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Opinion Bernie Sanders and Pramila Jayapal: We must fix the gaping holes in Medicare

Rep. Pramila Jayapal (D-Wash.) and Sen. Bernie Sanders (I-Vt.). (Chip Somodevilla/Getty Images and Cliff Owen/AP)
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Bernie Sanders, an independent, represents Vermont in the U.S. Senate. Pramila Jayapal, a Democrat, represents Washington’s 7th Congressional District in the U.S. House.

More than 55 years ago, President Lyndon B. Johnson signed Medicare — one of the most popular and successful government programs in our nation’s history — into law. Before the enactment of Medicare, about half of our senior citizens were uninsured and roughly 35 percent lived in poverty. Today, everyone in America aged 65 or older is guaranteed health-care benefits through Medicare regardless of income or medical condition, while the official poverty rate for seniors is now less than 9 percent.

That is the good news. The bad news is that, since its inception in 1965, Medicare has not covered such basic health-care needs as hearing, dental care and vision. The result: Millions of senior citizens have teeth rotting in their mouths, are unable to hear what their children and grandchildren say or can’t read a newspaper because of failing eyesight. It is a cruel irony that older Americans do not have coverage for these benefits at the time when they need it the most.

The lack of benefits for hearing, dental and vision has severe consequences for worsening a whole host of other medical conditions. Researchers at Johns Hopkins found that mild hearing loss doubled dementia risk. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia. Aging affects teeth as well, as gum tissue naturally recedes exposing roots to decay and infection. Poor oral health and untreated gum disease leads to increased serious risk of heart attacks, strokes, rheumatoid arthritis and worsened diabetes. Aging also takes a toll on vision, leading to injury, cognitive impairment and depression.

And yet, in the richest country in the world, the outrageous reality is that 75 percent of senior citizens who suffer from hearing loss do not have a hearing aid because of the prohibitive cost. Sixty-five percent of senior citizens have no dental insurance and no idea how they will be able to afford to go to a dentist. More than a quarter of senior citizens in this country are missing all of their natural teeth, with many unable to properly digest the food that they eat. Over 70 percent of Americans 65 and older have untreated gum disease. We simply cannot tolerate this any longer.

The original vision of Medicare was to provide quality health-care coverage to our nation’s seniors. Today, it’s past time to fix the gaping holes that are the lack of coverage for dental, vision and hearing, which are so critical, especially as we age. We must do what the overwhelming majority of Americans want us to do: expand Medicare to cover hearing aids, dental care and eyeglasses.

But expanding benefits is not the only thing we need to do. Too many older workers are uninsured or underinsured, which is why we must lower the eligibility age for Medicare to at least 60. Doing so would give 23 million older workers the security of knowing they can finally address illness and injury and not worry about how they will pay for a doctor. This is not only the right thing to do from a public policy perspective; it is also what the overwhelming majority of Americans support. That’s why we are joined by over 100 colleagues in the House and the Senate — including those in some of the most vulnerable districts in the country — who last month asked President Biden to include these critical proposals in his American Families Plan.

Expanding Medicare and lowering the eligibility age will cost money. So, how are we going to pay for it? There is an easy, popular and necessary answer: by taking on the greed of the pharmaceutical industry and demanding that it stops ripping off U.S. taxpayers by charging us the highest prices in the world for prescription drugs. Medicare and the rest of the federal government should do what Veterans Affairs already does, and what every major country on Earth does: negotiate with pharmaceutical companies to lower the outrageously high price of prescription drugs. It is a travesty that in the United States, one vial of insulin has gone from costing $21 in 1999 to $332 in 2019, reflecting a price increase of more than 1,000 percent.

By setting drug prices at the median price of other major countries like Canada, the United Kingdom, Germany and France, the Congressional Budget Office estimates we’ll save taxpayers at least $500 billion over a 10-year period. Additional cost-saving measures can raise the total saved to at least $650 billion. With those savings, we can finally make drug prices affordable for all Americans, give Americans over 60 the security of having Medicare, and expand the benefits that Medicare provides to include dental, vision and hearing. Let’s do what is wildly popular with the American people and get this done.

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