At the start of the August congressional recess, Senator Bernie Sanders announced that he will introduce a senate bill this September "to expand Medicare to cover all Americans." Since the election, the movement for improved Medicare for all, has been urging Sanders to introduce a companion to John Conyers' HR 676: The Expanded and Improved Medicare for All Act, which currently has a record 117 co-sponsors in the House and is considered the gold standard by the movement.
Recent reports are that Sanders' bill falls far short of HR 676 in fundamental ways. In fact, Sanders' bill is a multi-payer system not a single payer system. His bill reportedly would allow private insurers to compete with the public system, allow the wealthy to buy their way out of the public system and allow investor-owned health facilities to continue to profit while providing more expensive and lower quality health care.
As a leader in the Democratic Party in the Senate, Sanders is trying to walk the line between listening to the concerns of his constituency, which overwhelmingly favors single payer health care, and protecting his fellow Democrats, whose campaigns are financed by the medical industrial complex. Sanders needs to side with the movement not those who profit from overly expensive US health care.
Today, August 30, Health Over Profit for Everyone steering committee members and supporters sent the letter at the end of this article to Senator Sanders raising specific concerns and urging Senator Sanders to amend his bill before it is introduced.
There are two realities
It has become the practice in Washington, DC to offer weak bills, which fail to address the roots of the crises we face, to make them 'politically feasible'. The Affordable Care Act (ACA) is an example of this. It was a compromise with the health insurance, pharmaceutical and private hospital industries from the start -- an attempt to appease them with public dollars in exchange for greater access to care. The ACA was built on a foundation of private industry even though the priorities of those industries are profit for a few, not health for everyone. That faulty foundation has perpetuated the healthcare crisis -- tens of millions without health insurance, tens of millions more who have health insurance but can't afford health care and poor health outcomes including tens of thousands of deaths each year.
There are two realities that must be considered. The healthcare crisis will not end until a system is put in place that guarantees universal comprehensive and affordable healthcare coverage through National Improved Medicare for All or another form of single payer system such as a national health service. That is what we call the 'real reality', and it simply won't change until there are real changes in policy that solve it. The political reality of what is 'politically feasible' is the other reality. This reality will change as people organize and mobilize to demand what they need. Politicians change their positions when they believe it is necessary to maintain their position of power. It is the task of movements to change what is politically feasible.
The movement for National Improved Medicare for All has been working for decades to educate, organize and mobilize the public to change the political reality. And it is working. There is broad public support for Improved Medicare for All and legislation in the House that articulates the demands of the movement. What is needed now is a companion bill in the Senate that is as strong as HR 676. Once that is introduced, activists will work to secure support for it.
Sanders has it backwards. Rather than starting from a position of strong legislation and building support for it, he is starting from a position of weak legislation that he considers to be more politically feasible. By doing so, he is losing the support of the movement that he needs to pass expanded and improved Medicare for all.
Activists versus legislators
This is where it is important to recognize the difference between activists and legislators. Activists and legislators have different priorities. Activists work to solve crises. Their dedication is to an issue. Legislators work to maintain their position, whether it is re-election, seats on committees, good standing with other legislators or continued funding from Wall Street or other wealthy interests. Legislators compromise when they believe it is in their personal best interest. Activists can only compromise when it is in the interest of solving the crisis they face.
To win National Improved Medicare for All, activists need to follow the principles outlined in I.C.U.:
The "I" stands for independence. Activists must keep their allegiance to their issue independent of the agenda of legislators and political parties. The goal is to solve the healthcare crisis, and politicians from both major parties will need to be pressured to support Improved Medicare for All. Remember, the movement is going against the interests of the big money industries that finance members of Congress.
The "C" stands for clarity. Legislators will attempt to throw the movement off track by claiming that there are 'back doors' to our goal or smaller incremental steps that are more 'politically feasible'. They will use language that sounds like it is in alignment with the goals of the movement even though the policies they promote are insufficient or opposed to the goals of the movement. This is happening right now in the movement for Improved Medicare for All. Numerous people, who consider themselves to be progressive but who are connected to the Democratic Party, are writing articles to convince single payer supporters to ask for less.