Holdout Democrats Face a Single-Payer Surge
Health industry-backed Democrats who’ve yet to join their colleagues in backing Bernie Sanders’ Medicare-for-All bill will face a new wave of grassroots pressure, says Michael Lighty of National Nurses United
AARON MATE: It’s The Real News. I’m Aaron Mate. The long fight for single-payer universal health care has picked up steam. This week an unprecedented 16 Democrats signed on to co-sponsor Bernie Sanders’s Medicare for All bill.
BERNIE SANDERS: Today all of us stand before you and proudly proclaim our belief that health care in America must be a right, not a privilege. You, the Republican Party, have shown the American people what you stand for when you voted for legislation that would throw up to 32 million Americans off of the health insurance they have and at the same time give huge tax breaks to the rich and large corporations. You, the Republican Party, have no credibility on the issue of health care.
AARON MATE: Sanders’s Democratic co-sponsors joined him on stage. But what about the rest of the Democratic Caucus? There are still 31 Democratic senators who have not signed on. And a new analysis from the group MapLight suggests at least one possible reason why. These 31 Democrats have received an average $55,000 from the health insurance industry since 2010. Michael Lighty is a Director of Public Policy for National Nurses United. Michael, welcome.
MICHAEL LIGHTY: Thank you Aaron, and I should also say I’m also a fellow at the Sanders Institute, so I am pleased to be with you.
AARON MATE: That’s the group that Sanders has recently set up in the aftermath of the election?
MICHAEL LIGHTY: It’s really … yeah, it’s run by Jane Sanders, separate obviously from the political operation, devoted to policy. So they’ve asked me to participate as a health care policy fellow.
AARON MATE: Okay. Look, let’s talk Sanders and health care policy. First, your response to just the unveiling of this bill, with an unprecedented number of Democratic co-sponsors going on record to say, along with Bernie for the first time, that health care is a right.
MICHAEL LIGHTY: It’s extraordinary and I think it directly results from Senator Sanders’s political work making this the signature issue since his campaign. We’re seeing the fruits of that here with the movement, the grassroots movement, responding and generating just an immense campaign of phone calls, town halls, district visits, to really move these senators. It really went from zero in 2013 to 17 today, and it’s a movement on the ascension and it’s very strong policy, and we I think deserve to give a lot of credit to Senator Sanders.
AARON MATE: And the grassroots movements like yours that have been pushing for this for a long time.
MICHAEL LIGHTY: That’s right.
AARON MATE: Let’s talk about the Democrats on the other side, those who are not on board, the 31 that I mentioned. There’s that study from MapLight showing that they have received an average of $55,000 from the health insurance industry. Your thoughts on the struggle and the challenges of trying to get them on board.
MICHAEL LIGHTY: Well, it’s a pervasive problem. You’ve got the donor class, the political establishment, moving one direction, and you’ve got the people and their needs for healthcare moving in the other. And so that’s a classic kind of political conflict that I think will get resolved in favor of the people. We are confronting the corporate interests. They have more lobbyists for healthcare industry than there are members of Congress, three times as many. These are real issues. And it reflects the alienation of voters from politics that this big money dominates the most intimate policy arena of their lives. There’s nothing more personal than healthcare, and yet these corporate interests dominate and dictate.
The Princeton study from 2014’s very relevant here. Elite opinion and legislative priorities track. Popular opinion and legislative priorities tend not to. And that is the corruption of the American political system, nothing more personal than in health care.
AARON MATE: Speaking of which, I want to read for you a tweet from Bernie Sanders. He’s linking to an article from The Intercept that talks about the concerns of members of the pharmaceutical industry about his single payer bill. Sanders writes, ‘Pharma CEOs are nervous, and they should be.’ And let me just play you a clip that comes from that article by Lee Fang in The Intercept, talking about a pharmaceutical executive speaking recently to a conference about his fears around single payer. Here he is.
BRENT SAUNDERS: You know, I think we’ve gotta do things to bring that trust back, because ultimately someone’s going to be in the White House, somebody’s going to be in Congress, someone’s going to be somewhere, and going to have to say enough’s enough. Let’s just change the whole system, let’s go to one payer, let’s do something. The left of their party is really gotten a lot of voice and taken control, and so you have Bernie Sanders and others in that movement have really tried to vet candidates. On the opposite side of the coin is the Tea Party. So we’re seeing the divide go further, and clearly they want to go to a one … that part of the party wants to go to a one-payer system.
AARON MATE: So Michael Lighty, that’s Brent Saunders of a company Allergan saying that Americans are going to say about healthcare enough is enough.
MICHAEL LIGHTY: Well, he’s right. He’s right. And it’s not just a segment of the Democrats who want this. This is very popular. A majority of Republicans support a Federal guarantee of healthcare. You’ve got a majority of Democrats, a strong majority, I mean it’s somewhere 60-70% support it. And you’ve got the momentum of the movement. There’s only one movement out there and that’s the one demanding Medicare for all, so I think it’s a misreading of the politics to say this is a narrow band of support. It’s a broad band of support, and Americans are fed up. Enough is enough, and they’re not afraid of losing what they have, because what they have is not good enough.
AARON MATE: What do you think of the concerns that people have raised about these 16 Democratic co-sponsors, that they’re not actually really serious about fighting for single-payer, that they know that because this is a Republican-controlled Congress, and also because so many Democrats are not going to sign on to single-payer, that simply for many of these people, like Cory Booker, Kirsten Gillibrand, others who are rumored to be contenders in 2020, that this is just a political stunt for them to be able to say, “Yes, I supported single-payer,” knowing that it actually has no chances.
MICHAEL LIGHTY: The movement’s going to hold them accountable, that’s what I’d say. I mean, it’s not up to them. A lot of these folks didn’t necessarily want to get on the bill, but the politics compelled them. Baseline policy is good, they recognize that. It’s very good, they recognize they had a comfort level with it, but this is being driven by the movement and their constituents, and they’re going to have to be continually accountable to them. I don’t really care about their motivations necessarily. What I care is when it comes time to vote, they vote for it.
AARON MATE: Right. And you know, once you go on record saying that something is a right, it’s pretty difficult to walk that back.
MICHAEL LIGHTY: I agree, Aaron. I really agree, because I was there yesterday, and I was thinking man, if these guys aren’t serious they’ve really committed themselves to something that they’re going to have to answer for.
AARON MATE: Yeah. But let me also put to you another argument I’ve heard in the liberal pushback to Sanders’s bill. This week in my segments on the Sanders healthcare bill, I’ve been trying to put forward the counterarguments that are going to be put forward against people who want to see universal healthcare. One of them is that we should be focusing our attention not on the impossible, but on shoring up what’s currently under attack, which is the Affordable Care Act. Do you think first of all that that’s mutually exclusive? That’s it not possible to do both?
MICHAEL LIGHTY: It’s not mutually exclusive number one. The folks, the activists and the regular folks who need healthcare were desperate for healthcare and got it under the ACA, came to Washington, protested at the Senate. They, as part of this movement, organically demanded Medicare for all. They were literally getting arrested to save the ACA and demand Medicare for all. So if those folks can do it, including disabled activists, I think members of Congress are probably capable.
But secondly, this reform is more popular that the ACA, it’s more popular than repeal, so why not do this, which is the popular part of the system, Medicare, that works. It only makes sense. We’ve tried everything else. So I just don’t buy that argument, and I just haven’t seen it in practice, because I’ve seen activists doing both all over the country.
AARON MATE: Okay. One more I’m going to throw at you. One figure we’ll hear often is that healthcare accounts for one sixth of the economy, so it’s simply just not feasible to try to undergo such a radical transformation of something so vital to the nation and immersed in so many different people’s lives, for many people as their place of work, because many people work for the healthcare insurance industry. Your thoughts on that.
MICHAEL LIGHTY: Well, we have to take care of the workers who are displaced as a result of this, and both Senator Sanders’s bill and other state bills have that provision for just transition for those workers, but the reality is this reform is not disruptive. 60% of healthcare expenses are paid by taxpayers today. This expands public financing, but that’s what it changes. You can still go to your doctor, in fact you can go to any doctor. You have complete choice, unlike the present system where there are narrow networks. So in fact, it preserves the doctor-patient relationship by enhancing access and by enhancing the role of doctors and nurses in determining care instead of insurance company bureaucrats. When you’ve eliminated insurance company premiums, deductibles and co-pays, that is popular, that’s not a disruption.
AARON MATE: Speaking of disruption, what about the companies themselves? Would Sanders’s measure result in putting the insurance companies out of business?
MICHAEL LIGHTY: No, they’ve got other lines of work, but you also have administrative role. Aetna process claims for Medicare, and they do it at a much lower rate of administrative cost, under 5%. So you can incorporate the administrative process, but you don’t want the denials, treatment reviews, the bureaucrats overlooking the shoulders of doctors and nurses, and that’s what we eliminate. The administrative function can remain.
AARON MATE: But even in the administrative function, there’s still a profit motive there, so …
MICHAEL LIGHTY: No, no, not on that basis. You could contract with them to process claims and pay bills. There’s no profit. There’s no role for the insurance company per se, but there is a role for that process.
AARON MATE: All right, Michael. As you fly out of DC, where you joined Sanders’s kickoff event, your thoughts on where the struggle goes forward?
MICHAEL LIGHTY: The struggle goes forward to every state in the country, to get every senator on this bill. We’re not going to give up, and California’s going to lead the way with Senator Sanders. He’s going to be out in California next week, and we expect that to be a rousing kickoff for this national massive campaign.
AARON MATE: Michael Lighty, Director of Public Policy for National Nurses United. If you’re wondering why he’s whispering, it’s because he’s at an airport after joining Bernie Sanders and many others for the kickoff. Michael, thank you so much.
MICHAEL LIGHTY: Thank you, Aaron.
AARON MATE: And thank you for joining us on The Real News.