Joe Biden

Remarks on Efforts To Lower Health Care Costs in Culpepper, Virginia

February 10, 2022

Thank you, Mr. President. [Laughter] I could have no more have done that when I was 12 years old than fly. I used to be a stutterer. I was scared to death I would stand up and ta-ta—ta-ta-talk—talk like that. And I can't tell you how much—how proud I am of you. And your brother is equally as impressive as you are. He's standing there—he's sitting there two seats over.

Shannon and Joshua—and by the way, happy birthday, man. He's going to be 13 years old—a teenager—in a couple days.

I want you to know that lowering the cost of prescription drugs is one of the reasons why I'm here with Abigail, your Congresswoman. And that's what I want to talk about with you today. Lowering the cost of health care overall, as well. Lowering the cost of prescription drugs is important. And giving families like yours just a little bit more breathing room makes a gigantic difference.

Before I get into that, I want to say: It's good to be here at Germanna school. And by the way, Abigail, if I want to know anything about community colleges in Virginia, I go to my wife. [Laughter] She teaches fulltime and has for the last 9 years. She's in the classroom now at the community college in Northern Virginia—Northern Virginia Community College.

And she says—she says, "You know, the single best kept secret in America is community colleges." And it really is. They are so flexible. They can do so much—so much. And if I had more time—which I don't—for all of you, I'd go into what we're going to try to do to increase the flexibility and the funding of community colleges for people.

But it's great to be here with Abigail—with Congresswoman Spanberger. In every chapter of her career—in every chapter,—she's always been about one thing: service. Service.

I also want to thank Mark Warner and Tim Kaine, who—Senators here—are good friends and worked closely with me on so many things when I was a Senator and now as President and when I was Vice President. But they needed to be in Washington today because there's votes in the Senate.

I also want to thank Secretary of Health and Human Services Xavier Becerra for two things: one, for answering my call when I asked him to come and be the Secretary. [Laughter] I was worried he wouldn't. And how much he's helped us make so much progress in getting people vaccinated, getting health insurance, and making more affordable health care.

Look, health care is part of Abigail—Congresswoman—your Congresswoman's background. Back in 2017, she saw her Representatives in Congress vote to repeal the Affordable Care Act. That was one of more than 100 Republican efforts—there were 100 Republican efforts since we passed it in our last administration to repeal the Affordable Care Act.

But she knew that that was the exact opposite of what central Virginia badly needed. You needed then, and you need now, more access to quality health care that is more affordable.

So, when I became President of the United States, that's what we did. We passed the American Rescue Plan, which made quality coverage through the Affordable Care Act more affordable than ever before, with families saving, on average, who have signed up—a family, on average—$2,400 a year in their annual premiums.

Compared to last year, the average monthly premium for Virginia—for Virginians has gone down more than 25 percent. Over 5 million people have gained coverage through the ACA since I became President. As was mentioned by Xavier, over 300,000 Virginians have signed up for health insurance during open enrollment period here in Virginia.

And we want to go further: lowering prescription drug prices; get a cap on the amount people pay on Medicare, pay for prescription drugs; and to bring more clarity and fewer surprises when you get your bills if you've been hospitalized.

So let me say a few words about each of these things now. With regard to prescription drugs: In America, we pay the highest prescription drug prices of any nation—developed nation in the world—the highest of any. And it's about two to three times higher than what other countries pay.

Let me give you one example. An anticancer drug to treat leukemia and lymphoma costs $14,000 a month in the United States. The same exact drug, made by the same exact pharmaceutical company, is sold in France, and it's $6,000 a month. $6,000 for the same exact drug, same exact manufacturer, same exact amounts. Not 14, but 6. That's for a month's supply.

Today, one in four Americans who need prescription drugs struggle to afford them—one in four. Nearly 30 percent have skipped doses of essential drugs they're supposed to take. Others have simply not filled prescriptions that the doctor had given them; tried to use over-the-counter drugs or pills cut in half because they can't afford the cost of their prescription.

This is the United States of America, for God's sake. That's just wrong. It's simply wrong, especially since it doesn't cost the drug companies nearly, nearly, nearly, nearly as much to make the drug or the research that went into them.

Let me regress for just a moment here. I started when—in the Obama-Biden administration an effort to deal with the Cancer Moonshot to change the way in which we deal with cancer. And I'm reinstituting that in my administration now.

And it was interesting. I met—we had these hearings all over the United States. And one of the major events we did, we—at Howard University, where there were 35 other events going on simultaneously with this. I had subsequently met with the heads of—I think it was 13 drug companies. And I asked them—I said, "If you found a cure for a particular cancer, how much you think you should be able to charge?" And the response universally was, "What the market will bear."

I said, "Hope I don't get elected President, because that's just not—what you'll get should be treated more like a utility." You should be able to make a significant progress for—let's add up how much—and like they do in Germany—how much did it cost you all, the research and development—all the effort. Add it all up. And then, on top of that, add a significant premium for it—a profit of 20 to 30 percent above that. Maybe, in some cases, more.

But the idea—the idea—you can charge whatever you want is just not going to happen in the United States of America if I have anything to do with it.

If you think this doesn't affect you, it does, by the way. Everyone has less money in their pockets today because of high drug prices—drug costs and health insurance. And it's more expensive for everyone.

And the reason it is, is this is what your insurance companies pay. Every—all of you who have insurance, you're paying a heck of a lot more even if you're not using the drugs. Over the past decade, health care costs have gone up 50 percent. Prescription drugs are a big chunk of that.

And there's a lot of things that almost every American can agree on. But I think it's safe to say that all of us—whatever our background, our age, where we live, whether we agree on prescription drugs—look, we all acknowledge they're outrageously expensive, and in many cases, there is no relationship to cost. It doesn't need to be that way.

Josh and Shannon, it costs drug companies less than $10 to make a vial of that insulin. Less than 10 bucks. That's what it costs. There's no reason you should be paying over $300 a vial for medicine you need every day to stay healthy and, in many cases, stay alive.

As your mom said, you've got to pay $5,600 for prescriptions before your insurance even kicks in. You've got to do the deductible.

Shannon, you should have peace of mind of knowing that if Joshua grows up and leaves your care—your health care plan, he'll be able to choose a job without ever having to make a choice between which one has the particular health care coverage.

You know, we're now in a position where we can cap copays for insulin at $35 a month. And it's still a staggering profit: three and half times what it costs to produce the drug. You can do that with a stroke of a—we can do that with a stroke of a pen.

In my Build Back Better legislation that with Abigail's leadership passed in the House of Representatives, we can do that. Now we just have to get through the United States Senate, and we're close.

We can do even more to lower out-of-pocket prescription costs. Under my proposal, we will hold drug companies accountable for the absurd price increases. Here's how: Drug companies that increase their prices faster than the rate of inflation, once the price is set, will face a steep tax.

This will help us end the days when drug companies could increase their prices with no oversight, no accountability, and no responsibility.

We're saying to drug companies: You are finally going to become accountable when you raise prices on the American people. Accountability. You're still going to make a significant profit.

And we can take additional steps to lower drug costs for people with Medicare, something Abigail has championed.

Right now the only thing Medicare is not allowed to negotiate the price of are prescription drugs. For everything else covered by Medicare—a doctor's visits—they negotiate and say, "We'll pay no more than this much for a doctor's visit." So if the doctors don't want to take any Medicare patients, they don't have to. But if they have a Medicare patient, which there are millions of them, they cannot charge more than a certain amount. Crutches—we limit the amount of money they can pay for crutches.

But—but—Medicare can negotiate everything except drug prices. The only outfit that can't do—they—they can't deal with. My plan is going to allow Medicare to negotiate the prices they're prepared to pay for each individual drug. If the company says, "I'm not going to sell it to you at that price," fine, but they're going to lose millions of customers. Millions of customers.

We're proposing—what we're proposing is that we negotiate fair prices, one that reflects the cost of research and development and the need for significant profit, but still is affordable and has some relationship to the cost the drug company had.

My plan also caps the amount that seniors on Medicare have to spend on prescription drugs each year total, so that if they're on Medicare, they'll not have to spend out of pocket more than $2,000 a year, no matter how many drugs they're taking, with drug companies, insurance companies, and medicine—and Medicare picking up the rest of the cost.

And just last month, to bring greater transparency to health care costs, my administration outlawed surprise billing.

I've had significant experience with hospital care. My son Beau, who was attorney general of Delaware and a—won the Bronze Star in Iraq—and, I mean, excuse me, in dealing with being deployed overseas for a long time, for a year. You know, he came back with glioblastoma, and he died.

But you know what? You know, the fact is that—and I was hospitalized a long time. I had, a couple years ago, a cranial aneurism, was hospitalized for a long time.

And you can no longer get that surprise billings we got. If your health care plan did not cover a particular doctor but you didn't even know he was being consulted and you get an extra bill for two to five thousand dollars, they can't do that anymore. No more surprise billing. No more.

Millions of hard-working Americans will no longer have to worry about unexpected medical bills. And Abigail has been making sure that we bring the same transparency to drug prices.

A couple of years ago, Abigail worked to pass a bipartisan legislation to make drug prices more transparent so you knew what you're paying for. And my administration is working with Abigail to make sure we enforce that.

She also has been relentless in making sure the law that's been on the books that says pharmaceutical companies need to provide rural clinics and community health centers with discounts on prescription drugs is actually enforced. And we're working together on that as well.

I've long said health care should be a right, not a privilege, in this country. This isn't a partisan—diabetes, Alzheimer's, cancer—they're not partisan issues. They're not Democrat or Republican.

This is about whether or not you and your loved ones can afford the health care you need and the medicines you need to stay healthy, because we need to ease the burden on working families by making everything more affordable and accessible.

Look, again, slight digression: Inflation is up. It's up. And coming from a family when the price of gas went up, you felt it in the household, you knew what it was like, it matters.

But the fact is that, if we're able to do the things I'm talking about here, it will bring down the costs for average families. It will bring down the costs for average families. I don't know why they keep moving all that, but the fact is: They keep down the costs for average families.

And look, the fact is that we're in a situation now where, you know, you should have peace of mind. I know food prices are up, and we're working to bring them down.

As I said, I grew up in a family where the price at the pump went up, you felt it. And I understand. But these things are necessities. We're working to bring down prices where there are not totally what the families, in fact, have to pay now.

You still have pay to for childcare. Childcare is a cost for millions of families. You still have to pay your prescription drug prices. You still have to pay for health care. You want to lower the cost of living for people? Help them in those areas.

So there's more than one way for a family, when it comes to raising their standard of living.

I'm going to work like the devil to bring gas prices down, which I'm going to—I'm working to make sure that we keep strengthening the supply chains to bring the cost of energy and everything else and the goods that come to America down by helping the ports 24/7, by changing a whole range of things that—you know, what's happened with COVID—COVID has caused significant increase in prices in the supply chain, because when a factory shuts down in another part of the world and you need that particular product in order to finish the—and build whatever you're working on, the price goes up exponentially, like for cars.

But in the meantime, there is a lot we can do to give families extra breathing room. We can do this when we cut the cost of childcare, making sure that you don't pay more than 7 percent of the family's income for childcare. That saves thousands of dollars in families—for families. Shannon, think about what these plans would mean for you and your family.

We're—already made a lot of progress on the economy. Last year, more jobs were created in America than in any year in American history. Unemployment has dropped more than any year in American history. We reduced the deficit—the Federal deficit—while doing those—both those things, by $300 billion. We lowered child poverty by nearly 40 percent in America, more than any year in American history, as a consequence of the child tax credit.

And we're coming out at these challenges from a position of strength unmatched by any nation in the world. And I might add, and I note here just to all of you, that this does not raise anyone's—if you're making less $400,000, you're not paying a single penny more in taxes—not a single penny more in taxes. And it does not increase the deficit, because it's paid for. It's fully paid for.

I've had a group of major companies, from Intel to General Motors to Ford to—down across the board—come to me and say they want to keep these programs going, increase corporate taxes to 24 percent, which they were supposed to be. It gets paid for. They understand the net effect on the economy is to grow it.

We know that when we invest in ourselves, there's no limit to what we can achieve with leaders like Abigail and the brave folks like Shannon and Joshua.

All of you know here today that all this progress we've made is going to be just the beginning—just the beginning. I promise you we're going to do so much more, and it will not—I emphasize, it will not—increase the debt. It will not increase taxes on anyone making less than $400,000 a year.

And by the way, I'm a capitalist. I'm a capitalist. You should be able to make a million or a billion dollars. Just pay a little bit of your fair share. That's all. We have over 53 companies in America that made $40 billion last year—didn't pay a single penny in taxes. Not a single penny. That's not right.

And so you find that a lot of these corporations realize: To grow and be competitive, it makes sense just to pay a little more in taxes at the top end in order to afford this economic growth we're creating.

But bringing down the cost of health care, bringing down the cost of prescription drugs is an easy thing for us to do. It can be done legally with a stroke of a pen.

We just got to get Abigail's enthusiasm that she gotten it through in the House of Representatives to the United States Senate. So we may be dragging you over to the Senate to spend some time. [Laughter] But all kidding aside, there's so much we can do.

And I want to thank the family for being willing to stand up here and share their story. And, Dad, stand up so everybody knows who you are. I want them to see you. That good-looking guy back there, that's Dad. [Laughter]

Every time I'd walk out of my grandpop's house up in Scranton, Pennsylvania—his name was Ambrose Finnegan; he was an All-American football player out in Santa Clara when he was a kid—and he used to always yell, "Joey, keep the faith." And my grandmother would yell—she'd yell back, "No, Joey, spread it." Let's spread the faith and get this done.

Thank you very, very much. Appreciate it.

NOTE: The President spoke at 12:49 p.m. at Germanna Community College. In his remarks, he referred to Chesterfield, VA, resident Joshua Davis, who introduced the President, and his parents Shannon and Brian. He also referred to H.R. 5376.

Joseph R. Biden, Remarks on Efforts To Lower Health Care Costs in Culpepper, Virginia Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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