In tough economic times, senior citizens often pay a brutal toll. Already saddled with limited means and poor health, it can be a struggle for some seniors even to get regular meals. A 2009 study found that 5 million seniors face the threat of hunger, which is over 11 percent of all senior citizens in the country.

A Senate subcommittee on Primary Health and Aging, chaired by Senator Bernie Sanders, held a hearing Tuesday on the “human toll and budget consequences” of senior hunger. Panelists shared tales of woe from older Americans unable to get enough food, and urged increased funding for nutrition programs under the Older Americans Act of 1965.

This might have been non-controversial a few years ago, but not with the Tea Party in town. The hearing produced a fierce debate between Sanders, a self-described democratic socialist, and Senator Rand Paul, the prototypical Tea Partier, about whether the government should even perform simple tasks like feeding hungry senior citizens.

Kathy Greenlee, the Assistant Secretary for the Administration on Aging, began by assessing the problem. Of the millions of hungry senior citizens assisted by the federal government, 24 percent simply do not have enough money or food stamps to purchase enough food. Beyond poverty, millions of other seniors have trouble getting meals because they are either functionally impaired or live alone. Seniors in rural areas, far from grocery stores and perhaps family members, are particularly vulnerable. For around 60 percent of the seniors assisted by the government, the meals they are provided make up half or more of their daily food intake.

In written testimony, one panelist shared the story of Peggy Shannon, a 63-year-old administrative assistant in California who was laid off in 2008, two years before retirement. Unable to find work, Shannon was forced to choose between paying for either medications or meals—both requirements, especially given her severe diabetes. “The stress of her situation caused her to lapse into a deep depression where she isolated herself in her apartment and cried most of the time,” the testimony read. “Her deep pride and embarrassment over her situation prevented her from reaching out to family and friends.”

Though Shannon found food through a government-assisted program, her situation underscores how the recession is particularly endangering those already near retirement. Since the downturn, 80 percent of aging agencies have seen requests for home-delivered meals increase, with one in five of them unable to fulfill all of the requests.

“From a moral perspective, it is clear to me that in this great nation, no one should go hungry, especially those that are old and frail and unable to take care of themselves,” Sanders said.

But there’s a financial element as well—medical care for senior citizens is a massive driver of overall health care costs, and ensuring basic nutrition among seniors is a simple way to control those costs. One day in a hospital is equivalent to the cost of a one-year supply of home-delivered meals, according to the subcommittee’s research.

Mary Jane Koren, a geriatrician and vice-president of the Commonwealth Fund, noted that seniors often suffer health problems and are put in nursing homes after falling down. Poor nutrition leads to decreased muscle strength, meaning a higher chance of falling—and weaker seniors are more likely to be gravely injured in such a fall. Koren noted that by 2020, the annual cost of medical care for seniors who fall is expected to reach $54.9 billion—many magnitudes more than the approximately $2 billion per year the federal government spends on nutrition assistance for senior citizens.

Senator Paul, however, explicitly rejected this logic. “It’s curious that only in Washington can you spend $2 billion and claim that you’re saving money,” he said. “The idea or notion that spending money in Washington somehow is saving money really flies past most of the taxpayers.” Instead, Paul touted the “nobility of private charity” as opposed to government-funded “transfer programs.” He suggested privatizing Meals on Wheels and other government assistance for hungry seniors.

Sanders had none of this. “Senator Paul has suggested that only in Washington can people believe that spending money actually saves money. And I think that’s the kind of philosophy that results in us spending about twice as much per person on health care as any other country on earth,” Sanders said. “We have millions of millions of Americans who can’t get to a doctor on time. Some of them die, some of them become very, very ill and end up in the emergency room or end up in the hospital at great cost.

“Maybe it’s the same reason why we have more people in jail than any other country on earth including China, tied to the fact that we have the highest poverty rate among children among many other major countries on earth,” Sanders continued. “I happen to believe that intelligently investing in the needs of our people does in fact save substantial sums of money.”

Nevertheless, Paul—who’s home state of Kentucky is ranked twentieth in the nation in senior citizen food insecurity, with over 5 percent of seniors there facing hunger—pressed on. Addressing Greenlee, he asked: “If we are saving money with the two billion we spend, perhaps we should give you 20 billion. Is there a limit? How much money should we give you in order to save money? If we spend federal money to save money, where is the limit? I think we could reach a point of absurdity.”

Senator Al Franken turned on his microphone and offered a quick reply: “I think you just did.”

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