× Expand Senator Sanders Sanders Medicare 4 All Senator Bernie Sanders unveiled his signature Medicare for All bill in April. Opponents of the proposal have often invoked right wing talking points to knock the socialized health care plan.

Listening to the Democrats debate health care policy calls to mind a memorable aphorism: “It’s bad enough riding out to face the rifles and shotguns, but the worst part is doing it with a back full of arrows.”

That’s a fitting analogy for the situation faced by Medicare for All supporters Senators Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts. Medicare for All is the target of a truly massive negative public-relations campaign led by insurers, the pharmaceutical industry, and for-profit hospitals.

Medicare for All (or single-payer health care) is championed by its advocates as an alternative to a system that enriches costly insurance-company middlemen and the high-profit, rapacious drug industry. As the most comprehensive and experience-based plan, it promises to hold down costs for patients and employers by eliminating needless insurer overhead; offer free choice of doctors and hospitals; and cover all Americans. (More complete outlines of Medicare for All’s advantages are available at pnhp.org)

The health industry, burdened by a 38 percent favorability rating (Big Pharma is particularly despised, with a 27 percent rating), knows that it must fight back with all its resources. A foundational step for fighting reform has been to popularize the misleading notion that Medicare For All is a “government-run” program.

Ferocious opposition to Medicare for All from the medical-industrial complex should come as no surprise, given what’s at stake for these corporations. But genuinely troubling is the effort of many leading Democrats to portray Medicare For All as both utterly impractical and as a potential life-preserver to a sinking Donald Trump.

On November 15, Barack Obama took what many saw as a thinly veiled swipe at Medicare for All. “This is still a country that is less revolutionary than it is interested in improvement,” the former President told a group of wealthy donors. “The average American doesn’t think we have to completely tear down the system and remake it.”

Apparently, Obama is forgetting his own stated support for Medicare for All in 2003 and 2018. After all, the concept is not that different from the long standing “single-payer” system just across the border in Canada, which offers higher quality health outcomes, universal coverage, and completely free choice of doctors and hospitals for patients—all at around half the cost of the U.S. system on average. Nearly 90 percent of Canadians believe its elimination would result in a “fundamental change to the nature of Canada.”

As Obama joked in 2006, “Anything that Canada does can’t be entirely revolutionary—it’s Canada. When I drive through Toronto, it doesn’t look like a bunch of Maoists.”

However, Obama’s recent suggestion that voters are intrinsically cautious about bold proposals feeds the narrative that only centrist ideas and incremental change will capture voters in critical states like Pennsylvania, Michigan, and Wisconsin. As we heard Joe Biden proclaim flatly at the November 20 debate: “The majority of Democrats don’t want Medicare for All at all,” a statement directly at odds with a Kaiser Family Fund showing that 77 percent of Democrats in fact support Medicare For All.

Moderates shamelessly leave the impression that Medicare for All would leave them without protection, and for an indefinite period of time.

In fact, there is little reason to worry that the promotion of Medicare For All will drive away culturally conservative Democrats since 57 percent of them—the subject of so much hand-wringing by those opposing Medicare For All—support the plan.

“Moderate” Democratic candidates like Minnesota Senator Amy Klobuchar and even some liberals raise fears that Medicare for All would mean eliminating private insurance, when in fact the program would replace the vast majority of corporate health insurance with a government-administered system. Private insurance would still be able to play a role in offering supplemental or specialized plans.

The trope about taking away “private insurance” undermines the momentum for Medicare for All reform in three significant ways. First, using terms like “banning private insurance” reinforces the carefully crafted “government-run” term employed by the health care industry and its conservative allies.

Second, the moderates’ talk of “depriving” some 150 million people of private health insurance depicts Medicare for All advocates as heartlessly wiping out the life raft on which working families depend. Klobuchar, at last week’s debate, claimed Medicare for All would mean “kicking 149 million off of health care.” The moderates shamelessly leave the impression that Medicare for All would leave them without protection, and for an indefinite period of time.

Third, moderate candidates’ apparent concern for the status quo advances the notion that American workers feel a special affection for corporate insurance firms. Most Americans with employer-provided health insurance—about 49 percent of the population—have faced the acceleration of what Dr. Don McCanne calls “unaffordable under-insurance.” That means sharp deterioration of coverage coupled with sky-high deductibles and copays that lead a high number of Americans to forego a trip to the doctor because of the cost, even when serious symptoms present.

The health insurance industry—as opposed to individuals’ perceptions of their own plans—is perceived by a huge majority as valuing profits over offering dependable and affordable healthcare coverage. And only about a third of the insured report being “happy” with their insurance coverage.

Recent polling shows that Americans mostly want to have an ironclad assurance of health coverage, not an attachment to private insurance per se. As the publication Business Insider reported in August, 59 percent of respondents who get their health care coverage through their employer said “they would be fine switching to a government insurance plan under ‘Medicare for All’ — as long as it meant no change in coverage.”

Yet little of this sentiment is reflected in media coverage about the Democrats’ health-care debate. A New York Times November 25 article read like a virtual obituary for Medicare for All, quoting one voter who said, “America is about choice—not, oh, suddenly we have a gigantic bureaucracy that may or may not work.” Instead of Medicare for All, the article focused hope on the “public option,” which would allow citizens to buy into a new insurance option.

Nowhere in the article is it mentioned that the program does provide for a degree of choice of providers that the public option would not guarantee. Further, Medicare for All would slash the 30 percent overhead costs imposed by corporate insurers, and operate a system with a far slimmer administrative structure.

But with the barrage of false narratives being fired from influential Democrats, including Barack Obama, Medicare for All’s unique programmatic strength and its broad political support are being obscured in rhetorical smoke.