MANCHESTER, N.H. -- Physicians have to "get their act together" to help stop the opioid addiction epidemic, Sen. Bernie Sanders (I-Vt.) said at a Democratic presidential candidates' debate here Saturday.
"I think we have got to tell the medical profession and doctors who are prescribing opiates and the pharmaceutical industry that they have got to start getting their act together," Sanders said. "We cannot have this huge number of opiates out there throughout this country where young people are taking them, getting hooked, and then going to heroin."
In addition, "We need to understand that addiction is a disease, not a criminal activity, and that means radically changing the way we deal with mental health and addiction issues," he continued. "When somebody is addicted and seeking help, they should not have to wait 3, 4 months in order to get that help. They should be able to walk in the door tomorrow and get a variety of treatments that work for them."
Former Secretary of State Hillary Clinton also chimed in. "On the prescribing end, there are too many opioids being prescribed and that leads directly to heroin addiction," she said. "We have to change the way we [do] law enforcement and we need more programs and facilities so when somebody is ready to get help, there's a place for them to go, and every law enforcement [officer] should carry the antidote to overdose, naloxone, so they can save lives that are on the brink of expiring."
As did his two opponents, former Maryland governor Martin O'Malley agreed that "We need to rein in the overprescribing" and added that he thought the problem needed a $12 billion federal investment. "We have to invest in local partnerships, and [what is] the best place to intervene? The best indicator of when a person is on the verge of killing themselves because of an addiction, is [found] at the hospital. That very first time they show up with a 'near miss,' we should be intervening there."
"That's what I said to my own public health people -- 'What would we do if this were Ebola? How would we act?'" he continued. "So many more Americans have been killed by the combination of heroin and these highly addictive pain pills, and yet we refuse to act. There are things that can be done ... It's one of 15 strategic goals I've set up to make our country a better place by cutting these sorts of deaths in half in the next 5 years."
Two of the candidates were also asked how they would improve on the Affordable Care Act (ACA). Clinton pointed to several successes of the ACA, including its prohibition on insurance discrimination against people with preexisting conditions and the fact that women are no longer charged more than men for insurance. However, she added, "Out-of-pocket costs have gone up too much and prescription drug costs have gone through the roof."
Clinton said she would propose a $5,000 tax credit to help people with large out-of-pocket costs. "I [also] want Medicare to be able to negotiate for lower drug prices just like [drug companies] negotiate with other countries' health systems ... and I want us to be absolutely clear about making sure the insurance companies in the private employer policy arena, as well as in the ACA exchanges, are properly regulated so that we are not being gamed. We don't have enough competition and don't have enough oversight of what the insurance companies are charging everybody right now."
Sanders, who noted that he serves on a Senate committee that helped to write the ACA, said that despite all the progress it has produced, "not only are deductibles rising, 29 million Americans still have no health insurance and millions of people can't afford to go to the doctor -- a major crisis in primary healthcare."
The reason that the U.S. doesn't yet have a single-payer healthcare system "ties into campaign finance reform -- the insurance companies and the drug companies are bribing the U.S. Congress," he said. "We need to pass a 'Medicare for All' single-payer system; it will lower the cost of healthcare for a middle-class family by thousands of dollars a year."
O'Malley was not asked to answer the ACA question. However, his website states that he will simplify Medicare by combining hospital care, physician services, and prescription drugs into a single plan; increase support for primary care services; work to get more states to expand their Medicaid programs; and enforce antitrust law to counter large increases in healthcare costs.