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Sanders writes: "Every man, woman and child in our country should be able to access the healthcare they need regardless of their income."

Sen. Bernie Sanders. (photo: Getty Images)
Sen. Bernie Sanders. (photo: Getty Images)

Health Care for All

By Bernie Sanders, Reader Supported News

06 October 13


start my approach to health care from two very basic premises. First, health care must be recognized as a right, not a privilege. Every man, woman and child in our country should be able to access the health care they need regardless of their income. Second, we must create a national health care system that provides quality health care for all in the most cost-effective way possible. Tragically, the United States is failing in both areas.

It is unconscionable that in one of the most advanced nations in the world, there are nearly 50 million people who lack health insurance and millions more who have burdensome copayments and deductibles. In fact, some 45,000 Americans die each year because they do not get to a doctor when they should. In terms of life expectancy, infant mortality and other health outcomes, the United States lags behind almost every other advanced country.

Despite this unimpressive record, the U.S. spends almost twice as much per person on health care as any other nation. As a result of an incredibly wasteful, bureaucratic, profit-making and complicated system, the U.S. spends 17 percent of its gross domestic product --approximately $2.7 trillion annually -- on health care. While insurance companies, drug companies, private hospitals and medical equipment suppliers make huge profits, Americans spend more and get less for their health care dollars than people from any other nation.

What should the United States be doing to improve this abysmal situation? President Obama's Affordable Care Act is a start. It prevents insurance companies from denying patients coverage for pre-existing conditions, allows people up to age 26 to stay on their parents' insurance, sets minimum standards for what insurance must cover and helps lower-income Americans afford health insurance. When the marketplace exchanges open for enrollment on Tuesday, many Americans will find the premiums will be lower than the ones they're paying now. Others will find the coverage is much more comprehensive than their current plans. Most importantly, another 20 million Americans will receive health insurance. This is a modest step forward. But, if we are serious about providing quality care for all, much more needs to be done.

The only long-term solution to America's health care crisis is a single-payer national health care program. The good news is that, in fact, a large scale single-payer system already exists in the United States and its enrollees love it. It is called Medicare. Open to all Americans over 65 years of age, the program has been a resounding success since its introduction 48 years ago. Medicare should be expanded to cover all Americans.

Such a single-payer system would address one of the major deficiencies in the current system: the huge amount of money wasted on billing and administration. Hospitals and independent medical practices routinely employ more billing specialists than doctors, and that's not the end of it. Patients and their families spend an enormous amount of time and effort arguing with insurance companies and bill collectors over what is covered and what they owe. Drug companies and hospitals spend billions advertising their products and services. Creating a simple system with one payer covering all Americans would result in an enormous reduction in administrative expenses. We will be spending our money on health care and disease prevention, not on paper pushing and debt collection.

Further, a single-payer system will expand employment opportunities and lift a financial weight off of businesses encumbered by employee health expenses. Many Americans remain at their current jobs because of the decent health insurance provided by their employer. Without the worry of losing benefits, those Americans will be free to explore other opportunities as they desire. For business owners, lifting the burden of employee health care expenditures will free them to invest in growing their businesses.

Congressman Jim McDermott and I have introduced the American Health Security Act. Our bill will provide every American with health care coverage and services through a state-administered, single-payer program, including dental and mental health coverage and low-cost prescription drugs. It would require the government to develop national policies and guidelines, as well as minimum national criteria, while giving each state the flexibility to adapt the program as needed. It would also completely overhaul the health coverage system, creating a single federal payer of state-administered health plans.

The time is long overdue for the American people to understand that our current health care system is not working and that there is something fundamentally wrong when the United States remains the only country in the industrialized world that does not guarantee health care to all people. A single-payer system will be good for the average American, good for businesses, good for workers and good for our overall economy. Health care is a right and we must establish that right in America.

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+61 # CarolYost 2013-10-06 11:21
Thank you for advocating for single-payer healthcare, Bernie. Question: How is your bill different from HR 676, Rep. John Conyers's bill? Is it in competition with it? I do love seeing more and more single-payer advocacy. Really! It's the only solution!
-56 # randyjet 2013-10-06 11:28
I support this proposal and is simple common sense. The only fly in this ointment is the huge number of illegals living here. It is simply impossible to have such a plan without secure borders since there will be a flood of sick people who wish to get free medical care.
+44 # universlman 2013-10-06 12:24
Quoting randyjet:
a flood of sick people

Your attitude, to turn away any sick person, regardless of their origin is disgusting and cruel. Canada does not have a secure border using your definition, and they do not get a "flood" of sick Americans, although they do get and look after their share.

In the words of Steely Dan, "the things you think are precious, I don't understand."
+4 # smb7777777 2013-10-06 12:45
Quoting universlman:
Quoting randyjet:
a flood of sick people

Your attitude, to turn away any sick person, regardless of their origin is disgusting and cruel. Canada does not have a secure border using your definition, and they do not get a "flood" of sick Americans, although they do get and look after their share.

In the words of Steely Dan, "the things you think are precious, I don't understand."

My eleven-year-old son is high-functionin g autistic and we were flatly told by Canadian officials that not only were we not welcome to move to Canada because of he is autistic, but that we couldn't even step foot in Canada to visit. Could we have snuck across the border though I don't know. Lately I have been thinking of trying a hot air balloon.
+8 # Rick Levy 2013-10-06 19:54
To be honest, America already has a flood of illegal immigrants. Canada does not. I fully support an American single payer / Medicare for all plan. "All" meaning every citizen and legal alien.

The reason that sick Americans don't flood Canada's health care system is that most of them don't know about it, and if they did try to access it, would they not be (rightfully) turned away?
+32 # Madmedic 2013-10-06 12:41
[quote name="randyjet" The only fly in this ointment is the huge number of illegals living here. It is simply impossible to have such a plan without secure borders since there will be a flood of sick people who wish to get free medical care.

They already get care in one of the most expensive ways possible. Through the emergency rooms when their problems become dire enough to merit such care.

Granted, borders need to be reinforced, but to deny good healthcare to 50 million or so citizens because one fifth of that number, or so, might be illegal aliens is absurd.

Better to have HEALTHY illegal aliens who can work for a living than unemployable SICK ones who are not able to contribute anything to the economy.
-3 # Rick Levy 2013-10-07 19:28
Better to have NO illegals, period. Why should these gate crashers be given preference over LEGAL immigrants who abide by the rules and wait years for a visa before entering the U.S. Meanwhile, while they're waiting in their home countries, illegals are pouring across the border and taking jobs and benefits to which they're not entitled.
+24 # Phlippinout 2013-10-06 13:08
Actually, undocumented workers pay everyday living expenses like everyone else. The fact is, when they are pushed out of neighborhoods, the economy suffers. I live in one of those neighborhoods! I liked having working neighbors, now i have people who never go to work or come out of the house and they are AMERICANS. Take your hateful misinformation and stuff it!
+18 # cwbystache 2013-10-06 15:21
“They also will answer, ‘Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?’

“He will reply, ‘Truly I tell you, whatever you did not do for one of the least of these, you did not do for me.’
+4 # bingers 2013-10-06 18:41
Are you blissfully unaware that the ACA doesn't apply to illegals?
+45 # Henry Braun 2013-10-06 11:42

While trying to decide,
we travel between Yes and No,
that most immoral
of destinations.
+43 # Barbara K 2013-10-06 12:03
I watched all the making up of the Bill in the Senate. The Rs would not agree to anything if there was the single payer. So, Senator Kennedy said "We'll just take half the loaf of bread and come back for the rest later". Unfortunately, it won't get passed the Tbagger Repugs until we have more Dems in congress. So let's work at getting more Dems so we can accomplish the good things that were set out for us and that they are holding up in the Senate by placing holds on them, over 300 of them now; and then there are the 400 filibusters by the Rs too. We need to work hard at getting more Dems.

+22 # Madmedic 2013-10-06 12:44
Quoting Barbara K:
We need to work hard at getting more Dems.


A great idea, but it won't amount to a hill of beans if the Dems. we elect/reelect are DINO's (Democrats In Name Only) like Mary Landreau (sp.?) and a dozen or so others.
+31 # universlman 2013-10-06 12:17
With 50,000,000 Americans without health insurance in the US and over 30,000 gun deaths per year, it is pretty obvious that the majority of the entrenched leadership in this country would rather strut around in their "safe" districts and squawk about Obama and Obamacare rather than deal with either of these deplorable statistics.

Term limits would help a lot to clear out the deadwood.
+5 # smb7777777 2013-10-06 13:25
I agree that term limits would help. How about one term in any seat. You can run for a different office altogether but not the same seat ever again. Totally eliminate the need to legislate while trying to stay in good graces with the corporate/union donors dangling the reelection campaign bribes.
+13 # LiberalRN 2013-10-06 15:58
On its face, the idea of term limits sounds like a good idea - prevent the entrenched "leadership" you speak of. In practice... not so much. Lobbyists LOVE the idea of term limits...they'd be the only ones in Washington with the necessary experience in how to run the place. And run it they would - even more than they do now.
+9 # bingers 2013-10-06 18:46
Sadly, true, and additionally we would have people learning on the job only to lose the job by the time they understand it. Besides, we wouldn't have Bernie Sanders around any more as he's been in both houses of Congress.
+3 # Merschrod 2013-10-06 19:31
RN, you are absolutely right - a two year term is too short, there is a learnikng/study curb. My guess is that a 6 year term, one renew would do it for the House of reps. Stagger the rotation for a little more stability and it would be a great make over of the hosue of Reps.

Actually if the "no-re-election were added, then the lobbyists would have a rough time once a lameduck weer in. The rep could tell them to bug off and then serve the real constituents.
+43 # goodsensecynic 2013-10-06 12:21
Well said, Senator Sanders!

Nothing could be more obvious.

Meanwhile, you might not be aware (and are not to be blamed for the failure of others) but the continuing battle over "Obamacare" (a modest half-measure at the very best) has external consequences.

We to the near north of your verdant State of Vermont have had a universal public health care system since the 1960s. Not to be overly dramatic, but I owe my life to it as a cancer survivor who'd have had to pay about $150,000 for the same treatment I received with no out-of-pocket expenses except for the daily $12 fee for a TV in my room.

The problem? The propaganda that flows north from your corporate broadcast media, combined with a robust right-wing minority in Canada, is encouraging the "privatization" of our health insurance system.

We will try to hold out, and to remain a model for the USA to follow (though not necessarily the only model, since there are many themes and variations in Europe and elsewhere which end up in a similar place).

I'd like to come and help; but, although cancer-free for five years, I can't get travel insurance and the possibility that I'd trip and break an ankle or suffer a box jellyfish sting would financially cripple me.

I will, however, be visiting Cuba and Ireland soon - where the medical costs are reasonable and would easily be covered by my Canadian health insurance plan.

I'll wave as I fly over your republic.
+11 # bingers 2013-10-06 18:48
Ironically, I have had 3 cancer surgeries in the States, but since I'm on Medicare I haven't been bankrupted. I have basically, Canadian healthcare, and I love it.

Under the ACA you will be able to say the same.
-13 # smb7777777 2013-10-06 12:22
I agree that a single-payer is the only viable answer to controlling costs and getting all people securely covered. However, self-declaring something to be a right and then arguing from that denied-their-ri ghts victim mentality really turns a lot of people off. How about legislating it as a right before declaring it as such? Another issue that is standing in the way to single-payer is that while people may understand that in theory a single-payer system is the only option to truly bring healthcare into the modern era; they also wonder will it be run as poorly as other government programs, e.g. public education.

Are any single-payer advocates willing to prohibit single-payer public healthcare employees from forming unions? For the record, I am 100% pro-union in the private sector but public employee unions make an adversary out of the very public they are supposed to be serving. I have no doubt that many of my friends who are by no means progressives would in fact support a single-payer system if implemented rationally and efficiently, but unfortunately that does not seem to be how things are done anymore in corporate and union owned USA. I also have no doubt that while I am pro single-payer my entire character will be attacked here now for voicing my discontent with public unions. If progressives could only see real reason why they lose so many middle-of-the-r oad folks, and then do something about it, this country would move forward again.
+12 # bingers 2013-10-06 18:52
All unions are good in spirit, if not in fact. Not having unions leads to being cheated by scum like Scott Walker. No employer should have that much control over employees. Now in Germany with conservative Angela Merkel the head of the government, companies are required to not only have unions, but also to have union representation on their boards, and they are doing a lot better than we are. At leaast in large measure BECAUSE of the unions.
+35 # Paul Larudee 2013-10-06 12:36
I do not understand why the business community does not form a powerful campaign for universal Medicare. It eliminates a major cost and a major headache for them. If they donate to such a campaign, it could be a very powerful force against the HMOs that are bleeding us dry and it could put pressure on the Republicans to support it.
+10 # smb7777777 2013-10-06 14:23
I do not understand how at this point businesses in states that have decided not to expand Medicaid are not putting more pressure on their corporate sponsored elected officials to just accept reality and expand Medicaid in their state. Does Big Business really think they will still have their cheap labor pool in those states for very long once word gets out to low wage workers that in the next state over they can have decent healthcare coverage to go along with their low wages? Do they think people will just dismiss the HUGE benefit of having decent healthcare for yourself and your family until you get better on your feet - which of course is a lot more likely as well in an expansion state without the million dollar hospital bill after you have a fender bender.

Is it their hope to keep people so poor and downtrodden that they won't even be able to hop on a bus to the next state to actually have dramatically better quality of life as a low-wage worker? When their cheap labor pool dries up and they have to pay people $25/hour to flip burgers or cashier for lack of applicants will they be so ideological about 'socialist' healthcare then? Of course they will characterize it as entitled 'takers' flocking to other states to get free healthcare but regardless of how they spin it the poor workers are going to be fleeing these states and the smug "good riddance" crowd might want to rethink who is going to do their dirty jobs then for cheap.
+17 # samiam 2013-10-06 12:40
As long as there are Americans still believing there's a communist or socialist hiding under their beds nothing is going to improve.
+7 # Gfulmore 2013-10-06 12:44
A story in my local paper today on health care reform tells us early in the story about some people who were “floored” when they found out that their health insurance bills had risen for 2014. The story does not, however, tell us what they paid before, the percentage increase in the premium, the ages of the individuals, or what insurance company they are with. These are very important elements in this discussion.
Insurance companies are conduits between consumers and services, in this case the doctors, hospitals, device makers, drug companies, etc. For cars, we have insurance companies. We have them for term life insurance. We have them for homes.
The newspaper writer would be better served to get a bigger picture of how rates are rising or not rising for a broader set of consumers, especially in light of the federal subsidies and the exchanges. The truth is that most of those in the individual insurance marketplace who fall under the maximum financial limits for their number in their family will come out ahead with their insurance premiums, compared with what they had before. And, those who have AGIs in excess of the maximum limits will probably pay more, mainly due to the fact that they are simply in the free-market world where companies charge more each year if they can get away with it.
+4 # bingers 2013-10-06 18:55
A high % of the rates that have increased is because under the ACA the companies have to meet certain standards and the ones that are going up were so crappy they were of no use at all, despite being pretty expensive as well in a lot of cases.
+14 # angelfish 2013-10-06 12:52
As always, Bernie is right! Why the ReTHUGlicans DON'T want Americans to have decent Health Care is anathema! The ONLY reason I can think of is, that their Wealthy friends who own HMO's might lose a few dollars of profit! WHAT other reason IS there? Of COURSE Americans deserve and should have access to decent, affordable Health Care as our other CIVILIZED neighbors offer their citizens. Why WE have not been a Leader in this endeavor is puzzling. Then again, when the PROFIT motive entered Health Care Delivery, sanity and reason were thrown out along with the Baby and the bath water! I listen to some of my conservative friends (yes, I STILL have a few) and it amazes me how they have bought the Party Line that the wealthy DESERVE their wealth, simply because they HAVE it...???!!!, and working Americans should be GRATEFUL for the crumbs that fall from their Banquet table! We are Americans and shouldn't have to beg for ANYTHING, especially after bailing out their sorry a**es on Wall Street! A TINY portion of the Military/Defens e Budget should be allocated to: 1.) Expedition of ALL Veterans Claims and issues. 2.) Funding decent, affordable Single Payer Health Care (Medicare) for ALL Americans! Practical, Painless, Problem SOLVED!
+10 # capnDave 2013-10-06 13:10
More US cars are built in Canada than Detroit because of the cost of health care. We are required to have insurance to operate a motor vehicle so why not health insurance ? Is our body lesser than an ordinary car ?
+9 # Nigeldp 2013-10-06 13:14
The "Right" express pride in the strengths and achievements of the country They pretend to be the creators and owners. But they are NOT. The pride belongs to the workers, military, healthcare workers, teachers, municipal leaders and all who actually are the real creators of the society. The Right place themselves above and outside of that. That is why they don't care about the general populations health They have anointed themselves as the benefactors and believe that their largesse is the true cause of all that is 'good' in the world
-1 # smb7777777 2013-10-06 13:39
This would never happen but if the GOP put forth a unanimous GOP supported single-payer healthcare system bill that did everything that Mr. Sanders and other single=payer advocates suggest but with the one iron-clad caveat that no public healthcare employee could unionize (and worded in such a way to void the entire law if any any portion of the 'no public healthcare employee union' requirement could not be upheld); Would the Democrats support or defeat it assuming it was entirely their decision at that point to make it law or to abandon it?
+2 # bingers 2013-10-06 18:58
As Lincoln (A Republican, by the way) said, "Labor is superior to capital."

That wouldn't even be legal, so, no, no rational person, Republican or Democrat would support it.
+9 # MindDoc 2013-10-06 13:47
Absolutely. "Single payer" is the way - less its about skimming profits by insurance middlemen, and rationing healthcare, and more focus on the care itself rather than subsidies for the insurance cabal. THEY are between doctor and patient, not government.

Yes, the heart of the matter:
It is unconscionable that in one of the most advanced nations in the world, there are nearly 50 million people who lack health insurance and millions more who have burdensome copayments and deductibles.

Actually, a single-payer system, a national "health care system" as enjoyed by virtually all of the developed world except us, simply removes the layers of administrative costs, profiteering, and rationing of care by insurers. But in true GOP/Rove doubletalk spin, we're told *government* stands between doctors and patients. That's from the same company that manufacturers our Empire's New Clothes. When we're finally able to see it and say it, we must give real voice to the 'power of the people'.

Sen. Sanders is truly the stuff of leadership and compassion towards our citizens Congress serves, or should. Would that at least a solid majority of OUR Congress could be of the Sanders calibre. Yes, we have a handful, maybe two hands full, but it's just lost in so much noise by the ranters and ravers. We need to express our support for the 'good guys' who speak truth to power and who debunk the double-spin lies. And we need to remove those who stymie OUR work. A.S.A.P.
+3 # Dr Peter Sloane 2013-10-07 01:57
I live in the U.K. Here we have proper health care as any developed country should. Sure it has a few minor problems which some people whinge about but Come On America, it's like reading from a pre 1948 (National Health Service) British newspaper. Fancy people having to pay the hospital for making you better. A few years ago, I went to my doctor with a sore hip. It turned out to be damaged beyond repair. Six weeks later I had my new metal hip fitted. Spent a total of four days in hospital followed by weeks of physiotherapy. Now it's a few years old and un-noticable. Cost to me - zilch! This is NORMAL here as it surely should be there. I cannot even take on board the idea that if I had to attend accident and emergency in the middle of the night I would have to check my bank account first, or contact my insurance company. If I had to call an ambulance, it's another zero cost to me directly and it WOULD be here within fifteen minutes. Obama care is something but surely it's only one step on the ladder of a first world economy country's free health system. 'Free for all at the point of delivery'
+3 # Nell H 2013-10-06 13:51
Could we get rid of party labels on ballots?
-3 # smb7777777 2013-10-06 14:29
How would Democrats or Republicans know who to vote for then?
0 # bingers 2013-10-06 19:00
Quoting smb7777777:
How would Democrats or Republicans know who to vote for then?

Yeah, God forbid they would have to pay attention to the issues. I detest what the Republican party which I belonged to for decades has become, but based on issues, I vote for the occasional Republican.
+4 # fredboy 2013-10-06 17:33
Amazing to take this step forward, joining other advanced nations who let their people know "we care about you." A first for America.
+3 # bingers 2013-10-06 18:40
Good ol' America, the shining city on the hill, the only first world country where profits are considered more important than people's lives.
0 # Rain17 2013-10-06 23:46
The bottom line is that, if single-payer is ever to become a reality, American attitudes toward government would have to have to radically change. The problem is that you have a large number of Americans who believes:

1) I shouldn't have to pay for "other peoples' healthcare".
2) Were it for their decisions to have flat screen TVs, cable TV, Internet, IPhones, and laptops, the poor could easily afford health insurance.
3) Anyway, even if they can't afford insurance, they can go to the emergency room for free.
4) I don't want to pay for the healthcare of lazy people who don't want to work.
5) The main beneficiaries will be "those people" (i.e., minorities on welfare).
6) Single-payer will enable/promote/ reward the pathological behavior of "those people".
7) I'll lose the right to pick my own doctor.
8) The government will decide what treatments I get and don't get.
9) I'll have to wait three years for that knee replacement.
10) Illegals and people on welfare will get all the benefits!
11) I'll pay higher taxes for a program that benefits "those people" (minorities on welfare) at my expense!
12) I'll have to report to a central government building staffed by hostile bureaucrats whose only mission in life is to deny me care and come between me and my doctor!

I've had these conversations many times with people. And until these opinions change single-payer is politically a nonstarter.
+3 # Sandy 2013-10-07 11:21
Thank you Bernie, and especially for pushing this issue right now. We need to get and stay on the offensive regarding this issue, not let common sense and the truth get railroaded amidst all this Republican craziness.

The most obvious huge industries/lobb ies to be against a switch to universal healthcare are: big insurance and big pharma. Don't get me started...

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