Sen. Sanders Urges A Medicare-For-All Health Plan

NPR's Steve Inskeep talks with Sen. Bernie Sanders on his plans to push forward with a bill for a single-payer health insurance system, in the wake of Republican failures to repeal and replace the Affordable Care Act.

STEVE INSKEEP, HOST:

Senator Bernie Sanders sees his moment, his moment to shift the debate over health insurance.

AILSA CHANG, HOST:

Sanders, of course, was on the Senate floor last week when Republican efforts to repeal and replace the Affordable Care Act flamed out. As we hear elsewhere in the program, lawmakers are discussing how they might tweak the law now.

INSKEEP: Sanders, Democratic socialist, former presidential candidate, wants a little more than a tweak. He sees a chance to reintroduce one of his signature ideas. He vows, this fall, to introduce a plan for single-payer health insurance, national health care. We reached him by phone in Vermont.

Is this Medicare for all, as you've said in the past?

BERNIE SANDERS: That's exactly what we're talking about. This is not complicated. The American people are familiar with Medicare. By and large, it's quite a popular program. But it starts, now, if you are 65 years of age. God didn't create 65 years of age for being the eligibility rate. It should be available to every single person in this country.

And the advantages of that is that from an administrative cost, when you have one payer, you save many, many billions of dollars on billing. You don't need to spend huge amounts of money in advertising. You're not going to have CEOs in the health care industry making huge compensation. Bottom line is if other countries around the world are providing quality care to all of their people, we can do the same.

INSKEEP: If this proposal were to advance, somebody would naturally ask, can people who like their current insurance keep that? Are you going to allow that, if this were up to you?

SANDERS: No, if you have a Medicare for all, there'll be one insurance company in America. It's not a question. Nobody in America likes their insurance company. What people...

INSKEEP: Oh, you're saying that any other insurance plan would go away under this plan?

SANDERS: Yes, that's right. What people like, Steve, is their doctor. They like their hospital. They like their nurses. And, of course, people would have absolute freedom of choice as to what doctor they wanted to go to, what hospital they wanted to go to.

INSKEEP: I think it might be fair to say that people suspect change. They're suspicious of change in this area. They're afraid of things getting worse. How, politically, would you reassure people that you wouldn't create a disaster for them?

SANDERS: First of all, we'd build on Medicare. And I think most seniors in this country will tell you that Medicare is not a disaster. You're building on something which is already popular and already working quite well. And second of all, I think we can learn from other countries around the world on how to create an even better and more cost-effective system than many of those do.

INSKEEP: What makes this the right moment to introduce that legislation of the sort that you have talked about in the past?

SANDERS: The Affordable Care Act has made some significant progress. But having said that, I think everybody understands that there remain very significant problems in the current health care system. Deductibles are far too high. Co-payments are also too high. Premiums are too high. So I think people are saying, OK, we had nothing. Then we passed the Affordable Care Act. It did some good things.

Then we had the Republicans trying to throw 22 or 23 million Americans off of health insurance. That's pretty dumb. That's moving in exactly the wrong direction. But the status quo is not working. We have to improve it.

INSKEEP: Senator, there was a reminder the other day of how politically difficult it can be to build support for this or to build legislative support for this. You mentioned that some parts of the Democratic Party do not agree with you. Republicans forced a vote on single-payer health insurance during the recent debate over repealing the Affordable Care Act. And if I'm not mistaken, a few Democrats voted no on single-payer and everybody else voted present. Not one Democrat was willing to go on the record to say it's a great idea.

SANDERS: Well, of course not. And I urged, I spoke on that issue at some length. And I urged my colleagues to vote present because we are not going to dance to the tune of right-wing Republicans, who of course were not prepared to support a single-payer. For them, it was just a political moment that they thought would be advantageous for them.

INSKEEP: Granting that it was - may have been seen as a sham vote, it underlined an awkwardness for Democrats, doesn't it? There may well be a number of Democratic lawmakers who agree with you but do not think the political moment is right.

SANDERS: That may be the case. What we do know is Republicans will be spending probably a whole lot of money on ugly, 30-second ads, distorting what we are trying to do. So there are some Democrats who, I think, will be hesitant about going forward. So it's not going to be an easy fight. We're going to have to take on everybody. It's not just the Republican Party. It will be the insurance companies and the drug companies and the corporate media, et cetera, et cetera. But I think at the end of the day, when millions of people stand up and demand that we do what every other major country on earth does, I think we can accomplish this goal.

INSKEEP: Is there a specific fix to the Affordable Care Act that you would support in the meantime, while you're pursuing this bigger goal?

SANDERS: Yes, short term - now this short term. Long - longer term, we need a Medicare-for-all, single-payer system. But right now, my proposals will be, number one, immediately, there should be a public option available - Medicare-type, public option available - in every state in this country. I think...

INSKEEP: Oh, that's something that was proposed under Obamacare and was knocked out...

SANDERS: That's right.

INSKEEP: ...During the legislative process.

SANDERS: You got it. Say, you got a good memory. You're exactly right. It had a lot of support. It didn't have the 60 votes, as I recall, that we needed. So it's not a radical idea. What it says is if you're in a community and you got one insurance company and you don't like what they're offering, there should be at least a Medicare-type, public option available.

Number two, we're going introduce legislation that would substantially lower the cost for prescription drugs. Number three would be to lower the eligibility age of Medicare from 65 to 55.

INSKEEP: Suppose you get into a bipartisan discussion like you're saying and Republicans come back at you and say, Senator Sanders, we're happy to listen to you. But we're Republicans. We have the majority here. And we believe in the free market. Are there any free market solutions to the Affordable Care Act you'd like to consider? What if they said that?

SANDERS: Well, I'm open to hearing what people have to say, period. And, you know, we'll take it a step at a time. But I think what the American people do want is for us to deal with the greed of the pharmaceutical industry. And they need to lower prescription drug costs. And I hope some Republicans - and I think there are - who may work with us on that. And I think the concept of a public option is a popular concept. I hope they will work with us on that as well.

INSKEEP: When you talk about single payer, are you conscious of the risk to such a huge part of the economy, that any change like this carries with it significant risks?

SANDERS: Oh, I think it will be a significant improvement for the overall economy. A competitive disadvantage that many companies in the United States have in a world economy is that virtually every other major country has much more stability in terms of its health care system. It's not a burden unnecessarily on the employer.

Also, we have millions of workers today, Steve, who are at their jobs not because they want to be at their jobs, but because they're getting decent health care for their families. And I think if we made health care a right for all people and people could say, you know what, I could start a business. Or I can go elsewhere, and I don't have to worry any more about staying at this job because it provides health care, I think that would also be a real boost to the economy.

INSKEEP: Senator Bernie Sanders of Vermont, thanks for the time.

SANDERS: Thank you very much. Take care.

(SOUNDBITE OF KELPE'S "CHIRPSICHORD")

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