Analysis | Cassidy says he thinks narrowly while Sanders thinks expansively

Sen. Cassidy on Addiction Bill, Community Health Centers, Tensions with Sen. Sanders

In past years, leaders Senate Committee on Health, Education, Labor and Pensions often worked together in a bipartisan fashion to solve tricky problems including surprise medical bills and drug prices.

But the dynamic between the committee of the current leadership of the duo president Bernie Sanders (I-Vt.) and its top Republican, Sen. Bill Cassidy (La.) is shrouded in tension. I spoke with Sanders last week (you can read our Questions and answers here), and today I bring you a conversation with Cassidy.

This interview has been edited and condensed for length and clarity. The first issue is about the Support Act, a bipartisan bill that authorizes a range of services to help treat people with addiction.

Health 202: You’ve been pushing President Sanders to take action on the expiring Affordable Care Act for some time now. Do you see any movement on that issue?

Cassidy: [Sanders] recently engaged, so the simple answer is yes. The longer answer is that we knew when this Congress started, he had to be reauthorized by September 30th, and he and his staff have shown no interest in holding hearings on that.

Health 202: When I spoke with Sanders last week, he characterized your position on the issue as simply a desire to reauthorize the law while calling for significant improvements. How would you describe the bill you introduced in July?

Cassidy: You know, I’m a doctor, and there’s a line in internal medicine training: Don’t just do something. Think about it. People in Washington assume you’re doing something if you spend a lot of money, even if you have no idea the money will be well spent.

I would disagree with his characterization [that my bill] is a modest solution here or there. What we offer is thoughtful, if you can imagine that. We are improving access to some of the innovative treatment options for depression. We give states more freedom to run their own prescription drug monitoring programs. We try to address telemedicine in the sense that we give [the Department of Health and Human Services] and [the Drug Enforcement Administration] instructions to finally issue a separate registration for practitioners to prescribe controlled substances via telemedicine. I could go on, but we have things that not only help at this point, but also set the stage for our next actions.

Health 202: Do you think your bill would get bipartisan support in your committee if Sanders called for consideration?

Cassidy: Absolutely. By the way, I learned that you can learn from other people. So if we had a hearing on it, there would be amendments offered to make it better. It is not humility that makes me say that, but her experience. And if Senator Sanders feels he needs to be stronger, the hearing is where you actually have the opportunity to do that.

Health 202: Let’s talk about funding community health centers. Your committee proposed a bipartisan package from Senator Sanders that would increase funding for the sites, but it didn’t win your vote. Do you think he has a chance in the Senate?

Cassidy: Senator Sanders has a bill that has no chance on the floor as far as I know. Because to say that it has not been paid means not to justify the appointment that has not been paid.

Health 202: You’ve been open about your frustrations with how Sanders is running the committee. How would you describe your relationship now?

Cassidy: Put it this way: Shall we have a beer together? One, I don’t drink, but two, probably not. We were cordial with each other and we don’t take anything personally. They were professionals and worked.

I just have a fundamentally different approach. Bernie likes to think big, but you can think big and really do a lot of damage. Whereas when you think about something carefully, you can take an infrastructure that’s already in place, maybe not working well, and adapt it and make it work really well.

Does the health system need a lot of work? Absolutely. But as my friend likes to say, Christmas lights can’t be untangled with scissors. The point is that in your effort to do something different, you can make it completely dysfunctional. And the people who get caught are not people with good insurance. The people who get caught are the people I treated when I was in practice: poor people, insured patients, and those on Medicaid. And that’s ironic, because Senator Sanders says that’s his biggest concern.

Health 202: Given the fundamental differences between the two of you, do you hope to be able to advance bipartisan legislation together in the future?

Cassidy: We worked well on [pharmacy benefit manager] reform law, and that’s why you have to have hearings. Did I mention that we haven’t had a health care hearing in almost two months? If you go through the process and people can come up with their ideas, you can actually do something good. But if you live in a fantasy world, then you will come up with something that is an exercise in futility.

Health 202: It’s been several years since your party abandoned its focus on repealing and replacing Obamacare. Where would you like to see Republicans go next on health care reform?

Cassidy: Republicans are interested in putting market forces into health care. If someone is going to have an X-ray, she needs to know how much it will cost her and be able to compare what it would cost her to go elsewhere. Listen to the rhetoric of our candidates, they will talk about price transparency.

The Senate passed a law on preventing a government shutdown

Late yesterday, the Senate passed legislation to expand funding for federal agencies and programs, sending a bill to prevent a government shutdown to President Bidens desk just days before the weekend deadline, The Posts Jacob Bogage it says

The bill, which was passed by art 87-11 votesrepresents a marked de-escalation between Democrats in Congress and the new Speaker of the House of Representatives Mike Johnson (R-La.). Without the new spending measure, called a continuing resolution, the government would shut down after midnight Saturday.

Nebraska group seeks to codify abortion rights in 2024

In touch today: Advocates calling for abortion rights to be included in the Nebraska They are the Constitution official launch of the offer to put that question before the voters next year, Matt Olberding reports for Lincoln Journal Star.

The Protect our rights the coalition filed paperwork with the Nebraska Secretary of State’s office late last month, but the language of the ballot initiative was kept secret until yesterday. If passed, the proposed amendment would declare a fundamental right to abortion until the viability of the fetus, or when necessary to protect the life or health of the pregnant woman. According to the language of the petition, the patient’s health care provider would determine viability.

• The coalition will need to collect around 122,000 valid signatures until next summer to get the measure on the November 2024 ballot.

Why it matters: The Nebraska legislature passed a 12-week abortion ban this year, and in the months after that, Gov. Jim Pillen (R) and other conservative leaders have promised to further tighten state laws. The coalition aims to stop future restrictions and reverse those already in place by taking the issue directly to the ballot box, where abortion rights advocates secured great victories in conservative-leaning states since the US Supreme Court was overturned Roe v. Wade.

In touch today: Judge from St. Louisa will hear oral arguments in the case of challenging the state ban on abortion. The lawsuit was filed on behalf of 13 Christian, Jewish and Unitarian Universalist leaders who say Missouri lawmakers who passed the restrictions imposed their religious beliefs on others who don’t share them. Jim Salter reports for Associated Press.

Amazon removes eye drop products after FDA warning

Amazon is removed seven eye drop products from your website after For food and medicine warned the company that the items were not approved for sale in the United States, The Washington Posts Julian Mark reports.

In a the letter this week to the CEO of Amazon Andrew Jassi, the FDA said the unapproved products are of particular concern from a public health perspective because they are administered through the eyes and can bypass the body’s natural defenses. (Founder of Amazon Jeff Bezos owns The Post. Interim Executive Director Patti Stonesifer sits on the company’s board.)

Key context: The letter to Amazon comes less than a month after the agency advised consumers to stop using it 26 non-prescription eye drops because of the risk of infection and vision loss. And one outbreak of a serious bacterial infection resulting in at least 14 cases of permanent vision loss and four deaths, has prompted two voluntary recalls of eye care products this year.

• Centers for Medicare and Medicaid Services completed the rule yesterday it will require nursing homes to provide more detailed information about their owners, operators and managers, with the aim of increasing transparency around the role that private equity and real estate investors play in the industry.
• House Energy and Commerce Health Subcommittee voted for advancement 21 bill to the full panelincluding legislation targeting the business practices of pharmacy benefit managers and how Medicare covers new technology.
• FDA suggests essential changes to its Office for Regulatory Affairsincluding a new name closer to its responsibilities within the agency: the Office of Inspections and Investigations, Sarah Overmohle reports for Statciting three people familiar with the planning.

Ballot initiative boom is reshaping this state’s democracy (By Greg Jaffe | The Washington Post)

Insurance executives refused to pay for cancer treatment that could have saved him. This is how they did it. (Maya Miller and Robin Fields | ProPublica)

Want weight loss pills? You may need to change your lifestyle first. (Kelly Hooper | Politico)

Thanks for reading! I’ll see you tomorrow.