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WASHINGTON -- President Biden didn't skimp on discussing healthcare in Tuesday night's State of the Union speech -- although he took a little while to get there.

His first mention of healthcare didn't come until about 25 minutes into his speech of a little more than an hour, after he talked about the Russian incursion into Ukraine and the American economy. His first healthcare-related topic was the high cost of prescription drugs, especially the high price of insulin.

Pushing for Capping Drug Costs, Medicare Negotiation

"We pay more for the same drug produced by the same company in America than any other country in the world," he said. "Just look at insulin." He introduced 13-year-old Joshua Davis, a boy with type 1 diabetes who was in the audience. "He and his dad both have type 1 diabetes, which means they need insulin every single day. Insulin costs about $10 a vial to make. That's what it costs the pharmaceutical companies, but drug companies charge families like Joshua and his dad up to 30 times that amount ... For Joshua, and for the 200,000 other young people with type 1 diabetes, let's cap the cost of insulin at $35 a month so everyone can afford it ... And while we're at it, let's let Medicare negotiate the price for prescription drugs, like the VA already does."

And, he added, "the American Rescue Plan is helping millions of families on Affordable Care Act plans save $2,400 a year on their health care premiums. Let's close the coverage gap and make those savings permanent."

Healthcare came up again 10 minutes later, when Biden expressed concern about Wall Street firms that were taking over many nursing homes. "Quality in those homes has gone down and costs have gone up. That ends on my watch," he said. "Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and expect and [they'll be] looked at closely." The White House on Monday announced more detailed plans for improving conditions in nursing homes.

Pandemic Progress

And, of course, the president discussed the COVID-19 pandemic, starting out on an optimistic note. "Because of the progress we've made, because of your resilience and the tools we have been provided by this Congress, tonight I can say we are moving forward safely, back to more normal routines." He noted that severe COVID cases have dropped to a level not seen since last July, and that the CDC recently issued new mask guidelines, under which "most Americans in most of the country can now be mask free."

Biden listed four steps to move forward on the pandemic. "First, stay protected with vaccines and treatments," he said. "We know how incredibly effective vaccines are. If you're vaccinated and boosted you have the highest degree of protection." He touted the Pfizer anti-viral pill, noting that it "reduces your chances of ending up in the hospital by 90%." And he noted that the administration is "launching the 'Test to Treat' initiative so people can get tested at a pharmacy, and if they're positive, receive antiviral pills on the spot at no cost." He also said that beginning next week, those who have already ordered and received four free COVID-19 tests from the federal government will be able to order another four tests from the website.

"Second, we must prepare for new variants," said Biden. "Over the past year, we've gotten much better at detecting new variants. If necessary, we'll be able to deploy new vaccines within 100 days instead of many more months or years ... I can't promise a new variant won't come. But I can promise you we'll do everything within our power to be ready if it does."

"Third, we can end the shutdown of schools and businesses," he said. "We have the tools we need. It's time for Americans to get back to work and fill our great downtowns again ... Our schools are open. Let's keep it that way. Our kids need to be in school."

"Fourth, we will continue vaccinating the world," said Biden. "We've sent 475 million vaccine doses to 112 countries, more than any nation on Earth. And we won't stop."

He urged Americans to put aside their divisions over the coronavirus. "Let's use this moment to reset," he said. "Let's stop looking at COVID-19 as a partisan dividing line and see it for what it is: a God-awful disease. Let's stop seeing each other as enemies, and start seeing each other for who we really are: fellow Americans."

Abortion Rights Defended

Abortion also came up during the speech, although Biden didn't mention it by name. "The constitutional right affirmed in Roe v. Wade -- standing precedent for half a century -- is under attack as never before," he said, referring to the 1973 landmark Supreme Court decision that legalized abortion nationwide. "If we want to go forward -- not backward -- we must protect access to healthcare. Preserve a woman's right to choose. And let's continue to advance maternal healthcare for all America."

Biden closed his speech with an exhortation for Congress to pass what he called his "Unity Agenda" -- a four-point plan in which every point touched on healthcare. The four points included:

• Beat the opioid epidemic. "There is so much we can do -- increase funding for prevention, treatment, harm reduction, and recovery," said the president. "Get rid of outdated rules that stop doctors from prescribing treatments. And stop the flow of illicit drugs by working with state and local law enforcement to go after traffickers."
• Take on mental health -- especially among children. "Children were also struggling before the pandemic -- bullying, violence, trauma, and the harms of social media," he said. "It's time to strengthen privacy protections, ban targeted advertising to children, demand tech companies stop collecting personal data on our children. And let's get all Americans the mental health services they need. More people they can turn to for help, and full parity between physical and mental healthcare" in terms of insurance coverage, something the administration previewed in a call with reporters Tuesday morning.
• Support veterans. "Our troops in Iraq and Afghanistan faced many dangers -- one was [being] stationed at bases and breathing in toxic smoke from 'burn pits' that incinerated wastes of war -- medical and hazard material, jet fuel, and more," Biden said. "When they came home, many of the world's fittest and best-trained warriors were never the same. Headaches. Numbness. Dizziness. A cancer that would put them in a flag-draped coffin. I know. One of those soldiers was my son Major Beau Biden. We don't know for sure if a burn pit that he lived near ... was the cause of his brain cancer, or the diseases of so many of our troops. But I'm committed to finding out everything we can."
• End cancer as we know it. Biden said that the goal of his newly relaunched "cancer moonshot" initiative "is to cut the cancer death rate by at least 50% over the next 25 years, and I think we can do better than that, turn more cancers from death sentences into treatable diseases ... To get there, I call on Congress to fund ARPA-H, the Advanced Research Projects Agency for Health."

"We can do these things," he said. "It's within our power, and I don't see a partisan edge to any of those four things." Biden ended on a familiar optimistic note: "The State of the Union is strong -- because you, the American people, are strong," he said. "And we will be stronger a year from now than we are today. This is our moment to meet and overcome the challenges of our time."

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