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Medicare for All: As Healthcare Costs Soar, Momentum Grows to Guarantee Healthcare for All Americans

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As Democrats prepare to take control of the House, pressure is growing on the Democratic leadership to embrace Medicare for all. Nearly 50 newly Democratic members of Congress campaigned for Medicare for all. In the last year, 123 incumbent House Democrats also co-sponsored Medicare-for-all legislation, double the number who supported a Medicare-for-all bill in the previous legislative session. Meanwhile, pharmaceutical, insurance and hospital companies are paying close attention. As The Intercept’s Lee Fang reports, over the summer the groups formed a partnership to fight the growing support for expanding Medicare. We speak to three proponents of Medicare for all who have assembled in Burlington, Vermont, for a gathering of The Sanders Institute: Kelly Coogan-Gehr of National Nurses United, British anesthesiologist Dr. Hosnieh Djafari-Marbini and organizer Jo Beardsmore.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: We are broadcasting from Colchester, Vermont, from the studios of Vermont PBS.

The U.S. midterms have made history with an unprecedented hundred women elected to serve in the U.S. House of Representatives, among them the first Native American women, Muslim women, the youngest woman ever elected to Congress, Alexandria Ocasio-Cortez. But there’s another first that’s been far less covered: the record number of new lawmakers who campaigned for Medicare for all. There are nearly 50 of them. Also in the last year, 123 incumbent House Democrats co-sponsored Medicare-for-all legislation. That’s double the number who supported the bill in the previous legislative session.

But there is a group that’s paying close attention. That’s the pharmaceutical, insurance and hospital industry. As The Intercept's Lee Fang reports, over the summer the groups formed a partnership to fight the growing support for expanding Medicare. Documents obtained by The Intercept reveal the group aims to, quote, “change the conversation around Medicare for All” and “minimize the potential for this option in health care from becoming part of a national political party's platform in 2020,” unquote. Despite this, the movement for single-payer healthcare is growing. There is now a Medicare for All Caucus, co-chaired by Congressmember Pramila Jayapal, which advocates say is a sign of lawmakers’ increasing interest in the issue.

Well, Democracy Now! is broadcasting from Vermont, just in Colchester, outside Burlington, where progressive leaders have traveled for The Sanders Institute gathering. Last night, Senator Bernie Sanders kicked off the event off with a keynote speech, which we’ll play later in the broadcast. But we’re starting with some of the organizers who have come to town to talk to Medicare for all.

Kelly Coogan-Gehr is the assistant director of public and community advocacy at National Nurses United. Dr. Hosnieh Djafari-Marbini is an anesthesiologist and Labour city councillor in Britain. And Jo Beardsmore is an adviser on the campaign for Medicare for all with National Nurses United and with Momentum, and a senior adviser at The Social Practice, facilitating collaboration between organizers in the U.K. and the United States.

We welcome you all to Democracy Now! We’re going to begin this conversation by talking to Kelly Coogan-Gehr. Talk about what is happening in the United States. I don’t think—yes, I think the hospital industry is paying very close attention, the drug industry and the insurance industry, but what—the kind of momentum that the Medicare-for-all movement is gaining, and what Medicare for all is?

KELLY COOGAN-GEHR: So, Medicare for all is guaranteed healthcare for all Americans. It’s portable. It’s free at the point of delivery. And it also essentially brings a multipayer system into a single payer. So you have the insurance industries, you have the government, you have individuals and families, and that would, in a single-payer system, all be brought together, and therefore be much more sort of administratively efficient than our multipayer system is now. Several studies have come out from conservative think tanks, from liberal think tanks. All of them confirm that a Medicare-for-all system, a single-payer system—it’s the same thing—would save Americans substantial amounts of money.

I think what we’re seeing is, for decades, people have known that Medicare for all will guarantee healthcare for everybody. I think unions and working people understand that delinking healthcare from employment status will increase the industrial power of working people. But I think what’s happening now is actually really unique, and that is that we are in an era of protofascism. And I think Americans, at an intuitive level, understand that given that right now healthcare spending is 18 percent of our gross domestic product—by 2026, it will be over 20 percent of our gross domestic product—by fighting for Medicare for all, the American people understand that they are taking back a fifth of their economy and that they are bringing it back into public accountability. They are bringing it back, essentially, to the people. And so it’s a much bigger fight than just guaranteeing healthcare for all Americans, and I think that’s why we are finding this level of deep commitment and enthusiasm.

AMY GOODMAN: And how big is it here in the country? I mean, 50 newly elected lawmakers, roughly, almost 50, ran on that platform.

KELLY COOGAN-GEHR: Right. Well, their constituents are saying to them that this is what they want. The people are putting pressure on establishment politicians. This is what they want. They want their politicians to support guaranteed healthcare for all Americans. And I think that—

AMY GOODMAN: How is the Democratic leadership responding?

KELLY COOGAN-GEHR: Well, I think one of our biggest—you were talking about the pharmaceutical industries. You were talking about the for-profit—other for-profit industries like hospital industries. I think one of the biggest forms of inoculation is the extreme center of the Democratic Party that is trying to respond with a public option, and so basically keeping the insurance industry in the driver’s seat, keeping the existing financing mechanisms of our healthcare system in the driver’s seat and offering sort of this option that people can go into and get publicly funded healthcare. But what that’s going to do is, the sickest individuals are going to go into that system, and it’s going to make it look like Medicare for all is much more expensive than it actually is.

AMY GOODMAN: I wanted to turn to Hosnieh Djafari-Marbini, a doctor, an anesthesiologist in Britain.

DR. HOSNIEH DJAFARI-MARBINI: Yeah, that’s right. Yes.

AMY GOODMAN: Explain how Britain adopted the system that it got.

DR. HOSNIEH DJAFARI-MARBINI: So, actually, the NHS, the National Health Service, came into being at the end of the Second World War. And this was at a time when the U.K. was at its knees after the war. And it was a publicly funded, publicly provided and publicly accountable service. And the NHS is hugely popular and revered in the U.K. It’s more of a national obsession than a great cup of tea or the weather, and it really makes or breaks elections if people feel that politicians are not looking after the NHS.

But what we’ve seen in the U.K. since the Conservatives have been in power has been a privatization, a market-based approach, bringing in different providers and a fragmentation of service, which is affecting the patients I see, who are getting, for example, social care visits that are 10 minutes long and completely inadequate. And we are actually fighting this neoliberal ideology alongside the Americans, so it is actually the same ideology that we’re battling, but from different starting points.

AMY GOODMAN: We’re going to go to break and then come back to this discussion and talk with someone who’s been negotiating on both sides of the pond, who’s been mobilizing here in this country, bringing that back to the U.K. and then bringing back U.K. successes to the United states. Stay with us.


AMY GOODMAN: This is Democracy Now!,, The War and Peace Report. I’m Amy Goodman. We’re broadcasting from Vermont PBS, just outside Burlington, in Colchester. Today and tomorrow in Burlington, there is a gathering that’s sponsored by The Sanders Institute. Senator Sanders spoke last night. We’re going to hear his speech in a moment, speaking to a gathering of international progressives.

One of the key issues here is the issue of Medicare for all. There’s a new caucus in Congress right now, the Medicare for All Caucus. Something like 48 of the newly elected congressmembers ran on a Medicare-for-all platform. Our guests are Kelly Coogan-Gehr of National Nurses United; Dr. Hosnieh Djafari-Marbini, an anesthesiologist in Britain who speaks for nationalized healthcare in the United Kingdom; and also Jo Beardsmore. Jo, talk about your work here and in Britain.

JO BEARDSMORE: So, I’m helping to organize in the Medicare-for-all campaign and to mobilize the hundreds of thousands of people who are fighting for healthcare justice in the U.S. And we’re doing that using campaigning techniques that have been used both in the U.S. and in the U.K. So, we’re seeing similar political moments on both sides of the pond. In the U.S., we saw Bernie Sanders’ campaign in 2016, which mobilized an unprecedented number of people in the fight for social justice. In the U.K., we saw a similar movement propel Jeremy Corbyn to the leadership of the Labour Party, becoming one of the most significant and powerful political figures in the U.K.

Now, these things didn’t just happen by accident or by coincidence. It was the result of active solidarity by Americans and people in the U.K. who are fighting for the same just causes. Now we’re bringing those campaigning techniques, which focus on talking to all voters and listening to their concerns, and we’re bringing that to the Medicare-for-all campaign. So we have volunteers who are out knocking on doors and making phone calls every single weekend.

And this movement is led by nurses. And that’s very relevant, because nurses are the people who see, are on the front lines of the healthcare crisis in the United States. They’re leading this campaign and the fight for Medicare for all. And it’s a fight we really believe we can win, because we are seeing this emergence of new campaigning techniques which allow far more people than ever before to engage in politics. We saw at the recent midterm elections the number of volunteers who stepped forward to help elect progressive politicians, and now we’re seeing the energy directed into causes like the fight for healthcare justice in the U.S.

AMY GOODMAN: Kelly Coogan-Gehr, in the lead-up to 2020, what is your new approach? I mean, before Bernie Sanders ran for president and shocked all by the enormous momentum that he gained as he pushed for Medicare for all and other issues—I mean, you’re in a whole different landscape right now.

KELLY COOGAN-GEHR: That’s exactly right. So, as Jo started to mention, we are moving into a modality of organizing called big organizing. And for those who are familiar with organizing methods, there is an organizing method called Alinsky, the Alinksy method, and it’s sort of one-on-one, personal conversations.

AMY GOODMAN: Named for Saul Alinsky?

KELLY COOGAN-GEHR: Yes, yes. And what we’re trying to do is use the technologies that mediate our everyday lives to scale up, in a matter of weeks, to literally reach hundreds of thousands of people. And this methodology for organizing was developed on the Bernie 2016 campaign, and it is one of the reasons why I think Bernie became such a household name so quickly. And it allows us to use phone banks and text messages to literally reach people with our message about Medicare for all and then get them engaged and taking on leadership roles in our movement.

AMY GOODMAN: So, what are the critical issues that people are most concerned about healthcare in this country?

KELLY COOGAN-GEHR: Cost. I mean, when people talk about single payer and they say to me, “Well, how could we possibly afford it?” how can we not afford single payer? Not even for the moral and ethical reasons, but you have 85 million Americans who are underinsured, and officially what that means is that 10 percent of their income goes into co-pays and deductibles. You have one in three Americans in the course of their lifetime declaring bankruptcy because of medical costs. You have over 40 percent of Americans, within two years of being diagnosed with cancer, going through their entire life savings. This is unconscionable. We absolutely can’t afford it. And when Republicans take the message and reframe it, what they are focusing on is they are focusing on federal healthcare expenditure. But every single study, even from the conservative Mercatus institute that came out this past summer, shows that—

AMY GOODMAN: This is the Koch-brothers-funded—

KELLY COOGAN-GEHR: This is the Koch-brothers-funded—

AMY GOODMAN: —libertarian think tank.

KELLY COOGAN-GEHR: —libertarian—$2 trillion dollars of savings over the course of 10 years, using extraordinarily conservative metrics.

AMY GOODMAN: And today there is going to be a major report revealed at the Sanders gathering—


AMY GOODMAN: —on the cost of Medicare for all.

KELLY COOGAN-GEHR: Which actually reveals similar findings. I mean, what’s fascinating—the savings that this report will reveal is a little bit greater, but it’s fascinating that on both the libertarian end and on sort of the more left progressive end, both ends of the spectrum are seeing savings, but where they’re seeing savings is in the national health expenditure.

AMY GOODMAN: And how do you address people’s concerns they can’t choose their own doctor?

KELLY COOGAN-GEHR: Of course you can choose your own doctor. Yeah, I mean, as a matter of fact, people are going to have more freedom of choice.

AMY GOODMAN: That you’ll wait on lines, that you won’t ever get to see whoever that doctor is?

KELLY COOGAN-GEHR: I think that a lot of that kind of stuff will have to play out once the legislation gets passed, once the regulation process begins. And, you know, another huge issue, of course, is, is that we need an increase in the number of primary care doctors. And once that were to happen, people wouldn’t have to wait in line. But then we also have to then, of course, address the exorbitant cost of medical school and higher education.

AMY GOODMAN: Dr. Djafari-Marbini, as you look at the struggles here, what would you advise people in the United States, based on your own involvement in the National Health Service in Britain?

DR. HOSNIEH DJAFARI-MARBINI: It’s really interesting what Kelly was just talking about, because actually in the U.K. outsourcing has actually cost us a huge amount of money.

AMY GOODMAN: That means the privatizing of your healthcare system.

DR. HOSNIEH DJAFARI-MARBINI: So, for example, maintenance of hospitals is being done by outsourcing via now-bankrupt Carillion maintenance service. And actually changing a lightbulb is—the cost of changing a lightbulb has become—has been rising dramatically. And actually, the outsourcing and the fragmentation is a real issue that we are trying to get away from. And I think the only way to do that is to look at progressive politics and get away from this marketization and neoliberal ideology, which has been so prominent both in the U.K. and in the U.S.A. politically.

AMY GOODMAN: Jo Beardsmore, you see both systems operating. So, what is the message? And what did you take from the Bernie Sanders campaign back to the Jeremy Corbyn campaign? He’s the second most powerful person now in Britain, behind Prime Minister Theresa May. He’s the head of the opposition party, the Labour Party.

JO BEARDSMORE: Well, we learned that in order to mobilize people to take action on the scale needed to win big progressive causes, we have to offer them a big political vision which will inspire them to take action. We saw that with Bernie, we saw that with Jeremy, and now we’re seeing that with Medicare for all. It’s not enough to offer small technical solutions to these big complicated problems that just tinker at the edges. We have to offer bold solutions which really match the scale of the problems we face. When we do that, we can build volunteer armies which are actually able to overpower corporate interests and establishment politicians. And that’s how progressives like Jeremy Corbyn are going to win in the U.K. That’s how we’ll defend healthcare justice in the U.K. and save the NHS. And it’s also how we’re going to win Medicare for all here in this country.

AMY GOODMAN: Finally, Kelly, the difference between the British system and the Canadian system?

KELLY COOGAN-GEHR: So, the British system is a nationalized healthcare system. The government owns the hospital. The hospital workers, healthcare workers are government workers. In the United States, the provisioning of care would still remain private. We already have Medicare right now. It’s for those 65, 67 and older. It would be expanded to everybody. So, the payment—

AMY GOODMAN: And we’re going to hear Bernie Sanders talk about that in just one minute. I want to thank you all for being with us, Kelly Coogan-Gehr, assistant director of public and community advocacy at National Nurses United. We have also been joined by Hosnieh Djafari-Marbini, anesthesiologist, Labour city councillor in the United Kingdom, and Jo Beardsmore, adviser on the campaign for Medicare for all with National Nurses United, as well as the group Momentum in Britain.

This is Democracy Now! When we come back, Bernie Sanders speaks.

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