping constituents.

Kucinich Wins Five Amendments to Health CareReform Bill

During consideration of HR 3200, America’s Affordable Health ChoicesAct in the Committee on Education and Labor, Congressman Kucinich added 5separate important amendments to improve the bill.

The first amendment created an opening for thesingle payer health care movement by eliminating a federal barrier to stateschoosing to enact single payer health plans.  Although the amendment doesnot create a single payer health care system, it removes a major obstacle forany state that wishes to pursue the single payer option.   This amendmentbuilds on the momentum of the national movement for single payer health care.

For years there has been a growing support for afundamental change in the way we look at health care in this country.  Asingle payer health care plan is the best and most tested way to provide healthcare for everyone while increasing quality and controlling costs.  The amendment removes a legal obstacle tostates that choose single payer plans.  The Employee Retirement IncomeSecurity Act (ERISA) has been used to pre-empt health care reform at a statelevel if the state efforts challenge employer-based health care plans.  TheHouse Education and Labor Committee passed the Kucinich Amendment by a bipartisan27-19 vote.

In addition to securing a historic victory forstates’ single-payer health care, Congressman Kucinich won adoption of fourother amendments. 

1.      Physician Prescribing Habits - Drivedown the cost and increase the access of prescription drugs by ending thepharmaceutical industry’s practice of manipulating physician prescribing habitsto pharmaceutical representatives;

2.      Consumer Costs and Plans Protection - Endthe insurance industry practice of raising costs or decreasing coverage forAmericans during the time Americans are not allowed to switch plans;

3.      Physician Tracking - Require thedisclosure of insurance company costs like advertising and marketing costs, aswell as executive compensation, that use consumer’s money to increase profitsinstead of covering care;

4.      Integrative Health Care - Improve accessto integrative medicine by requiring its consideration for standard coverageand by requiring the identification of integrative medicine providers.

1. PhysicianPrescribing Habits

Many people know that the pharmaceutical industry has anarmy of lobbyists that focus not on Congress, but on doctors.  They try to get doctors to prescribe theirdrugs, which are usually more expensive, even when there is an equallyeffective but cheaper drug available.And it works.  That is why thepharmaceutical companies hire so many doctor lobbyists.  Most people don’t know, however, that apharma representative will buy a list of what the doctor has prescribed beforeshe goes to visit that doctor.  By knowingthat the doctor is prescribing a competitor’s pill instead of their own, theycan more effectively manipulate the doctor.When doctors prescribe more expensive drugs, it drives up the cost ofhealth care and undermines the integrity of the doctor-patient relationship.

My amendment prohibits the sale of physician prescribing habitsto pharmaceutical representatives. This will allow doctors to prescribe fortheir patients the best medication for them, without the influence of drugcompanies. The amendment will also protect patients’ confidential prescriptiondrug records and increase access to cheaper generic drugs.  Three states have already passed such laws.

2. Consumer Costs andPlans Protection

Consumers must have confidence that when they sign up for ahealth insurance plan, the costs and coverage will not be subject to the whimof the health insurance company. If the consumer can’t quit the insurancecompany part of the way through the year, the insurance company should not beable to raise the premium or take a drug off the formulary or reduce coverageof an illness.  If the patient has to doit, so should the insurance company. 

My amendment protects consumers by prohibiting insurancecompanies from changing the coverage or increasing costs in the middle of aplan year.  This is a pro-consumeramendment that protects Americans and ensures that health insurance companieshold up their end of the bargain.

3. Physician Tracking

Oftentimes, when consumers are weighing their healthinsurance options, they are afraid to change insurance providers for fear thatthey will lose access to their doctor of choice. Now, in order to find outwhether a doctor is covered in a given insurance plan, you have to leaf throughevery plan.  But if there is a doctor youwant, you should be able to go to a website, click on that doctor’s name, andsee which insurance plans include that doctor in your network. 

If the insurance they choose does not include a physicianin-network, the consumer will incur additional costs.

This amendment makes it easier for consumers to compare healthinsurance plans by requiring the online Exchange, the portal through which allnon-employer health insurance plans will be offered, to enable Americans toeasily see all the insurance plans that include a given doctor in theirnetwork. The consumer will be able to simply click on their doctor’s name andreceive a list of insurance plans that include that doctor in-network.  It will help customers better understand whichinsurance plan is right for them.

4. Integrative HealthCare

A 2008 study by the NationalCenter for Complementary andAlternative Medicine and the NationalCenter for HealthStatistics revealed that 38% of American adults used some form of alternativemedicine to meet their health care needs; however, access to these services islimited because of lack of insurance coverage of these safe, cost-effective andclinically effective medical approaches.

As more and more Americans turn to alternative medicaltherapies to meet their medical needs, any reform of the health care systemmust reflect this and ensure that someone’s access to these therapies is notlimited by their financial situation.

This amendment recognizes the growing popularity andimportance of integrative medicine by guaranteeing that a practitioner ofintegrative medicine is one of the people that decides the minimum requiredbenefit package.  It also creates a taskforce of integrative medicine practitioners to help inform the decision makersabout what should be covered.  Finally,it requires that when you go to the Exchange website and look up doctors, anypractitioners of integrative medicine are easily identifiable.

Senior Summits on Medicare and Transportation

Congressman Kucinich held three Senior Summits on September 2, 2008, at the Donna Smallwood Parma Senior Center, the Westside Community House, and the Garfield Middle School in Lakewood. At each summit, Kucinich highlighted recent, important changes to Medicare enacted in H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008, which overwhelmingly passed both houses of Congress over President Bush’s veto.  He discussed the restoration of the scheduled 10% cuts to physicians through decreasing overpayments to private Medicare plans over time, the expansion of eligibility for Medicare Savings Programs, the increase of some preventative benefits, the postponement of rules which would have limited access to Durable Medical Equipment provider choice, and the establishment of greater mental health care parity. 

Kucinich also outlined his introduction of the Medicare Drugs for Seniors (MEDS) Act of 2008, which would replace the privatized Medicare prescription drug benefit with a simplified, comprehensive prescription benefit program for all Medicare beneficiaries. He also discussed recent developments in transportation for seniors and the disabled, including RTA service issues.

Health Care Tax Credit (HCTC)

With the loss of approximately three million manufacturing jobs in the United States since 2001, many families know the effects of increased foreign imports and the outsourcing of their jobs too well.  The Health Care Tax Care Credit (HCTC) was created to ensure that the workers who lost these good manufacturing jobs would still be able to afford health insurance for themselves and their families. Working Americans who have lost these jobs should not also have to endure lost or inadequate health insurance.

Unfortunately, the spouse of the wage earner will suffer the devastating loss of this needed financial assistance to obtain healthcare coverage when the qualifying wage earner becomes Medicare eligible. The current eligibility requirements for the HCTC program leaves a Medicare-ineligible spouse without continued assistance under the HCTC, which frequently means being left entirely without health care. 

Congressman Kucinich endeavored to close this unintended and unfair consequence of current law. Working with the Subcommittee prior to the introduction of H.R. 3920, the Trade and Globalization Act of 2007, Congressman Kucinich worked to ensure that language was included in the bill to extend eligibility for the HCTC to spouses and widows in situations where the wage earner has become Medicare eligible or passed away.

Investigation into Availability of Pediatric Dental Care Under Medicaid

After the death of a twelve-year-old boy from a brain infection caused by untreated tooth abscess, the Subcommittee undertook an investigation into the circumstances of his death and the adequacy of the health care he received.

The Domestic Policy Subcommittee held a hearing, entitled, “Evaluating Pediatric Dental Care under Medicaid,” to question the director of Medicaid, the Maryland State Medicaid Director and the managed care insurance organization that was responsible for the boy’s care.

The Subcommittee analyzed thousands of records produced by the boy’s Medicaid Managed Care Organization. In a letter, the Subcommittee published its findings: The boy was one of 10, 780 Medicaid-enrolled children who had not seen a dentist in four or more years; that most of the dental services provided by the MCO were delivered by only seven dentists; and that the MCO’s directory of providers was virtually useless. In response, the MCO conceded that the Subcommittee’s findings were correct and committed to rectifying its shortcomings.

Medicare Part D

In November 2003, during debate on HR 1, The Medicare Modernization Act, Congressman Kucinich stated, “This so-called Medicare ‘reform’ bill is nothing but a sham…. Medicare privatization is bad for seniors, bad for retirees, bad for employers, and bad for the economy. The only ones who benefit from this plan are the pharmaceutical companies and HMOs who seek to continue health care for profit in this country.” Congressman Kucinich voted against the legislation.

Today, as millions of seniors are confused by the plans that are so complex, even the Center for Medicare and Medicaid Services (CMS) cannot effectively implement them, Congressman Kucinich’s words ring true. Medicare Part D has benefitted the pharmaceutical and insurance companies at the expense of seniors and the disabled.

Despite Congressman Kucinich’s strong opposition to the bill, it is now law and he has worked to assist seniors in signing up for the proper plan for their needs. Congressman Kucinich has reached out to community leaders, senior groups and local pharmacies to help seniors get the all the information they need to decide which plan to choose, if any. In addition, Congressman Kucinich has co-sponsored legislation to extend the enrollment deadline from May to December and allow seniors to change plans once they are enrolled.

Congressman Kucinich also introduced a bill to replace the current privatized Medicare drug plan with one administered fully by Medicare.  H.R. 6800, The Medicare Drugs for Seniors Act, or MEDS Act, allows citizens to purchase their prescription drugs from an approved list of foreign countries, where those drugs sell for considerably less.  The bill also requires that Medicare use its bulk purchasing power to negotiate drug prices with the pharmaceutical industry, like the Department of Veterans Affairs does.  Finally, the bill would impose limits on prices pharmaceutical companies would be allowed to charge, if the research and development that led to the drug’s discovery had been financed by taxpayer dollars.  The bill uses the substantial savings from those provisions to provide comprehensive pharmaceutical coverage with no premiums, no co-pays and no deductibles.

Low–income Assistance for Medicare Beneficiaries

The Qualified Individual, or “QI” program, pays the monthly Medicare part B premium for low-income beneficiaries. On September 30, 2005, the authorization for QI expired. If it was not reauthorized, over 160,000 low-income seniors and those with disabilities would have lost this crucial assistance on which they rely to cover their health care costs. That means that some people who make less than $1,092 per month would have lost almost 10% of their income.

Congressman Kucinich introduced a bipartisan bill to continue the QI program. The extension of the program was supported by 35 separate health advocacy organizations. Because of the work of Congressman Kucinich, and others in Congress, the program was eventually reauthorized for two years.

Congressman Kucinich continues to urge Congress to turn its attention to a more permanent solution. Every year the benefit has strong support and, more often than not, there is a last minute rush to keep it alive. Congressman Kucinich continues to work to push Congress to pass a permanent reauthorization.

Avian Flu

If the highly pathogenic avian influenza strikes the US, we will need to marshal all of the world’s intellectual capacity to fight it and to minimize its effects.  The free flow of information, in particular, can accelerate research, and the development of vaccines, saving lives. In the case of Avian Flu, the very properties we fear the most - the ease with which the virus is transmitted and its ability to kill its host - are revealed in the virus' genome. Yet the genetic sequences are currently only immediately available to a select group of researchers, a practice which is hampering and delaying our ability to respond to the threat of the pandemic influenza. 

Congressman Kucinich organized a bipartisan group of cosigners to his letter to the Secretary of Health and Human Services.  The letter requested that all genetic and clinical data from Avian Flu research funded with American taxpayer dollars should be placed in a database for all researchers to analyze.  The letter was well received, garnering mention in Nature, one of the world’s most prestigious scientific publications.  The week after the letter was sent, Nature obtained leaked copies of the genetic sequences of the famed 2006 Indonesian familial cluster of 8 cases where the virus was passed from human to human.  They showed that there were significant mutations between each individual victim.  One of those changes showed an Avian Flu virus that was resistant to one of the few drugs we have against the Avian Flu, contrary to what Indonesian officials told the public.  Had this not been leaked to Nature, the truth may have never been told.   It was a clear case demonstrating why the genetic sequences should be publicly available.

After the Nature story ran and the Kucinich letter was sent, a steady stream of genetic sequences both inside and outside the US has been released.  The Centers for Disease control released 650 sequences from its database.  Indonesia released the sequences from the human-to-human cluster.  An initiative by some of the top Avian Flu scientists in the world, including Nobel Prize winners, was announced.  The group pledged to place sequences from their research into publicly available repositories.  Congressman Kucinich is pleased with the progress and will continue to work until all Avian Flu data is publicly available.

As experts continue to predict an outbreak of avian flu, and as the H5N1 virus is rapidly spreading in birds all over the world, it is more important than ever that we are prepared. Based on current information, an important part of our defenses will be the anti-viral drugs Tamiflu and Relenza. Early reports indicate that world demands for Tamiflu would not be met for 10 years. There is no reliable timeline for when US stockpile needs would be met. We must do all we can immediately to shore up our stockpile. Put simply, that means compulsory licensing.

Roche, maker of Tamiflu has twice announced their intention to begin negotiations with generics manufacturers. At the same time, generics manufacturers have expressed concern that Roche will change fees that are prohibitive. Roche has also indicated that they will take measures to insure that generic versions of the drug will not be sold in the U.S., which only marginally helps our efforts to stockpile.

Congressman Kucinich led his colleagues to call for Roche to release the patent to other manufacturers in order to meet world demand. After questioning Secretary Leavitt on HHS's unwillingness to do so, Congressman Kucinich and two colleagues followed up with a letter refuting Secretary Leavitt's stated reasons for failing to issue a compulsory license and renewed the call for it.

High Gas Prices and the Older Americans Act

The Older Americans Act provides several valuable services to millions of seniors in order to help them to maintain independence, dignity and health.  Many of those services require transportation and are being hit hard by fuel costs.  When the Older Americans Act came through the Education and Workforce Committee, of which Congressman Kucinich is a member, he introduced an amendment to address this problem. 

The Kucinich Amendment would have provided a formula for calculating annual increases in fuel costs for the three Older Americans Act programs that are the most heavily dependent on transportation.  These programs include the in-home nutrition services, the nutrition services in congregate settings like nursing homes, and the supportive services that provide rides to doctor’s appointments, trips to the grocery store and to senior centers, among other services.

These programs have been successful and important to seniors.  In FY2003, the Supportive Services gave almost 36 million rides and provided 20 million hours of personal care, homemaker and chore services.  In that same year, 248 million meals were served.  Fifty seven percent were provided in the home with the remainder in group settings.  Each meal required transportation.

The Kucinich Amendment failed on a party line vote in Committee.  When Congressman Kucinich attempted to offer it on the floor of the House of Representatives, it was blocked from consideration by the Republican majority.

Association Health Plans

Congressman Kucinich offered two amendments to H.R. 525, the Association Health Plans bill in the 109th Congress.

1. A Boston University study found that the US pays the highest drug prices in the world.  How much more?  81% more than seven developed nations in 2003.  And it is getting worse.  In 2000, the difference was 60%.  A big part of the problem is the exorbitant marketing and lobbying practices of big pharma.  For example, in 2001, the pharmaceutical industry hired 88,000 sales representatives to visit doctors in their offices and their hospitals in order to sell them on their company’s drug.  They also spent approximately $3 billion on advertising to consumers.  Pharma calls this “education.”

But these amounts are only estimates.  In our economic system, accurate information is the prerequisite for free and fair markets.  People need to know what they are paying for.  Congressman Kucinich offered an amendment in Committee that would give AHP consumers information they need to make informed decisions about spending their health care dollars.  With more information, the market should be able to lower prices, which will help AHPs to avoid the financial problems they will inevitably have.

Congressman Kucinich's amendment would require, as a condition of having a patented product like prescription drugs covered by an Association Health Plan, that the companies seeking to sell them to AHP customers would have to disclose the costs of marketing, public relations and research and development to AHP members.  The amendment failed by a party line vote.

2. Congressman Kucinich attempted to offer another amendment when HR 525 came to the House Floor. But the Republican leadership wrote the rule for the bill in a way that precluded it from even being considered.  The amendment prevented administrative costs for AHPs from being more than seven times that of Medicare, drawing attention to the inefficiency of AHPs and the efficiency of Medicare.

One of the biggest reasons that America’s health care costs are so high is that we pay far more for administrative costs in privately administered health plans than other industrialized nations.  The average private health plan gives 12-15% - sometimes as high as 30% - of your health care dollar to administrative costs.  AHPs would not only fail to address this problem, but could make it worse.  In fact, a study by human resources consultants, William Mercer, Inc. found that “… the potential administrative cost increases typically would exceed the potential administrative cost savings.  We estimate that the additional costs for small firms who buy AHP coverage typically would range from 1.5% to 5% of premiums."  That is above and beyond the average administrative costs of 12-15%.

Now contrast that with the overhead costs of Medicare, whose administrative costs are 2-3%!  That means that Medicare is about 5 times more efficient then private health plans and could be 7 to 10 times more efficient than AHPs.

Durable Medical Equipment

Congressman Kucinich contacted the Center for Medicare and Medicaid Services (CMS) to voice concern about the contract deadline for suppliers of Durable Medical Equipment to bid on becoming a Medicare reimbursed provider.  Their certification process for bidders was backlogged and not able to complete the application in time to meet the deadline.  A local business had applied for certification to become a bidder because Medicare reimbursed business was the largest part of this providers customer base.  Congressman Kucinich pursued CMS on this matter and they extended the contract deadline for all applicants nationally.

Free Market Drug Act

The main reason that drugs are costly is that the government grants manufacturers patent monopolies, prohibiting normal market competition for long periods of time. These monopolies allow manufacturers to charge several hundred percent, sometimes several thousand percent more than the competitive market price. For example, some patent protected AIDS drugs originally sold at prices of more than $10,000 for a year's dosage. Generic producers, who manufacture and sell the drugs in a competitive market in other countries, are able to make a profit charging less than $200 a year for the same drugs. Simply put, if drug manufacturers were operating in a free market like most other businesses in the US, drug prices would be significantly lower.

In addition, pharmaceutical companies are putting out declining numbers of "breakthrough" drugs that represent large steps forward for public health. Instead, they frequently try to tweak a currently patented drug enough to extend the patent life so they can continue to charge prices at far above market value. According to the FDA, over 70% of new drugs are "copycat" drugs like Clarinex, a slightly different (and newer) version of Claritin. The result is too many drugs that simply make money but do not substantially contribute to our health.

Congressman Kucinich introduced the Free Market Drug Act, which would effectively result in most major drugs being priced as generics by removing patent protection on pharmaceuticals produced with public funds. The bill would fund the world-renowned National Institutes of Health (NIH) to perform or control the research and development (R&D) on pharmaceuticals in the US. Some funds would be used to expand NIH's capacity to do R&D and other funds would be granted to pharmaceutical companies and universities who already have the infrastructure to do that research. But whenever a drug developed with public funds was ready to be marketed, any qualified entity able to get FDA approval would be able to manufacture and distribute it. This introduces free market competition and consumers could expect much lower prices as a result.

Another advantage of this bill is that pharmaceutical companies would not make the decisions about which drugs to research based on which had the highest profit margins. Instead, some of the best scientists in the world at NIH would make that decision based on the greatest public health need. Finally, any NIH funded pharmaceutical researchers would be required to publish their results in order to ensure all data about drug performance - good and bad - will not be hidden from the public. This is especially important in light of the recent controversies surrounding drugs like Vioxx and Prozac, when pharmaceutical companies withheld safety data.

The savings to the government and consumers from competition in the prescription drug industry would likely exceed $130 billion annually.

In summary, the Free Market Drug Act would do three things. First, it would turn most of the drug market into one that uses competition to bring drug prices down to the level of generics. It would do that by effectively removing monopoly protection drug makers currently enjoy that allows them to charge what they will. Second, drug profitability would not dictate which drugs would be researched. Instead, that decision would be based on the greatest public health need. Third, most drug researchers would be required to publish their results, making it exceptionally difficult to withhold data.

Using Free Trade Agreements to Inflate the Price of Drugs in Guatemala

One of the most harmful aspects of free trade agreements like the Central American Free Trade Agreement (CAFTA) has been the intellectual property (IP) provisions, like those that translate into longer patent protection periods, which will limit access to affordable medicines, particularly for the poor in these countries.  The US was not able to get such strict IP protections for pharmaceutical companies that it wanted during negotiations with the Central American countries.  Congressman Kucinich learned that the US negotiators were forcing countries like Guatemala to accept the IP protections by threatening to stop CAFTA from going into effect.   He organized his colleagues to send a letter to the US negotiators at the US Trade representative’s office asking for a public admission of the practice and demanding that it stop.


Prescription Drug Reimportation

Congressman Kucinich has also supported easing regulations to permit importation of prescription drugs from countries where prices are much lower.  In June of 2005, Congressman Kucinich joined with senior Democrats in calling on Speaker Hastert to schedule a vote on a comprehensive drug importation bill. Congressman Kucinich also sent a bipartisan letter to his colleagues urging them to support legislation to bar the administration from including in future trade deals provisions making Rx drug importation impossible.

Asbestos

There is a long history of asbestos causing serious health problems and even death for people who have work with it. When the law firm of Morgan, Lewis and Bockius attempted to withdraw important asbestos guidance for mechanics through a Data Quality Act request, Congressman Kucinich spearheaded a letter to oppose this effort. While many people, including mechanics, believe that asbestos was banned, the ban was overturned more than a decade ago. Mechanics still need to take precautions when working with car brakes, which often contain asbestos. That is why the EPA’s Gold Book is an important guidance document to protect workers and individuals who work on their cars. Congressman Kucinich sent a letter to ensure that mechanics are adequately warned of the dangers of working with asbestos products and take the appropriate precautions.  In August of 2006, EPA announced they were releasing the Gold Book with recent revisions for public review.

Another government document that warns brake mechanics of exposure to asbestos in brakes is called the Asbestos-Automotive Brake and Clutch Repair Safety and Health Information Bulletin. Like the Gold book, its release was delayed, leaving mechanics with no information about their own safety.  In July 2006, Congressman Kucinich pressed OSHA to release the Bulletin by sending a letter requesting the reasons for its delay.  The Bulletin was then released.
However, representatives of the asbestos industry pressured OSHA to weaken the Bulletin by distorting the science.  OSHA then threatened the author of the Bulletin, an OSHA employee, with disciplinary action.  Congressman Kucinich wrote a letter to OSHA demanding an explanation.  They quickly replied with assurances that the Bulletin would be unchanged, would stay in public circulation, and the author would not face disciplinary action.

Read a press release from Congressman Kucinich regarding OSHA oversight on asbestos, read the report regarding OSHA's failure to monitor asbestos regulations, or read the letter from Congressman Kucinich.

Pharmaceutical Reform

In December 2002, Congressman Kucinich asked President Bush to establish a Federal Pricing Commission on Prescription Drugs after an analysis of more than 5,000 hospitals nationwide by the Institute for Health and Socio-Economic Policy (IHSP) hospitals revealed that hospitals increase the price of medication by an average of 340 percent. The Pricing Commission would be a federal commission charged with the gathering and reporting of pharmaceutical costs and charges in health facilities. “Drugs are driving up the cost of health care overall, and we must find which facilities are charging the most, and how this is impacting the rest of the health care system,” stated Congressman Kucinich.

"Big Pharma": Mergers, Drug Costs and Health Caregiver Staffing Ratios

The office of Congressman Kucinich conducted a nationwide study of hospitals to find what effect the high price of prescription drugs is having on hospitals, especially the current nursing shortage. Congressman Kucinich’s office also worked with the Institute for Health and Socio-Economic Policy to create a comprehensive report. This is what Congressman Kucinich’s survey found: 68 percent of hospital executives said that current staffing levels will likely worsen because of the pressure caused by increases in drug prices. In the Midwest, 79 percent of hospital executives said that staffing levels will worsen. Even though we are in the midst of a national hospital nursing shortage, causing emergency room overcrowding and other problems, hospitals expect that they may layoff even more nurses!

This study finds escalating drug prices - not the reductions in Medicare reimbursement rates as many contend - are the primary reason for lower revenues and profits for many hospitals and managed care plans. Hospitals and health plans have, in turn, encouraged cost cutting in the form of staffing cuts and service reductions. Meanwhile, the pharmaceutical industry is more and more dominated by a few powerful companies. The top 20 drug firms accounted for almost 60 percent of mergers and acquisitions. In any industry, this is a red flag to consumers. Drug prices are expected to go up nearly 18 percent this year, and the prices of most commonly used drugs are growing at twice the rate of inflation. Drug company mergers are therefore associated with rising prices.

The study that Congressman Kucinich has released shows that rising drug prices and mergers in the pharmaceutical industry will aggravate the nursing shortage. Now, as hospitals are in great need of resources to hire more staff, drug prices are squeezing hospital budgets to the extent that hospitals may actually fire the staff they currently have. This study shows that pharmaceutical mergers are creating a few powerful players in the industry, and are having a catastrophic effect on the health care system. As a member on the Committee for Government Reform, Congressman Kucinich plans to ask for hearings on this issue and work toward stronger enforcement of antitrust laws.

On April 19, 2004, two experts debated the issue of maintaining the status quo or establishing a new way for drug research, development and manufacture. The debate was moderated by Dr. Fitzhugh Mullan, M.D., Contributing Editor of Health Affairs and a Clinical Professor of Pediatrics and Public Health at the George Washington University. The debate features Dean Baker, Economist and Co-Director of the Center for Economic and Policy Research (CEPR) and Dick King ham, Attorney at Covington & Burling, representing PhRMA (Pharmaceutical Research and Manufacturers of America).

Flu Vaccine

When it was announced that roughly half of the US supply of flu vaccines was contaminated, there were reports of price gouging all over the country. The American Society of Health-System Pharmacists conducted a survey of its members on October 8, 2004 and found that “more than 55 percent of respondents had been contacted by vendors offering to sell vaccine at highly inflated prices. Of these, more than 80 percent reported being offered the vaccine at over four times the original market value.” Almost 20 % had been offered the vaccine at $80 per shot.

Several examples are noteworthy. Florida has received reports of a $90 price tag for the $10-20 shot. Kansas has also reported a $90 price tag. Texas reported $95. Connecticut and New York: $100.

To combat this practice, Congressman Kucinich introduced H.R. 5404, the Fair Vaccine Price Act, which would make it a federal offense to price gouge when the Secretary of the Department of Health and Human Services declares a vaccine shortage. It would apply to flu vaccines as well as vaccines that can be used against bioterrorism attacks.

The Congressman also submitted testimony to the House Committee on Government Reform, where he documented the failure of the Food and Drug Administration (FDA), whose job is to make sure vaccines are safe. More specifically, he spoke of the undue deference to industry in enforcement of vaccine safety at Chiron’s vaccine manufacturing plant.

NIH Open Access

An NIH proposal will make a substantial and highly useful body of biomedical research much more widely available than it is today. The plan will share precious knowledge and accelerate medical research.

Most Americans do not have timely access to the results of research paid for with their tax dollars, including biomedical research conducted with National Institutes of Health (NIH) support. In other words, if a new study on medicines for heart attack patients was released, the general public (including a recent heart attack victim) would not be able to access it without paying, in some cases, over $50, even though the research was conducted with taxpayer funds. Congressman Kucinich believes the widespread dissemination of medical advances and scientific findings is critical to obtaining the best return possible on our nation’s investment in research. Put simply, an informed citizen is a better citizen. That is why he submitted written comments in support of the NIH’s proposal to make taxpayer-funded research accessible by the general public.

Vaccine Liability

The FY 2006 Defense Appropriations bill contained a massive holiday gift to the pharmaceutical industry in the form of liability immunity for pandemic flu vaccines.  This giveaway will not result in increased vaccine production, but it leaves consumers with no recourse if they are injured, and it could exacerbate the epidemic.  This provision was slipped into the bill without any public deliberation or vote on the critical issues.  As such, the insertion of the language represents an unapologetic abuse of majority power.

Congressman Kucinich argued powerfully against this provision in a letter to all of his colleagues in the House of Representatives.  He pointed out that a study in the Journal of the American Medical Association found that liability concerns are not the reason that pharmaceutical manufacturers do not want to manufacture vaccines. In fact, Chiron, a major pharmaceutical company and vaccine manufacturer, does not need more financial incentives - they have been working on an H5N1 vaccine since 1997.  Congressman Kucinich pointed out that medical personnel would be less likely to take the vaccine if the Congress saw enough potential for harm that it removed liability protections.  Congressman Kucinich also pointed out that the very safety of the vaccines was suspect because they contained a controversial adjuvant which is suspected to be part of the cause of Gulf War Illnesses.  Congressman Kucinich further brought attention to the issue by speaking to his colleagues on the House floor about it.

Emergency Room Overcrowding 

After the closing of two community hospitals, Mt. Sinai and St. Luke’s, emergency departments at other Cleveland area hospitals experienced overcrowding. In order to find out other reasons for the overcrowding and work towards a solution, Congressman Kucinich hosted an ER Summit in the Lakewood District Office on May 7. Doctors, paramedics, nurses, patients, hospital administrators and local officials came together to discuss the problem.

One of the ideas was to create a web-based information system so hospitals instantly know about empty hospital beds in specific departments. This system, which has worked successfully in other cities such as Milwaukee, would help doctors transfer patients efficiently from the emergency room to the next appropriate department. This would also help alleviate overcrowding in the emergency room. Now, local Cleveland officials are investigating different systems to find the best one for Cleveland. Congressman Kucinich has helped to find several federal grants that could pay the cost of implementing the system.

Environmental Health

In order to draw attention to regulatory processes that delay or block environmental health legislation, Congressman Kucinich introduced the Value of Human Life amendment. Contrary to what Congress permits agencies to do, the Office of Management and Budget insists that agencies include human life discounts when cost/benefit analyses are conducted of proposed regulations. For certain, regulations that affect human health, such as regulations related to toxic or other pollution, a monetary value of a life is estimated.  For each year that a person is exposed, OMB insists that the value of a life is depreciated by applying a yearly percentage decrease to human lives. Congressman Kucinich’s amendment to the Treasury/Postal Appropriations bill would forbid discounts to be applied to people to ensure that all lives are worth the same.

Health Costs

Congressman Kucinich passed an amendment in 2002 to ensure that government wide Cost Accounting Standards are applied to health plans in the Federal Employee Health Benefits Program, just as they are applied to all other federal contractors. Cost Accounting Standards ensure that the charges made to the government are appropriate and accurate.  The amendment was passed with support from unions, the Administration and other health plans as part of the Treasury-Postal Appropriations bill.

Health Services and Trade 

On March 18, 2003, Congressman Kucinich spearheaded a letter to United States Trade Representative Zoellick urging him to exclude vital human services, including health care and water, from negotiations over the General Agreement on Trade in Services (GATS). The General Agreement on Trade in Services (GATS), currently being negotiated among the 145 member nations of the World Trade Organization (WTO), seeks to override national rules and regulations that could pose "barriers to trade" in services. GATS threatens to place corporate interests above health, both in the U.S. and abroad. GATS could limit the ability of Congress, any U.S. state, or any region to enact and enforce regulations concerning: health care services including nursing homes, hospitals, or health maintenance organizations; clinician licensing; public subsidies for the safety net and other services; health insurance; environmental protections; occupational safety and health; distribution of alcohol, tobacco, and firearms; and public administration of safe water and sanitation.

Complementary and Alternative Medicine (CAM)

Congressman Kucinich is the House Co-Chair of the Congressional Caucus on Complementary and Alternative Medicine and Natural Foods. As Co-Chair, he hosted the inaugural meeting of the Caucus with a briefing on May 20, 2003, in the Capitol. The briefing discussed opportunities for healthcare integration.

Also, Congressman Kucinich wrote to Secretary of Health and Human Services Tommy Thompson about the printing of the final report of the White House Commission on Complementary and Alternative Medicine Policy. While the report’s printing had been delayed for more than a year, it was finally printed in the fall of 2003 to allow greater dissemination of the report’s findings.

Finally, Congressman Kucinich has actively worked to ensure that CAM professionals have a voice in the future of healthcare integration. When the Institute of Medicine Study Committee on Complementary and Alternative Medicine removed the only two appointees who have real CAM experience, the Congressman led the Caucus in protesting this action.

Lung and Breast Cancer

The New York Times reported on February 15, 2006 that Roche and Genentech plan to charge $100,000 for a year’s supply of Avastin to late stage lung and breast cancer victims.  This represents a price increase over the already astronomical $50,000 price tag for its current use for colon cancer.  These exorbitant prices bear little on the cost of production, which is “a fraction of what Genentech charges for it.”

Roche and Genentech’s pricing decisions will force many cancer victims to choose between extending their lives and leaving their family a burden of irreconcilable debt.  In fact, The New York Times reports that some are already opting for less life for cost reasons.  Furthermore, the poorest and sickest among us will be the most likely to refuse the treatment.  Even those patients with insurance are not protected because the copays are likely to approximate $1000 per month for Avastin alone, to say nothing of the cost of chemotherapy pharmaceuticals that often accompany it.

Pricing schemes like these will have ripple effects.  They will make it easier for other companies with similar drugs to charge higher prices.  Insurance companies will pass on much of the cost, accelerating already out of control health care costs.  If the trend of this legal price gouging proceeds unchecked, Medicare’s own future will be imperiled, especially in the absence of the ability to negotiate prices with drug manufacturers.

On February 21, 2006, Congressman Kucinich sent a letter to Health and Human Services Secretary (HHS) Leavitt demanding that HHS issue a compulsory license for Avastin. Doing so would allow other manufacturers to compete with Roche/Genentech and therefore drastically lower the price of Avastin.  Roche and Genentech would be guaranteed “reasonable and entire compensation” as required by law (28 USC 1498).  A compulsory license would also send a clear signal to the pharmaceutical industry that abuse of the patent system, especially when at the expense of health, will not be tolerated.

Bureau of Mental Retardation and Developmental Disabilities

Congressman Kucinich intervened on behalf of parents of mentally retarded children and adults who live in Intermediate Care Facilities in opposition to proposal by the State of Ohio to eliminate such facilities.  Congressman Kucinich filed “Friend of the Court” papers in federal court on constituents’ behalf and hosted an ICF/MR task force at his Congressional District Office to organize opposition to the cuts.  Congressman Kucinich has successfully forestalled the cuts.

Autism

Congressman Kucinich, as a member of the Congressional Autism Caucus, is dedicated to finding the causes of autism and helping individuals with autism access the therapies they need. He has spoken out in favor of additional research during hearings of the Committee on Government Reform.

Thimerosal

In December 2002, pharmaceutical manufacturers of Thimerosal were granted a liability exemption from health affects caused by Thimerosal-containing vaccines in the Homeland Security bill. Congressman Kucinich strongly opposed the process by which this provision was inserted at the last minute without the knowledge of Members.  On the first official day of business, the Congressman offered a procedural change to the Rules of the House of Representatives so that Members would have at least 24 hours to review conference reports before voting on them.  He is also a cosponsor of legislation introduced by Rep. Tom Allen and Rep. Dan Burton to eliminate the Thimerosal exemption.

Protection of research subjects

The federal government provides funds for a vast complex of experiments that involve human subjects. More than $16 billion per year in federal funds are used for such research. Some 20,000 experiments at more than 4,000 institutions are involved. In 2000, human subject research was monitored by a small office --the Office for Protection from Research Risks (OPRR) -- that was buried far down in the organizational structure of the National Institutes for Health (NIH) and now in the office of the Secretary. The Human Research Protection and Promotion Act of 2000, HR 3569, would have improved the protection of human research subjects and encouraged ethics in human experimentation. It would have done this by making OPRR an independent agency and extending its authority over 16 other agencies that perform human research experiments but do not maintain proper protection for human research subjects. The bill would have ensured that all federally funded research on human subjects received the proper oversights, and that human subjects had adequate protection. I believe that the public and Congress should have an independent authority over the protection of human research subjects.

Cuyahoga County Hospitals

Congressman Kucinich’s office conducted a survey of hospitals in Cuyahoga County about the amount of charity care that each hospital provides. Click here to read the study.

Blue Cross and Blue Shield: Protecting Taxpayers’ Interests

Shortly after taking office, Congressman Kucinich intervened in an attempt by Blue Cross and Blue Shield of the National Capital Area (BCBSNCA) to convert to a for-profit company. His experience as a state legislator when Blue Cross of Ohio attempted to sell its assets to the nation’s largest for-profit hospital chain, Columbia/HCA, led him to take this action.

In March of 1997, Congressman Kucinich sent a letter to Senator Glenn alerting him to the problems in this bill, and that this bill was soon to be considered by the Senate. Senator Glenn put a hold on the bill until protections were secured to prevent the loss of millions of tax dollars to a for-profit insurance company.

After months of negotiations, a compromise was reached to allow BCBSNCA to merge with the non-profit Blue Cross of Maryland, while at the same time protecting the assets accumulated in the nonprofit sector. The federal charter that has been governing BCBSNCA since 1939 was not lifted, thus protecting taxpayers’ interests.

Related Documents:

Press Release - Kucinich Renews Calls for Extension of Unemployment Benefits

Press Release - New Yale Study Highlights Role of Fast Food Marketing in Childhood Obesity Epidemic

Press Release - Kucinich Proposal Would Raise $15-19 Billion for Childhood Nutrition Efforts

Press Release - Kucinich, Conyers, Sanders Renew Call for National Single Payer on Medicare’s Birthday

Press Release - Two Kucinich Amendments Strengthen ‘Improving Nutrition for America’s Children Act’


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Related Files:

Analysis of NIEHS Direction Under Dr. David Schwartz

HR 676 Summary

Medicare Part D Tips

GWI Conferees Letter

Avian Flu Statement

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