Even though the short-term dream of having a Medicare for All (M4A) champion in the White House ended with the defeat of Senator Bernie Sanders’ primary campaign in 2020, the struggle to secure funding for healthcare Single-payer health care in the United States is far from certain. The House and Senate M4A bills have more than 100 Democratic co-sponsors, and the insurgent left flank in Congress is growing. Voters continue to express strong support for reform and continue to prioritize health care above almost any other political issue. Meanwhile, a year after the start of the global Covid-19 pandemic, the inequalities at the heart of the market-driven health system have never been more apparent – and no policy is better equipped to combat them than M4A.

Nonetheless, the way forward for any solid reform is difficult. Moderate Congressional Democrats opposed to M4A consistently outnumber those in favor, and President Joe Biden is on their side. Republicans are clearly hostile to large-scale public programs and will almost certainly continue to threaten to obstruct Democratic legislation. An even bigger hurdle is America’s $ 3.8 trillion healthcare industry, whose lobbying arm and business models would be fundamentally disrupted by replacing the private health insurance industry with a public insurance pool.

But that’s no reason to despair, argue Drs. Abdul El-Sayed and Micah Johnson in their new book Health insurance for all: a citizen’s guide. Instead, M4A’s meteoric rise in a few short election cycles should galvanize supporters to continue building the movement to win it. This book is a resource for that effort, outlining how Medicare for All will revolutionize America’s health care system, why no other reform proposal falls short, and how to navigate the hairy politics of its passage. I spoke with El-Sayed – a former Detroit public health commissioner, Michigan gubernatorial candidate and campaign substitute for Bernie Sanders – about the ascendant left wing’s request for signing in American politics.

–Nathalie Shure

NOTatalie Shure: You started working on this book before the Democratic presidential candidate was picked, and now it’s coming out weeks after the inauguration of Joe Biden, a longtime M4A opponent. How did your understanding of the political terrain change during its writing, and how should you think about this moment in regards to M4A?

Abdul EI-Ssays: We wanted to talk about politics as it relates to the real lives of real people across our country. And we wanted to reignite a conversation that I think we need to have in this country about the fundamental flaw in our health care system. Much has changed since Medicare for All was discussed in the Democratic primaries in late 2019 and early 2020 – we had a pandemic that brought our healthcare system to its knees. Many, many people have suffered from the way our health care system is built. We were actually between the publication of the book on two different days, depending on where we thought the political conversation was going to be. But ultimately it’s important to us that it came out early in the Biden administration, because we think we need to have this conversation now that there will be changes coming to our healthcare system. And we think they must be the to the right changes.

NOT. : In your assessment of the political terrain for M4A, you look at its relative and growing popularity in the polls, but you also note its limitations – the so-called public option votes equally well, for example, and support seems to plummet when questions are asked. focus on higher taxes. . Meanwhile, pro-M4A candidates have both won and lost in various elections against establishment-friendly Democrats who oppose this policy. Given its ambiguous political power among the electorate, should M4A be a litmus test for Democrats? And how do you make one?

ABDOS: Yes, and I think it’s already emerging that way. If you’re being honest — if you truly believe healthcare is a human right, and you truly believe healthcare companies stand in the way — there really is only one answer you can answer. reasonably happen. Elections are multi-faceted; the result of any one is not a referendum on medicare for all. Due to the huge political spending of the health care industry, what you see in our policy is not necessarily representative of what people want on the ground. So what I would say is, if you were serious about fixing both our politics and our health care, then the answer here is pretty obvious. You must support Medicare for All, and you must support the reforms of our political system which continue to corrupt it and prevent the will of the people from being translated into our public policy.

NOT. : Medicare for all has become a central political axis for left-wing candidates like Alexandria Ocasio-Cortez and Cori Bush challenging the powerful Democrats to their right. What role do you see these insurgent figures playing in the Medicare for All movement, and how should they fight for it during the Biden administration?

ABDOS: They are going to be essential in ultimately winning the future of Medicare for All. And we need more. In a democracy we have to win in the middle, we have to keep pushing and keep winning race after race. We are making incredible progress in this area, and more are winning with every cycle. But what powers it’s not just the people in Congress; these are people across the country, in communities who face health care inequalities and challenges in their own lives, and decide to be part of the movement to empower insurance- disease for all.

We focus a lot on electoral politics in particular, but sometimes we forget that this movement is just beginning and has had huge success, and I think we can have more of it. Many opponents of Medicare for All are afraid that we will keep moving forward, and they want this movement to think it can’t win, and think that because we don’t have a president who supports it. health insurance for all is impossible. But I take it very differently — we’re not going anywhere, and I’m really excited about it.

NOT. : You discuss the importance of organizing a grassroots movement to win Medicare for All and how mass mobilization has been key to winning Medicare and Medicare over the years. 1960, when his absence also contributed to the failure of earlier reforms. But how exactly to organize this movement is far from clear. How can Medicare for All empower power outside the electoral system?

ABDOS: In the book, we talk about the key ridings that we need to organize, and the ones that I think are really at the tipping point right now are doctors, seniors, workers, and businesses. When it comes to doctors, for example, we’ve seen that the evolution of the healthcare industry has largely frozen them. Increasingly, physicians no longer own their own practices, and the average physician now works for a large health care system. As these systems deprive physicians of autonomy, it is no wonder that the opinions of physicians are starting to change. The average doctor today too believe in single-payer health care. We must therefore continue to work to bring doctors together. One opportunity is to reorganize medicine into unions instead of guilds like the American Medical Association.

When it comes to business, the cost of health care has become so expensive, and businesses are starting to realize that it’s untenable for them — and I think we have to keep making that argument. With the elderly, a lot of them worry because there has been so much propaganda about what will happen to Medicare itself; they think Medicare for All would mean the healthcare pie cut into bite-size pieces, but in fact one of the most important things we can do to ensure Medicare’s longevity and security is to expand it to more people paying in a larger system.

And when you think of work, the reality is that every dollar they negotiate in the form of health care benefits would be better spent like a dollar in the pockets of their members. At the end of the day, the industry will spend a lot more money than we can on advertising and fear-mongering, telling people that they will lose their choice and autonomy, that it is going to cost too much and that they will have their care rationed. But really, we know that the healthcare industry, as it is, already does all of these things. Our job is to sustain and build a conversation between and among these diverse stakeholders about what could be if we were ready to embrace a future where we have health care worthy as a human right, rather than just a privilege.

NOT. : You have emphasized the importance of advancing the cause of Medicare for All in the context of the health care policy debates that are nearly looming with a slim Democratic majority under the Biden administration. How should Medicare for All advocates move towards incremental reforms and differentiate those that bring us closer or further to our goals?

ABDOS: I have a fairly simple section: I ask myself: (a) Does this widen access to health care in general? (b) Does it do so by public means? And (c) does it reduce the power and influence of healthcare companies? If the answer to these three questions is yes, then I support it. And if the answer to any of these things is no, I need to take a closer look, but usually I don’t. So, for example, take the COBRA grants for people who have lost their employer sponsored insurance. In theory, this will expand access to health care, but this injects money into the corporate health system and does not expand the footprint of public health care. So I don’t support COBRA grants: I think they’re fueling the failure of a system that isn’t doing the job it’s supposed to do, that won’t fix its own failures. Compare that to something like a public option which, make no mistake, has its real problems; but if you really have Public public option that expands the footprint of public health care, expands health care in general, and reduces the power and influence of health care companies, so I think this is a plan we could support. But here’s the thing: we can’t take that for an answer. We can accept this as a step toward the answer. I want people to understand the difference. You cannot try to present it as the end and the end of health care reform, but only as a step towards a truly universal single payer system. But I’d rather take a step forward than a step back, and I’d rather take a step forward than stay where I am.