Daniel was 29 when he died. He killed himself after failing to get his medication refilled because he missed a $20 premium he was not aware of.

“I promised his siblings and him at the funeral in front of everyone that I was going to make our lawmakers look me in the eye and see the consequences of their decisions,” his father, Scott Desnoyers, tells The Independent.

One of America’s worst kept secrets is just how flawed its healthcare system is.

The US has some of the best doctors and facilities in the world – but accessing them for many is a constant battle. Millions of Americans are uninsured, and high deductibles mean even those that have it often struggle to pay for treatment and medications. “Surveys show that many Americans with insurance are forgoing needed care because of cost,” Bob Doherty from the American College of Physicians (ACP) says. “Surveys also show that concern about not being able to afford care ranks among the top concerns of the public.”

Among the poorest 20 per cent of Americans, one-third of their income is spent on healthcare, according to a new study. Out of pocket payments have grown over recent years, and nearly half of millennials have put off needed medical care because they can’t afford it.

In March 2019 Daniel Desnoyers from Saratoga, New York, tried to get his prescription of Risperidone refilled, which helped manage his mental health issues, but he couldn’t. He told his father that day: “Pops I know I need this medicine!”

Daniel called his provider – Fidelis Care – at the beginning of April and found out that he had missed a $20 premium. “He paid his $20 on the phone that day and was told his ‘plan’ would be reinstated on the next billing cycle of May 1st,” his father says. “On April 9th I saw his Facebook post only seconds after he posted it.”

The post in question was a heartbreaking suicide note from Daniel, suggesting he was going to drive his car into a lake. Scott rushed to stop him, but was too late.

Daniel Desnoyers died in 2019 aged 29

When asked to comment on the case, a Fidelis Care spokesperson said: “We were deeply saddened to hear of Mr Desnoyers’ loss, and our hearts go out to the family.” The multi-billion-dollar company says they take the health of members “very seriously” but were unable to comment on Daniel’s case specifically due to privacy regulations. “We can say that for members who have a monthly premium, Fidelis Care provides approximately 60 days (including a grace period) to make their payment.”

Mr Desnoyers has channelled his grief into political action. From attending rallies to lobbying lawmakers, speaking at public hearings to being active on social media, he does all he can to share Daniel’s story.

The now 50-year-old first made contact with the Bernie Sanders campaign after a post about his son was shared thousands of times on Twitter, and someone who worked for Texas Democrat Sema Hernandez got in touch with him. “Before Bernie I was not aware that other countries had universal care. I had bought all the media bulls*** and thought, this is America, we have the best of everything including healthcare.” Now Mr Desnoyers campaigns regularly for Medicare for All, and says his “entire life from the time I get woken up at 3am almost every day” is dedicated to the fight. “This fight is all I can do for Danny now.”

The Bernie Sanders campaign is an electrifying movement – regardless of what you think of his policies. An engaged left show up in their thousands at rallies, with many sharing their personal stories online in an attempt to galvanise movements.

Sanders is not the only 2020 presidential candidate backing Medicare for All. Elizabeth Warren also supports it, but with a slight difference. Whereas Bernie Sanders would prohibit private plans after a brief transition period, Warren’s plan would offer a public option alongside existing private insurance plans before passing Medicare for All in her third year as president.

A November poll found that 53 per cent of voters support a Medicare for All plan that would cover everyone through a single government plan. However, 65 per cent said they support a government-run health plan that would compete with private insurance. The same poll found that Senator Sanders, who has long championed Medicare for All, is the most trusted candidate on healthcare among voters under 34, at 47 per cent. Joe Biden, however, was the most trusted candidate among senior voters.

16 male celebrities who have spoken about mental health Show all 16 1 /16 16 male celebrities who have spoken about mental health 16 male celebrities who have spoken about mental health Stormzy Stormzy told Channel 4 in 2017 that by opening up about his depression he hoped to help others. "I think for them to see I went through it would help," the BRIT-award-winning musician said. "For a long time I used to think that soldiers don’t go through that. You know? Like, strong people in life, the bravest, the most courageous people, they don’t go through that, they just get on with it...and that’s not the case." Rex Features 16 male celebrities who have spoken about mental health Robert Pattinson Twilight star Robert Pattinson told The Telegraph he struggled with depression for a period of time. “'I had a bit of a struggle at first because my life really contracted and I couldn't do a lot of the stuff I used to be able to do." He advised aspiring Hollywood actors to "take care" of your mental health. "If you get as famous as quickly as I did, your personal growth stops suddenly.” Rex Features 16 male celebrities who have spoken about mental health Michael Phelps Former American swimmer Michael Phelps, the most decorated Olympian in history, experienced periods of depression and suicidal feelings. He told Today in 2018: "After years and years and years of just shoving every negative, bad feeling down to the point where I mean, I just didn't even feel it anymore...and for me, that sent me down a spiral staircase real quick and like I said, I found myself in a spot where I didn't want to be alive anymore." Rex Features 16 male celebrities who have spoken about mental health Zayn Malik Zayn Malik told The Sunday Times Style magazine about suffering with an eating disorder and anxiety. "We’re all human. People are often afraid to admit difficulties, but I don’t believe that there should be a struggle with anything that’s the truth," said the former One Direction singer. "If you were a guy, you used to have to be really masculine, but now expressing emotion is accepted and respected.’ Rex Features 16 male celebrities who have spoken about mental health Will Young Singer Will Young has spoken about his experience with suicidal thoughts. "There's a part of my brain that is telling me that you're about to die, [so] you either shut down, freeze or you run. The only thing I can do is go to bed." He said that without the help of his therapist he probably would have been successful in his suicide attempts. “I have so many mental thoughts in my head: ‘You’re never going to sing again’. ‘That was a s*** dance move.’ ‘They’re hating you.’” Rex Features 16 male celebrities who have spoken about mental health Professor Green After his father took his own life in 2008, rapper Professor Green started speaking openly about his mental health problems and the pressure on men to be strong. “We have to figure out a way that men can talk to one another and figure out how to make themselves feel better,” he told theiNews. Although he is pleased to "start conversations" Green warns how becoming a mental health spokesperson can be high pressure. “It’s difficult because sometimes you’re having a great day, then someone comes up and tells you something absolutely horrific; I’m not a psychologist and it’s really hard." Rex Features 16 male celebrities who have spoken about mental health Donald Glover American actor, comedian, writer and musician Donald Glover, who performs under the name Childish Gambino told Vice in 2013 he'd been through periods of depression following the end of his tour. "I was just super depressed. I mean, I tried to kill myself. I was really fucked up after that [tour], because I had this girl that I thought I was going to marry and we broke up. I didn’t feel like I knew what I was doing. I wasn’t living up to my standard, I was living up to other people’s standards, and I just said ‘I don’t see the point'.” Rex Features 16 male celebrities who have spoken about mental health Shawn Mendes Shawn Mendes told People magazine that talking about his mental health problems was the "scariest" thing he's ever done. "I still struggle with it but just remember every day that everyone deals with some level of anxiety or pressure; we're all in it together." He told The Sun in 2018: "All pain is temporary, and the thing is with anxiety, and why it's such a hard thing for people who don't have it to understand." Rex Features 16 male celebrities who have spoken about mental health Jim Carrey Comedian and actor Jim Carrey told iNews that he had struggled with depression throughout his life. “At this point, I don’t have depression. I had that for years, but now, when the rain comes, it rains, but it doesn’t stay. It doesn’t stay long enough to immerse me and drown me anymore.” Rex Features 16 male celebrities who have spoken about mental health Pete Wentz Fall Out Boy frontman Pete Wentz has spoken openly about his bipolar disorder diagnosis and other mental health problems. He said that it took him to reach breaking point before asking for help. "My best piece of advice, more than anything, is that there's other people out there that feel [suicidal], or are feeling that right at that time," he said. "Maybe your favorite actor, or a guy in a band, or whoever, there are people who feel that exact same thing and have made it through that. I would say more than anything, you're not alone in it." Rex Features 16 male celebrities who have spoken about mental health Jon Hamm "I struggled with chronic depression," Mad Men star Jon Hamm told The Guardian in 2010. "I did do therapy and antidepressants for a brief period, which helped me." Hamm said medication helped change his "brain chemistry" enough so he could get out of bed. "I don't want to sleep until four in the afternoon. I want to get up and go do my shit and go to work," he says. Rex Features 16 male celebrities who have spoken about mental health Rob Delaney Catastrophe actor and comedian Rob Delaney, who lost his son Henry to brain cancer in January 2018, said he has long struggled with depression and encouraged others in the same position to seek help. "Asking for help is strong because it leads directly to staying alive," he says. "Not asking for help is as fear-based a decision as a human being can make and can lead you swiftly in a bad direction. It's not exaggerating to say that path can end in death." Rex Features 16 male celebrities who have spoken about mental health Dwayne 'The Rock' Johnson Dwayne Johnson has spoken on numerous occasions about mental health. On ITV's Lorraine Kelly he said: "Depression doesn't discriminate, and I thought that was an important part of the narrative if I was going to share a little bit of my story of the past. Regardless of who you are or what you do for a living or where you come from, it doesn't discriminate, we all kind of go through it. If I could share a little bit of it and if I could help somebody, I'm happy to do it." Rex Features 16 male celebrities who have spoken about mental health Ryan Reynolds "I have anxiety, I've always had anxiety," the Deadpool actor told the New York Times in 2018. "Both in the lighthearted ‘I’m anxious about this’ kind of thing, and I’ve been to the depths of the darker end of the spectrum, which is not fun.” Reynolds said he went through a period of partying to try and make himself "vanish" in some way and would frequently suffer with anxiety-related insomnia. Rex Features 16 male celebrities who have spoken about mental health Bruce Springsteen Bruce 'The Boss' Springsteen told Esquire magazine in 2018 that although he wouldn't describe himself as being mentally unwell, he has "come close enough" and takes medication to cope. "I’m on a variety of medications that keep me on an even keel; otherwise I can swing rather dramatically and the wheels can come off a little bit.” Rex Features 16 male celebrities who have spoken about mental health Prince Harry Prince Harry has been a vocal supporter of mental health campaigns like 'Time To Talk'. He also has spoken openly about his own problems following the death of his mother, Princess Diana. He told The Telegraph: “I have probably been very close to a complete breakdown on numerous occasions when all sorts of grief and sort of lies and misconceptions and everything are coming to you from every angle." Harry said there was "huge merit" in talking about your issues and keeping quiet only makes things worse. Rex Features

There is resistance to Medicare for All, with questions surrounding cost estimates and people with effective insurance not wanting to give it up among the criticisms, but the tide seems to be turning.

The American Medical Association (AMA), the largest physician group in the United States, last year left the Partnership for America’s Health Care Future, an industry opposing Medicare for All, and the ACP – America’s second-largest physician group – recently backed Medicare for All.

Joe Kassabian from Michigan was won over by Bernie Sanders after his family’s traumatic difficulties with affording healthcare. The 31-year-old, who served two tours in Afghanistan, says his family “nearly lost everything” because of having to pay approximately $100,000 for his sister’s kidney treatment. His mother, who was a single parent working two jobs, did not have health coverage through her work. During this time Mr Kassabian would only eat once a day on weekends, twice on school days because of free lunches. “We did not have birthdays or Christmas. After school activities had to be stopped so we could all get whatever jobs we could in order to help out. It led me to enlist in the US Army when I was 17 so I could send more money home.”

He says they were forced to leverage the house and car to pay for the treatment. “If she had required a transplant we would have been on the streets.” Thirteen years later and the debts are still not paid off.

Mr Kassabian heard about Bernie Sanders after leaving the army, and, once he found out more about him, decided to support him as “one of the few politicians in the US that actually seems like he gives a s***”.

“I believe Medicare for All is the only way forward ... Our current system deems those with more money or better jobs more deserving of life and health.”

Janet Mullen, 49, actually did lose her home in Massachusetts after struggling to pay $75,000 out of pocket.

Ms Mullen – also known by her online persona ‘Lumpy Louise’ – suffers from a rare disorder called Dercum’s disease, among a range of other health ailments and conditions. “Even when I was actively working and on insurance ... I had $75,000 in out of pocket expenses just for my treatments and medicines.” After trying various different loans she ended up losing her home of 12 years, eventually quitting her job and filing for disability. “I’m almost 50 and my husband and I cannot afford to live on our own.”

Some do manage to avoid extortionate costs billed to them, such as Amy Sterling Casil, who was charged $50,000 after her baby died. In 2005, Ms Sterling Casil, from South Carolina, arrived home where her husband at the time and two children were. “My daughter Meredith, age 12 at the time, found Anthony ... Meredith had Anthony in her arms, and there was milk all over his face. I will never ever forget her face, or her voice when she said: ‘Mom...’”

Anthony, known to his family as ‘Lali‘, died in 2005

Despite performing CPR, and an ambulance arriving to take Anthony to the hospital, he did not survive. Ms Sterling Casil claims the ambulance took him to a hospital where the family was not insured, despite there being a hospital 15 minutes nearer where they were insured. “The total bill I got about a week after Anthony died was about $50,000. I was asked to pay $20,000 of that.”

After writing a letter to the president of the hospital explaining her situation, she paid $1,000 and was forgiven the remainder of the debt.

Ten years later, when she went with some friends to see Bernie Sanders speak, the senator talked about healthcare. “I hadn’t heard of Bernie Sanders before 2015 but my entire life experience says he and Our Revolution are the only hope we’ve got.”

There are still many hurdles – one of these candidates actually winning the presidential election being the greatest of all – but this is the closest the US has been to approving a universal healthcare system since the 1930s. The battle has raged for decades, and candidates such as Bernie Sanders are willing to lead their entire campaign on it.

“There have been many efforts over the last 100 years to establish a national system of insurance,” Dr Miriam Laugesen, political scientist and health policy researcher at Columbia University says. “The one thing that is palpable in public discussions today is a new degree of consternation or frustration with hospitals and other organisations’ pricing and billing – previously people blamed insurance companies, and now people are beginning to realise that there is something deeply off. It’s not only Democrats, it’s across the partisan spectrum.”

Many of these tragic stories have turned into action, with Americans volunteering, campaigning and sharing their stories online in a bid to encourage others to back Sanders. Mr Desnoyers and Ms Sterling Casil's tweets about their children have been shared thousands of times, with hundreds more posting their own experiences online.

As we saw in 2016, having the most passionate and engaged supporters does not always translate into a primary win. But with soaring healthcare costs, and polls suggesting more young people are likely to vote in presidential caucuses and primaries in 2020 than 2016, this year's election could be different.

Today, Mr Desnoyers struggles to make ends meet and regularly uses food banks. His financial difficulties prove a constant obstacle for his campaigning, making it difficult for him to afford to attend events, but he continues to fight. “This is just one more obstacle that I have to overcome to be an activist. It will not stop me!

“I can truly say if I did not decide to fight like this I do not know if I could survive.”