In 1969 Senator Ted Kennedy recognized via the success of Medicare that the only rational solution to our challenges with health care was to offer it as an option for everyone. Indeed, he spent most of his career fighting for Single Payer, which is why I was quite confused when Democrats hailed the passing of Obamacare as the fulfillment of the Senator’s legacy. Obamacare is not single payer. It is not even universal health care. Obamacare is largely an insurance mandate that preserves the status quo and enriches the pockets of insurers and drug companies. More and more people are finding that they can not afford insurance even with the subsidies Obamacare provides and in many cases the plans’ deductibles are so high that the insurance is rendered useless. I bet that if Senator Kennedy were alive today he would be disappointed in Democrats for reaching for so little when they had a presidential mandate and control of both houses of Congress.

Now, buoyed by extreme popularity during the 2016 election cycle and the failure by the GOP to provide an alternative, Senator Bernie Sanders has introduced his Medicare for All bill with a bevy of noteworthy co-sponsors. Nearly all of the Democratic 2020 hopefuls have signed on to co-sponsor the bill and there is a similar bill making its way through the House. And, all of this is great but the fact still remains that Democrats are in the minority in Congress and do not control the White House. Trump has pledged to veto the bill if it were to pass, a myopic pledge considering his recent willingness to do deals with Congressional Democrats. So, he is willing to alienate his base over DACA, the debt ceiling and the budget, but not to fulfill an actual campaign promise of universal health care?

If the Trump administration were to do a little research they would discover that Single Payer is not only wildly popular on our side, but also becoming more popular everyday on his side. I remind you that Vox found in a health care focus group of Trump voters that half of the participants preferred Single Payer- a system like Canada’s as they put it. Various members of the Alt-Right have called for Single Payer, advisors who are supposedly close to Trump have called for Single Payer and most importantly Single Payer would be of huge benefit to the type of voter that Trump claims to love- White, working class citizens left behind by the system. If Trump can somehow avoid Mueller’s wrath, he would be a dangerous incumbent going into 2020 with a DACA deal, debt ceiling deal and Single Payer under his belt.

Sanders has updated his Medicare for All plan from the campaign. During the campaign he said his plan would cost $1.38 trillion a year for the first ten years. This would have been paid for by a tax on employers, a tax on households, taxing capital gains and dividends like income, adjusting the estate tax, etc. Now, he is working with a group of Democrats to devise a plan to fund the bill. However, important aspects of Bernie’s campaign plan remain, which is that under Medicare for All, Medicare would replace the insurance industry (people could still buy premium coverage from insurers), patients would no longer pay copays and patients and doctors would no longer have to argue with insurers and providers over what they believe they should be getting.

Before Obamacare we had two major problems with health care in the US- access and cost. On access, we had far too many people living without insurance and going to the emergency room instead of regular visits with a doctor. On cost, most Americans described the cost of health care as at crisis level. Obamacare addresses access by mandating that everyone buy insurance or be covered under their parents’ plan, a clumsy mechanism that does not take into account the fact that many people can not afford insurance. Obamacare addresses cost by providing subsidies to low income citizens. But, in neither case did Obamacare actually solve the problem. As I wrote previously, even with the subsidies many Americans simply can not afford to buy insurance or get stuck in useless plans with very high deductibles. Include in that equation the fact that Obamacare does not have a cap on premium increases so insurers are free to price gouge. Lastly, Obamacare forced insurers to raise premiums for individuals who buy insurance outside of the markets and do not have employer based insurance. It is an unworkable system. So, Single Payer to the rescue.

Single Payer addresses both access and cost in the best ways possible. On access, everyone can have Medicare under Senator Sanders’ plan. On cost, Single Payer will save us all money. The average American spends twice as much as the average Canadian on health care. With the massive group bargaining power of Medicare for All we would have leverage to negotiate lower prescription prices from drug companies. Also, Single Payer would bring administrative costs associated with health care way down. And lastly, we would probably all be happier paying a little bit more in taxes if we could completely eliminate paying insurance premiums.

Single Payer is the health care system a first class nation should have. We have spent far too many years wrestling with the cost of the status quo while patients get inadequate care in many cases. Single Payer would address issues with access to care and the cost of care in the best ways possible. No longer would America be burdened by the cost of emergency care for the uninsured or the rising cost of health care for the average American. We need Single Payer now. And, hopefully the powers that be will see the light.