Green Party candidates Dr. Jill Stein and Dr. Margaret Flowers say Sanders is right about healthcare, but the Democratic Party will block him
PAUL JAY, SENIOR EDITOR, TRNN: Welcome to the Real News Network. I’m Paul Jay. Around a week ago, Dr. Margaret Flowers and Dr. Jill Stein, who are both Green Party candidates, one running for a Maryland Senate seat and one running for president of the United States, wrote an article examining the healthcare policies of Bernie Sanders, who’s also running for president, as you might have heard, and Hillary Clinton. And they said some favorable things about Bernie Sanders’ healthcare policy, some rather unfavorable things about Hillary Clinton’s healthcare policy, and of course advocated the Green Party healthcare policy. And here to talk about all of this are, first of all, Margaret Flowers. And Margaret is a pediatrician in the Baltimore area, co-chair of the Maryland chapter of Physicians for a National Health Program. She’s currently running for U.S. Senate, as I said, the seat left open by the retiring Barbara Mikulski. And joining us is Dr. Jill Stein. Jill is the Green Party–was the Green Party candidate in 2012, running for president. She’s in all likelihood going to be the candidate for the Green Party in 2016. The reason I phrase it that way is because there is a primary process for the Green Party, and Margaret and Jill have to win their primaries and go to the convention, and as the other parties do, become the actual candidates. But so far I think everyone kind of assumes they both will be the candidates. Stein was also candidate for governor of Massachusetts in 2002 and 2010. She’s an organizer, a physician, and a pioneering environmental health advocate. Thanks very much for joining us. MARGARET FLOWERS: Thanks for having us. JILL STEIN: Great to be here. JAY: So, Jill, because you’re running for president I’m going to talk to you first. Although if Margaret does get her seat in the Senate and you’re president, she could be quite independent, and organize the Senate, and be even as powerful, and more than you are, because we’ve seen such things. STEIN: Knowing Margaret, she will do that. JAY: But here we are. So talk a little bit about, first of all, the division between Sanders and Clinton on healthcare policy. We’re going to talk a bit–work our way through the article. And then we’ll get, we’ll dig in more into what differentiates the Green Party healthcare policy. But between the Sanders essentially Medicare for all plan, and Hillary saying incremental reforms to the Affordable Care Act, what’s your take? STEIN: It’s very clear that the Affordable Care Act has been very problematic. It has, you know, it has the benefit of having expanded Medicaid, and that’s been wonderful for poor people. But there are lots of other people who’ve been lost in the shuffle here. There are still about 30 million people who do not have coverage, and tens of millions more who have inadequate coverage. JAY: Drill into that. Why are so many people still not covered when the general idea out there is everyone now is covered? STEIN: Well, that may be the general idea, but that’s more propaganda than reality. What happened was that Medicaid got expanded in some states, and we didn’t actually need the Affordable Care Act to do that. The Affordable Care Act essentially creates another level of bureaucracy and complexity, and allowed the insurance companies to have a captured market, to require people, to mandate that people buy these stripped-down and expensive, skimpy policies, with a real feel-good sense about them, until you actually get sick. And then you find that they actually don’t fully cover you. You need to have a job–. JAY: Because of the size of co-pays, and such. STEIN: Yes, yes. Because of co-pays, because of limits on the network. There are all sorts of restrictions that are placed on it. We had Obamacare in Massachusetts for five years before Obamacare was passed. We called it Romneycare. It grew out of a Republican think tank. And it essentially expanded the market basis of healthcare. Healthcare should be a human right. We should be joining the community of nations around the world, developed nations who all provide healthcare at far less cost, at about half the cost or less of what we pay, and with far better health outcomes. In Massachusetts, we lost our safety net. And people who are truly ill in Massachusetts found that it only got harder to get coverage. People are being priced out. Workers have basically seen their costs, between premiums and co-pays, have seen their costs essentially doubled. And increasingly you have these stripped-down catastrophic insurance plans, which is all that people can afford to buy. JAY: So tell me what’s right and what’s wrong about the Sanders proposal. STEIN: Well, the Sanders proposal that he put out just before the debate is very good. It’s not yet legislation, but it appears to be the counterpart of what has been proposed in the House, HR 676, which is basically–. JAY: John Conyers bill. STEIN: Conyers bill, which is Medicare for all. And essentially it lowers the age of eligibility such that everyone is covered. And it uses Medicare, which spends about 2-3 percent on overhead, as opposed to 20 percent or more overhead through the privatized system. Medicare for all essentially costs the same, but covers us entirely, and allows us to expand coverage so that everybody’s in, nobody’s out, and you are fully covered, including your eyeglasses or your hearing aid, your mental health, your full reproductive healthcare. It takes the complexity out of healthcare, such that it’s between you and your health provider. It’s no longer in the hands of a profiteering insurance executive, you know, who is picking and choosing people based on who has least cost, and who is powerless to lower pharmaceutical costs, because that’s basically prohibited from, from the Affordable Care Act. JAY: So when it comes to healthcare, you think Sanders has more or less got it right. STEIN: He does have it right. I think where we would disagree with Sanders is just in saying that we can build on the Affordable Care Act, because you can’t. You can’t simply add levels of complexity, because it gets more expensive and untenable. It is collapsing under its own weight right now. We need to expand Medicare. FLOWERS: If I could comment–. JAY: Yeah. I mean, what does it mean to build on the Affordable Care Act? Because if you’re going to go to Medicare for all, you’re taking out private insurance companies. FLOWERS: Right. If I could back up and just comment on kind of the real–what I see as a really major difference between the Sanders approach and Clinton’s approach is, you know, the United States is the only industrialized nation that uses a marketplace to healthcare, that treats healthcare as a commodity. And that has been Clinton’s model. Even in the 1990s, what she was talking about back then was an insurance kind of monopoly. It was giving an insurance monopoly to a few insurance companies. That’s the same thing that the Affordable Care Act has basically done. There was this whole myth that it was going to create competition, and yet we still see that in all the various states with the exchanges there are a couple, one, maybe two, sometimes three dominating insurance companies that have the market. And so, and as we’re seeing mergers between the insurance companies, now we are really seeing them become much more of a monopoly. The Sanders approach, or the healthcare as a human right approach that we advocate for, gets rid of that whole insurance middle person, and creates a single-payer that’s publicly funded. So it’s accountable to the people, and it’s not trying to make a profit for its investors. It’s trying to cover necessary healthcare. And so that’s treating healthcare as a human right, it’s completely different. Now, in terms of Sanders’ plan, we haven’t really seen the details of his new plan that he came out with right before the most recent debate. It looks, sounds like it may be more like a John Conyers bill, but we really haven’t seen the specifics to critique it. JAY: Now, I’m not following this in as detail as I perhaps could. But one of the big things that President Obama did to pass the Affordable Care Act was make a deal with pharma, and essentially stop Canadian generics coming down, and bulk buying, and all the ways–for all the reasons why pharmaceuticals are so much cheaper in Canada and how beholden they are here. Has Sanders talked about this, and what’s your take on it? STEIN: I, you know, I don’t know. Margaret, you may be following this in more detail, on what Sanders says. But my sense is that yes, Obama, you know, continued to make deals with the devil here, around healthcare, as in, you know, foreign policy and civil liberties, you name it, that we have extremely compromised with Wall Street, et cetera. You know, we have a whole series of compromise policies. And you know, this is, as Margaret says, it’s about just creating greater market complexity. It’s not a system that works. I haven’t heard Sanders comment specifically on the pharmaceutical, you know, giveaway. But there’s no way that we can have affordable healthcare while we allow the pharmaceutical companies to essentially rake us over the coals. FLOWERS: Yeah, I think it’s–you know, I’ve worked with Sanders’ staff on their health policy. His initial plan was a 50 state administrative–each state administering their own plan, which was something that, very different from HR 676, and not something–. JAY: Because some states could come in, some states could have completely different standards. FLOWERS: They could make–there were certain decisions that they could make. JAY: But he fixed that. FLOWERS: Well, we don’t know. He basically came out right before the most recent debate with, oh, I think we need a national, you know, Medicare for all style-plan, but it was a very vague description. I think if you look at what we consider to be the gold standard, which is HR 676, it is very explicit about the fact that we need to negotiate for the price of pharmaceuticals, as well as medical service. JAY: Well, you know, the Canadian model, the provinces administer the healthcare plans, which are all publicly-insured plans, including publicly-owned hospitals, which, I don’t know if that’s what’s in your plan. And that, that’s a very significant piece of it. The only really private hospitals are grandfathered, things that existed before the legislation. I think there’s the beginning of a creep in some Alberta hospitals, but on the whole. But there is a national minimum standard, and if a province ever falls below the national minimum standard they lose their federal funding, which is the majority of the funding. FLOWERS: And that’s what Sanders was advocating for in his 50-state plan, as well. But there were certain decisions, like states could determine who a resident was, and they could decide that not everybody living in a state was a resident, and so people would be left out. Whereas under the HR 676, every person residing in the United States is in the system. And that’s, makes the most sense from a public health standpoint. If you want to keep a population healthy, everybody needs to have access to healthcare. JAY: I mean, I don’t know if people understand how simple healthcare is in Canada. I assume in Europe, too. It’s one card, you get it more or less when you’re born, and you show up and that’s it. You show your card, and you never pay co-pays, you’re not spending your weekends paying medical bills. STEIN: And the transition is really quick and simple, and easy. You know, it’s not like you have to create a website that integrates, you know, 100 different insurance plans, and you know, spend a year or two getting the website right. You know, the transitions to single-payer systems have been really unbelievably drop-dead simple. JAY: In your article–I’ll quote a piece of it. You talk about, that Bernie Sanders has introduced but never advanced legislation, meaning this type of health, Medicare for all. What does that mean, introduced but never advanced? What do you mean by that? STEIN: He didn’t get co-sponsors on the bill, he didn’t work to give it momentum. Now, why that is I don’t know. But you know, he, he took a step, but didn’t–you know, carry through and go all the way. Hopefully this new policy is better, it’s a better policy, it’s a much cleaner plan. You know, we’ll see what the legislation looks like. FLOWERS: I think that gets at the real crux of, you know, what it’s going to take. I mean, on the House side, the Conyers office has pushed the bill and has–I think right now we have, on the newest one we have 60 co-sponsors already on that. We’ve had as many as, well over 100 previous. If we want to get a real single-payer plan, what we’re looking for is leadership. Leadership at the presidential level would be wonderful. Obama could have been that person, because he certainly knew what a single-payer plan was. He–. JAY: Well, he certainly did, which is why he didn’t invite anyone on the Senate committee to advocate it, and hands the committee over to [inaud.], who he knew wouldn’t even listen to the single-payer idea. FLOWERS: Right. We need strong leadership in the White House, and we need strong leadership in Congress that’s going to say, you know, not only do we have a bill, but we’re going to make this bill happen. We see them do it all the time. We saw–you know, we fought the Obama administration on the fast track legislation for the Trans-Pacific Partnership. And that was something that, despite real public opposition to it, and even members of Congress, even within his own party opposed to it, they were able to strongarm that legislation through. Why aren’t we–you know, why don’t we have someone that uses that kind of leverage and energy to get us a healthcare system? JAY: Well, Hillary’s counterargument is that–Hillary supporters’ counterargument is that even Hillary’s very modest reforms to the Affordable Care Act would be a major war, given the Republicans control both houses and are likely, people seem to be predicting again, that the plan that Bernie Sanders is proposing is completely unwinnable. So even if it is the model plan, Hillary’s incremental changes actually have a more possibility of passing. STEIN: Yes. Well, you could also take the opposite point of view, which is to say that incrementalism never builds your public support to actually move things forward, and that it will be very hard to mobilize public opinion behind incrementalism, and a plan that people are actually outraged about. And most people are extremely opposed to the Affordable Care Act. JAY: Well, you can actually see that right now in the Sanders-Clinton campaign, because all the excitement about Sanders is that there’s a big idea there, not an incremental idea. STEIN: Yes, yes. Exactly. Which is why we think it’s definitely strategic here to not only stand up for single-payer, for Medicare for all, but also just tell the truth about the Affordable Care Act. Because if you want to get public resonance around this, and you want to go beyond the choir of the Sanders campaign, and you really want to reach out to all the people who are really up in arms about getting ripped off by the Affordable Care Act, you’ve got to tell the truth about it if you ever want to move forward. JAY: And why does Bernie keep building on the Affordable Care Act? He keeps wanting to say, I helped write the Affordable Care Act [crosstalk] when Hillary’s actually right. What he’s proposing does take the Affordable Care Act and throw it out. Of course, it doesn’t replace it with nothing, as she’s sort of trying to suggest. FLOWERS: Well, I mean, the majority of people in the United States– JAY: Why such a defender of this? FLOWERS: Well, I mean, the majority of people in the United States are actually healthy. So many of them don’t have experience with the Affordable Care Act and how lousy it is, because people find out how bad it is when they actually need to use it, and they find out that it’s not there for them. So he’s playing politics. He’s–so many people in the United States, especially on the progressive side, have been told for the last six years that this was the solution, that we did it, that we got national healthcare. And so he doesn’t want to, you know, offend those people. And that’s been a big part of the problem, is that. JAY: And probably also doesn’t want to be seen as dividing the fight against Republicans, who have waged such a campaign to undo it. STEIN: Yes. And also sort of define the Democratic party leadership, which is all behind Obama’s thing. And I think Bernie, you know, he’s a team player. FLOWERS: He always has been. STEIN: He always has been. He’s a Democrat, and, well, he’s functionally a Democrat. And I think he doesn’t want to really make big waves inside the party. And he’s a little bit [inaud.] by that. JAY: Okay. We’re going to do another, we’re going to do another segment of the interview, and we’ll talk about the politics of all of this. So please join us for part two of this discussion on the Real News Network with Dr. Stein and Dr. Flowers.