Bernie Sanders has for decades argued that the United States must establish a single-payer health-care system that provides the guarantee of care for all while controlling costs—what he calls a “Medicare for All” structure. So it came as no surprise that the senator from Vermont made single payer central to his 2016 presidential bid. What is striking, Now that the campaign has finished, however, what is striking is the burgeoning interest on the part of prominent Democrats in a reform that was once considered “too bold.” As Sanders prepared to introduce a detailed “Medicare for All” bill on Wednesday, Democratic senators from across the country and from across the ideological spectrum—including Elizabeth Warren of Massachusetts, Jeff Merkley of Oregon, Kamala Harris of California, Cory Booker of New Jersey, and Kirsten Gillibrand of New York—announced that they would be signing on as cosponsors. Unions such as National Nurses United were declaring their enthusiastic support for the measure. Congressman John Conyers, D-Michigan, was cheering on his longtime ally’s Senate proposal, while celebrating a surge in support for his own single-payer legislation in the House. And media coverage, while still too dismissive of real reform and too obsessed with disputes over the direction of the Democratic Party, afforded the plan dramatically more attention than previous efforts.
The Nation sat down with Sanders in his Capitol Hill office as he was preparing his legislation and asked him to explain why single payer is suddenly being embraced by top Democrats, and why so many Americans are expressing interest in going big when it comes to issues of health-care access and affordability.
The Nation: Why do you think single payer is gaining so much traction at this point? Your campaign certainly increased interest in the movement for a “Medicare for All” reform. But there’s more to it than that, isn’t there?
Bernie Sanders: I think its a combination of factors. Number one, obviously, we have had this Republican effort to destroy the Affordable Care Act. It gives people a sense of what is at stake when we make decisions about health care. I think that many people, even now, do not appreciate the impact that [repealing the ACA] would have on the country.
When I talk about many thousands of people dying every single year, and massive amounts of suffering, that is the truth. And what this [Republican] effort is about is not just the desire for tax breaks on the part of the rich, this is the fulfillment of the Koch brothers’ ideology to destroy virtually every government program. This is the beginning. If they are successful in destroying Medicaid, Medicare certainly will be next and Social Security not far behind that—and the Veterans Administration, as well. So this is part of a massive effort by the Koch brothers and other billionaires to take us back to the 1920s and to do away with virtually every major piece of legislation passed since the 1930s to meet the needs of our people.
TN: So do you believe in a ricochet effect in politics, where if one party (in this case the Republicans) goes to extremes on an issue like health care, that they ultimately open up a debate that creates space for the other party to make bolder proposals for alternatives such as single payer?
BS: I think the immediate impact of the Republican efforts is to make people realize that Donald Trump lied to them during the campaign. That’s the immediate political impact. In other words, this is a guy who said: We’re going to come up with a health-care plan that will provide health care to “everybody,” it’s going to be “great,” we’re going to “take on the pharmaceutical industry,” we’re going to “take on the establishment.” Well, I think more and more people understand that it turned out to be an entire pack of lies. He never had any intention of doing that at all.