Above photo: The audience waves signs as Sen. Bernie Sanders (I-Vt.) speaks during an event to introduce the Medicare for All Act of 2017 on Wednesday, Sept. 13, 2017. Bill Clark/CQ Roll Call.
We need to put single payer back on the table, loudly, proudly, and strategically.
In May 2009, Dr. Margaret Flowers, renowned single payer activist and humanist, was one of 13 single payer activists, doctors, and nurses arrested at one of the Senate Finance Committee meetings, chaired by then-Senator Max Baucus (D-Mont.), charged with reforming the U.S. health care system. The committee heard from 28 witnesses over two days representing major health care stakeholders. Missing from the lineup was even one witness in support of the obvious solution, single payer health care. As activists were hauled out of the hearing by police, one of them could be heard saying, “Why aren’t single payer activists at the table?”
Why indeed.
Then as now, single payer has been taken off the table, as evidenced by the recent 2025 Proposition Agenda released last week by the Congressional Progressive Caucus (CPC) to help energize the base of uninspired progressives and young voters to vote for President Joe Biden. Absent from the progressive blueprint are two items that surely excite progressive voters: Medicare for All and Gaza.
Even the 2019 agenda, as progressive Democrats faced the prospect of Trump’s reelection, mentioned “a truly universal system in the near future.” But in 2024, they seem to have abandoned even this paltry demand.
A timid health agenda that doesn’t call for bold action like national single payer, Medicare for All will keep voters home, away from the polls, where the Democrats need them.
Speaking to NBC News, the Chair of the CPC, Congresswoman Pramila Jayapal (D-Wash.), preferred to include in the agenda “things that were populist and possible… and affected a huge number of people.”
Nothing could be more populist or affect more people than single payer, Medicare for All. A majority of Democrats (54%) favor a single national government program to provide health insurance, including 57% of Democrats under 30 and even 43% of moderate to conservative Democrats. The only thing that makes it not “possible” is Congress, not the will of the people.
There is little in the CPC health care agenda that will energize voters to storm the polls in November. Other than calling for the expansion of Medicare negotiation to cover all drugs for all Americans and capping drug prices to the average price in the Organization for Economic Cooperation and Development (OECD) countries (something that could easily be achieved under Medicare for All), the rest of the 2025 health care agenda is anemic at best.
Adding dental, hearing, and vision to Medicare, “cracking down on privatization of Medicare” without any specifics, or “shielding patients with medical debt from financial devastation by removing medical bills from credit reports” are cynical, incremental steps that will not rouse disaffected Democrats. A timid health agenda that doesn’t call for bold action like national single payer, Medicare for All will keep voters home, away from the polls, where the Democrats need them.
Then as now, our health care continues to accommodate for-profit players at the expense of our nation’s health. Even as the economic outlook for U.S. health insurance in 2024 is “neutral,” according to Fitch Ratings, the insurance industry is still expected to report in excess of $1.4 trillion in gross statutory income in 2023. After the Center for Medicare and Medicaid Services (CMS) stuck to its guns and finalized a pay “cut” to Medicare Advantage plans (the private managed care plans for seniors on Medicare) in 2025, health insurance companies threatened to scale back benefits, hike premiums and reduce provider payments. No one, least of all officials at CMS, expects these insurance companies to scale back on profits to make up for the loss in revenue. Not in America. The “cut” the industry is moaning about is a payment rate increase of 3.7%, or more than $16 billion next year, but, because it is slightly lower than the rate hike they received in 2024, is considered a “cut” in the eyes of a greedy, profit-driven system that is overpaid by as much as $140 billion every year.
While progressive Democrats blame single payer as not being populist enough or politically possible, it is the corporate takeover of the political system through campaign contributions that has taken single payer off the table.
These insurance corporations are major campaign donors, the reason even progressive Democrats are timid about single payer. Over his 25-year career, the senator from Montana who kicked the activists out from the Senate hearing received $3.8 million in campaign contributions from the health sector, an average of $152,000 per year. Since 2019, health industry campaign contributions for the current Democrat chairing the Senate Finance Committee, Ron Wyden (D-OR), have totaled $1.4 million, or $280,000 per year. A quick search of campaign contributions to Democrats in the Congressional Progressive Caucus, shows across the board consensus: the health care sector is generous with progressives as well.
While progressive Democrats blame single payer as not being populist enough or politically possible, it is the corporate takeover of the political system through campaign contributions that has taken single payer off the table. Blinded by corporate dollars, Democrats are unwilling to recognize the perverse and exceptional role of profit, which has captured our health care system, our elected officials, and the government agencies tasked with protecting the health of the nation.
It’s time to put national, single payer, Medicare for All on the table. We need a reinvigorated campaign, like the one that started in 2009, when activists, nurses, and doctors were arrested for demanding that single payer be on the table. We call for everyone to stand up and put the real solution, National Improved Medicare for All free from corporate profit, on the nation’s agenda.
We are facing a crisis at home and abroad. The voters that progressive Democrats want to attract through their agenda not only support national legislation for single payer but support a ceasefire in Gaza by wide margins. If the Congressional Progressive Caucus wants to excite the base, move young people to vote in November, it must have the courage to propose bold, popular policies that uplift and inspire us. Everyone, not just the young, will come out to vote for that.