We Already Have Single-Payer for Seniors. We Just Need to Expand It.

Today we bring you a conversation with Benjamin Day, executive director of Healthcare-NOW!, a national single-payer health care advocacy group. Day discusses how Medicare was single-payer health care for seniors that passed in a contentious political setting, and argues that with enough pressure, Medicare for All could be won today.

Sarah Jaffe: We are talking on Monday, which is the anniversary of Medicare, it turns out. Talk about what this means in the context of thinking about single-payer health care.

Benjamin Day: Medicare turns 53 today. I think that as we have these intense political debates at the national political level about Medicare for All and single-payer, it is easy to forget that we basically have already won a single-payer plan for seniors and that it was passed under a similarly contentious and social movement setting.

It followed right on the heels of the civil rights movement and the upheaval of the political party system, and we are entering a similar stage where there is a lot of social movement activity and both parties are kind of in crisis. So, it is a good time to think about what is becoming possible at the political horizon.

Let’s talk about some of that upheaval. As you said, both parties are in crisis and are trying to figure out where to go, what to do. One of them seems to be interested in white supremacy and the other one has suddenly a really active progressive wing that is pushing for policies like single-payer health care.

Both parties are in crisis, but they are very different crises. One of the differences is that Republicans are in crisis, but they are generally winning. They have been winning elections now for over a decade and Democrats are in crisis, but they are losing, which is … I think there is a sense that the sort of survival of the party is at stake in the outcomes of this.

A lot of folks say that the rise of Medicare for All and single-payer movement is part of the left wing of the party gaining influence or the liberal wing of the party gaining influence or the progressive wing. But the truth is that single-payer is basically a consensus position among Democrats. Over 80 percent of Democrats support it. So, it is not a “wing.” It is just the actual position of Democrats being embraced, and we’re trying to get it to actually be embraced by the top level of the party. I think that is true for a lot of the so-called “progressive” issues.

It is true that there is still some resistance from the people who have been the party power structure for a while. We are seeing the victories of candidates like Alexandria Ocasio-Cortez running on single-payer, among other things. But what is happening in terms of shifting the people who have already been in power on this front?

I think this happened way before the elections. First, there was the 2016 primaries — the Sanders/Clinton primaries — where we saw a very credible run by someone running on Medicare for All, and I think partly that was Bernie’s run impacting the country and mobilizing people who believe in this. But part of it was also that this movement for Medicare for All had already been growing and kind of made it possible for someone like Bernie to have a viable run in the Democratic Party.

Then, after that, I think probably more important is what happened during the repeal-and-replace fight. There was a national uprising to oppose repealing the Affordable Care Act (ACA) with basically nothing. Actually, they were going to do more than that. They were going to roll back Medicaid as well as things that weren’t even in the Affordable Care Act.

Going into that, what I feared and I think what a lot of people expected was that people would just kind of fight for the status quo — that we want to keep what we have. And that is not what happened. When people were actually pushed out into these town hall meetings and were set up and just had to speak out, no one embraced the current health care system under the Affordable Care Act. I think everyone universally said, “This has got to be fixed. It has got to be changed.” And that is really different from six or seven years ago, like right after the passage of the ACA.

That moment was really pivotal, I think, where we had this big uprising. That politicized a lot of people and got them involved with the single-payer movement. So we are seeing the growth of all of our grassroots organizations across the country and we are seeing the formation of new groups where they never existed before. There is also all these kind of new political groups like Indivisible and Our Revolution that have proliferated across the country and many of them are also working on Medicare for All and fighting for it.

You recently hosted a strategy summit on Medicare for All. What were some of the interesting take-aways from that?

I think that there is going to be a few phases of this movement. Right now, there is definitely a focus on the elections and trying to … really pressur[e] all candidates to embrace Medicare for All. After this moment is over … and it looks like we will gain quite a few Medicare for All supporters in Congress just through the election process … but, after that, it is going to be sort of another social movement fight to get sitting [representatives] to embrace it like it happened last year.

I think what that looks like will really vary depending on whether Democrats retake the House or the Senate. We are kind of preparing the way for that. A lot of our work has been focused on these elections and pressuring candidates when they are most vulnerable and when they are most accountable, I think. But, phase two is really going to be doing very targeted, organizing the districts of Democrats who should be on board with this bill, and they are not yet.

People who live in districts that are in the middle of contentious elections, the answer to what you can sort of do is easy, but for people who are in places that don’t have either a competitive race or a competitive primary, what can they do to be working on this?

It is interesting: Just a week or two ago, the first Medicare for All Caucus was launched in Congress. This really, I think, marks the new phase of seriousness about single-payer in Congress. Basically, we have a lot of [representatives] who have signed on over the years, but they haven’t really been asked to do much more than that. The creation of the caucus is really asking [representatives] to take the next step and take on leadership roles, to start hosting public forums, to start really taking the policy side seriously … just being able to get a bill that is fully viable before Congress and to potentially be voted on in the next few years.

Even in districts where there is an incumbent Democrat who is never going to be run against, there is this important step of asking them to take on more leadership on the issue. I think we are seeing organizing in districts where there hadn’t been the need as much in the past. Then, for the conservative districts, it is really about base-building and grassroots organizing. I think during repeal-and-replace … a lot of the calls for Medicare for All were coming directed at Republicans. Asking them not to repeal the ACA, but also to go further. I think that made an impact, even if those are not going to be votes for the bill down the road.

How can people keep up with you and with Healthcare-NOW!?

The best way is through our website: www.Healthcare-NOW.org. We coordinate actions around the country. If you sign up for our action list, then we can get folks plugged in with their local groups, their local single-payer activist groups, and they can help get involved.

This interview has been lightly edited for clarity.

Interviews for Resistance is a project of Sarah Jaffe, with assistance from Laura Feuillebois and support from the Nation Institute. It is also available as a podcast on iTunes. Not to be reprinted without permission.