Vermont Senator and presidential hopeful Bernie Sanders says private insurance is causing anxiety, stress and even premature deaths as older Americans delay or defer medical care due to the costs.

“I get a little bit tired…the opponents of Medicare for All forget to tell us how we’re paying for it right now. We’re paying it out of people’s hides right now,” Sanders said Monday. “I’ve talked to folks who are paying $1500 a month in premiums.”

Sanders held a forum Monday in Des Moines with people from as far away as Oregon who talked about the challenges of paying for private insurance.

“The time is now. There’s too much suffering in this country. Too many people are uninsured, under-insured, going bankrupty…and we’re going to guarantee health care to all people as a human right,” Sanders said, to cheers and applause.

Robert Morrison of Burlington was laid off at the age of 64 when the Siemans plant closed. Morrison told Sanders he’s paying more than $700 a month for insurance.

“I got a notice the other day that the premiums are going up after the first of the year,” Morrison said, “so this is just like rubbing salt in the wounds of people like me.”

Sanders heard from one women whose family of five is paying more than $20,000 in premiums. Sue Baethke of Indianola is a cancer survivor who has insurance, but she and her husband have a $6000d dollar a year deductible.

“And so, lots of times, we just don’t go to the doctor, honestly,” she said.

Deanne Clemens Petersen of Cedar Rapids told Sanders her husband has Alzheimer’s and she drives 100-miles round trip every day to keep her job — and her insurance.

“I’ll probably end up on assistance and my husband probably will be, too, because you have to spend everything that you have in order to have care and when it’s gone, it’s just gone,” she said.

Sanders interjected: “And what you’re nervous about is at the end of the day, when you’re ready to retire, you not going to have anything in the bank.”

Petersen replied: “No, I won’t have anything and, in fact, I’ve mentioned to my kids that I hope they redo their basement nicely, because I’ll probably be in it.”

Another person in the crowd worried aloud about the push-back against rival Elizabeth Warren’s plan for paying for Medicare for All. Sanders did not outline his own proposals for financing Medicare for All, but he said talked in general about shifting to a universal health care system.

“I know some people think this is a radical idea,” Sanders said. “It is not a radical idea. It exists in Canada. It exists in Germany. It exists in France. It exists the UK. It exists in Finland, in Denmark, in Sweden and Norway. It exists in virtually every major country on Earth!”

Sanders said some Americans are paying “cruel” and “absurd” premiums for private insurance until they reach the age to enroll in Medicare.