‘Opponents of Medicare for All Are Deathly Afraid’

Even if the near-term dream of getting a Medicare for All (M4A) champion into the White House ended with the defeat of Senator Bernie Sanders’s 2020 primary campaign, the fight to win single-payer health care financing in the United States is far from over. The House and Senate M4A bills have over 100 Democratic cosponsors, and Congress’s insurgent left flank is growing. Voters still voice strong support for the reform, and continue to prioritize health care above nearly any other political issue. Meanwhile, a year into the global Covid-19 pandemic, the inequalities at the heart of the market-driven health care system have never been more apparent—and no single policy is better equipped to combat them than M4A.

Nonetheless, the path forward for any robust reform is challenging. Moderate congressional Democrats opposed to M4A still outnumber those in favor of it, and President Joe Biden is on their side. Republicans are demonstrably hostile toward large-scale public programs, and will almost certainly continue to threaten to filibuster Democratic legislation. Even greater an obstacle is the $3.8 trillion American health care sector, whose lobbying arm and business models would be fundamentally upended by replacing the private health insurance industry with one public insurance pool.

But that’s no reason to despair, argue Drs. Abdul El-Sayed and Micah Johnson in their new book Medicare for All: A Citizen’s Guide. Instead, the meteoric rise of M4A within a few short election cycles ought to galvanize advocates to keep building the movement to win it. This book is a resource toward that effort, laying out a case for how Medicare for All will revolutionize the US health care system, why no other reform proposal measures up, and how to navigate the hairy politics of passing it. I spoke with El-Sayed—a former Detroit public health commissioner, Michigan gubernatorial candidate, and Bernie Sanders campaign surrogate—about the signature demand of the ascendent left flank of American politics.

—Natalie Shure

Natalie Shure: You began working on this book before the Democratic presidential candidate was chosen, and now it’s coming out weeks after the inauguration of Joe Biden, a longtime vocal opponent of M4A. How did your understanding of the political terrain change over the course of writing it, and how should we think about this moment as far as M4A is concerned?

Abdul El-Sayed: We wanted to talk about the policy in the way that it maps onto the real lives of real people across our country. And we wanted to reignite a conversation that I think we have to have in this country about the fundamental brokenness of our health care system. A lot has changed since Medicare for All was discussed as part of the Democratic primaries in late 2019 and early 2020—we’ve had a pandemic that has brought our health care system to its knees. Many, many people have suffered as a consequence of how our health care system is constructed. We were actually between publishing the book on two different days,…