It's "single payer" and not "universal health care" and there some potential structural pitfalls in this incarnation, but Sanders, Warren and the two dozen progressive and health activist groups who've backed this proposal are planting a flag and declaring that healthcare is not something that markets can provide — it's the duty and right of civilized states to protect the health of the people who live in their borders.



The bill starts by sweetening the pot for seniors who may be wary about welcoming the rest of the country into their warm pool. It eliminates copays and deductions, except for name-brand drugs when generics are available, and adds dental, vision, and hearing aid coverage to Medicare where it didn't exist before — huge benefits that have long been a goal of public health advocates.

At the same time, people aged zero to 18 would be eligible for the coverage in the first year. In year two, the eligibility age would be lowered to 45. The next year, it would drop again to 35. In year four, the age restrictions would be eliminated.

The history of the expansion of the New Deal shows that once benefits have been enacted, they are difficult to take away. Opponents of Social Security, Medicare, and Medicaid have been working to cut or privatize all three since the day each was enacted, but instead each has grown over time. (The major exception was Aid to Families with Dependent Children, better known as welfare, which was repealed in 1996.)

By phasing in coverage, Sanders makes universal Medicare harder to repeal, and also easier for the public to understand. Everyone gets that transitioning when one turns 65 to Medicare is a relatively painless process. Under Sanders' plan, people would begin transitioning, after the first year, at age 45 instead of 65. That's not complicated.

The coverage of of dental care will also be life-changing for millions of people who live in pain — some of whom, unable to afford proper dental care, are even forced to change their diets.