Q. What is the federal government's role in requiring appropriate transparency and accountability of for-profit institutions?
BS: In my view, for-profit colleges and career programs have perpetrated a massive fraud at the expense of American taxpayers, and hundreds of thousands of students who are now saddled with worthless degrees and massive amounts of student debt. As the gatekeeper to financial aid programs, the federal government must be far more vigilant, and do a much more effective job in protecting students and taxpayers from low-quality and fraudulent programs. I support efforts to implement gainful employment regulations, and regulations requiring that no institution receives more than 85% of its revenue from federal sources. In addition, I support efforts to increase transparency in the sector, so students and policymakers have a clearer understanding of institutions' activities and quality.
Q. What are your views of the Affordable Care Act? What changes would you make, if any, to the ACA, including the excise tax on high-cost plans and the provisions on shared responsibility for employers?
BS: I start my approach to healthcare from a very basic point: healthcare should be a right and not a privilege. Our healthcare system is broken, and the Affordable Care Act was an important first step. It has done a lot of good things that have improved the health and economic security of millions of Americans, including closing the prescription drug "donut hole" for seniors, allowing young adults to stay on their parents' health insurance plans, and preventing insurance companies from discriminating based on pre-existing conditions. But the ACA was not perfect, and there are some improvements we can make. Although millions more Americans have insurance now, the ACA will still leave some 30 million Americans without health coverage. Families will still face plans that have high deductibles and copays, or do not cover the medications or doctors they need.
Beyond those larger improvements, any specific changes to the ACA must be done thoughtfully and with a few key principles in mind--namely, the impact any changes will have on the rest of the healthcare system. Changes to the employer shared responsibility provision should not be done in a way that leads to higher premiums for employees or reduced revenues for the government. As for the excise tax on high-cost health plans, it is important to preserve the savings Congress intended from that provision, but I want to be certain that workers who have traded lower wages for better benefits over the years are not penalized.
Q. Do you support initiatives designed to move health insurance coverage away from an employer-based model? If so, what would you propose as an alternative to the current system for covering working adults?
BS: As I said above, the Affordable Care Act was a good first step towards fixing our broken healthcare system--but it also heavily relies on continuing the employer-based model of health coverage. There is no reason employers should be in the insurance business, unless they actually happen to run an insurance company! I believe the best strategy is to move to universal coverage under a Medicare-for-all single payer system. Your health coverage and your level of benefits should not depend on your employer.
Q. Many licensed healthcare professionals, particularly RNs, are leaving hospital service because of difficult working conditions, including excessive and unsafe workloads, understaffing and mandatory overtime. What would you do to address these problems and to improve recruitment and retention of nurses and other healthcare professionals?
BS: I believe that health care is a right, not a privilege and every American should have access to the health care services they need, regardless of their income. I also believe improved access to primary care will keep people healthier and reduce reliance on emergency rooms as a first site of care. These changes in our health care system will improve the lives of patients but also of health care providers, including RNs working in hospitals, who are often the ones who bear the brunt of our flawed system. Until these types of changes can be made, we need to protect this critical workforce by ensuring they have the equipment and resources they need to provide world class health care without risking personal injury. I have long supported programs and policies, including the National Health Service Corps, designed to encourage caring and dedicated individuals to go into the health care field and serve in areas of greatest need.
Q. Merger and acquisition activity continues to consolidate the U.S. healthcare system into the hands of a few corporations, many of which are for-profit. What would you do to ensure competition in the healthcare industry is fair and protects the American consumer?
BS: Consolidation and concentration of power is occurring throughout every sector of our economy and it must stop. We must not allow a few companies and a few families to control every industry in this country. This is a problem in the health care industry where only a select number companies control the system and focus more on their shareholders' profits than the health of their customers. For example, prescription medications in this country are not only made by a limited number of companies but are distributed by only a few companies with the ability to set prices however they want and can limit the supply however they choose. America desperately needs a reinvigorated anti-trust system aimed at dismantling the growing concentration in many sectors of our economy.
Q. What would you do to ensure that communities have access to public health services?
BS: Access to public health services has been a substantial focus of my time in Congress. As Chairman of the Veterans' Affairs Committee in the Senate I worked tirelessly to make sure that every eligible veteran in this country had access to high-quality, timely care through the VA. And as Chairman of the Health Education Labor and Pension's subcommittee on Primary Health and Aging I led the efforts to reauthorize the Older Americans Act, which helps guarantee access to critical health programs for seniors throughout the country and fought hard to extend funding for three key public service programs: Federally Qualified Health Centers, Teaching Health Center Graduate Medical Education, and the National Health Service Corps. I am a huge supporter of community health centers as I believe they help all Americans, regardless of income, access the preventive care that keeps them healthy and well. I would like to expand these centers, making sure even more Americans can benefit. I have also fought hard to include dental care in more public health programs so more Americans aren't forced to ignore dangerous, even life-threatening oral health problems because they don't have coverage.
Q. What are your priorities for revitalizing the economy, strengthening the middle class, creating jobs and ensuring fair taxation? How would your plan help restore funding for education, healthcare, transportation, public safety and many other services provided to our citizens?
BS:. Creating Millions of jobs. If we are truly serious about reversing the decline of the middle class and putting millions of people back to work, we need a major federal jobs program. The most effective way to do that is to rebuild our crumbling infrastructure. That's why I've introduced legislation which would invest $1 trillion over 5 years to modernize our country's physical infrastructure. My bill would create and maintain at least 13 million good-paying jobs, while making our country more productive, efficient and safe.
Raising Wages and Benefits. The current federal minimum wage of $7.25 an hour is a starvation wage. The minimum wage must become a living wage -- which means raising it to $15 an hour over the next few years. My goal is to ensure that no full-time worker lives in poverty. We must also bring about pay equity. It's unconscionable for women to earn 78 cents on the dollar compared to men who perform the same work. Overtime protections must be strengthened for millions of workers. It is absurd that "supervisors" earning $25,000 a year -- and who may in fact supervise no one -- are currently forced to work 50 or 60 hours a week with no overtime pay. We also need paid sick leave and vacation time for all.
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