Healthcare for All: The Democratic Promise That Could Heal a Broken Nation

When politics becomes personal, policy becomes powerful, and there’s nothing more personal than survival…

When politics becomes personal, policy becomes powerful. And there’s nothing more personal than survival.

Every election cycle, candidates talk about “freedom,” “security,” and “opportunity,” yet ignore the most basic measure of all three: whether ordinary Americans can afford to stay alive.

In the richest nation in the history of planet Earth, millions of Americans are dying from treatable illnesses, rationing insulin, and running GoFundMe campaigns for chemotherapy. This isn’t just a policy failure, it’s a moral collapse.

And it’s the one issue that could unite the country, reshape the Democratic Party, and finally prove that compassion is not weakness, but strength.

Dilbert creator Scott Adams is begging Donald Trump for help forcing Kaiser to provide him with a possibly life-saving infusion for his cancer. That’s how f*cked-up healthcare is in today’s America.

When John McCain famously strode out onto the Senate floor and gave a thumbs-down to a bill that would have ended the Affordable Care Act (the ACA, aka “Obamacare”), it was roughly the 70th time Republicans had tried to end government-funded health insurance for average Americans.

They’re still at it.

They’ve voted over 100 times to date on bills that would end, gut, or severely disfigure the ACA and finally got a good chunk of it done with their so-called “Big Beautiful Billionaire’s Bill” that handed Trump, Musk, Zuckerberg, et al over four trillion dollars in tax cuts, while making up for it by eviscerating ACA subsidies and Medicaid eligibility.

The Trump administration tried their best to hide the pain, using the GOP’s government shutdown as cover, claiming that they just didn’t have the resources or ability during the layoffs to post the new ACA plans and prices. They’d calculated — wrongly — that Democrats would cave on the shutdown before the new prices were published.

But now that November 1st is in the past and we’re atop the actual enrollment period, 24.2 million people on the ACA plans are discovering their insurance rates, co-pays, and deductibles are exploding.

And they’re pissed. Even Marjorie Taylor Greene is pissed!

Adding to the insult of the GOP trying to hide these increases until after this week’s election is the actual injury of Americans paying roughly twice what the citizens of any other developed country do for healthcare.

We’re the only developed country in the world without a national healthcare system, and the only developed country in the world that doesn’t define healthcare as a right rather than a privilege determined by one’s wealth.

This is a golden opportunity for Democrats, or at least for those Democrats who don’t take big money from the healthcare or insurance industries, to reshape American politics and once again win elections in a big way.

Back in the 2016 primaries, Senator Bernie Sanders was promoting “Medicare for All,” a system similar to that of Canada, western Europe, and the democracies of Asia and Oceana.

Most Americans have no idea that the United States is quite literally the only country in the developed world that doesn’t define healthcare as an absolute right for all of its citizens. That’s it. We’re the only one left.

As a result, we spend more on “healthcare” than any other country in the world: about 17% of GDP.

Switzerland, Germany, France, Sweden and Japan all average around 11%, and Canada, Denmark, Belgium, Austria, Norway, Netherlands, United Kingdom, New Zealand and Australia all come in between 9.3% and 10.5%.

Health insurance premiums right now make up about 22% of all taxable payroll, whereas Medicare For All would run an estimated 10%.

We are literally the only developed country in the world with an entire multi-billion-dollar for-profit industry devoted to parasitically extracting money from us to then turn over to healthcare providers on our behalf after they’ve skimmed hundreds of billions off the top. The for-profit health insurance industry has attached itself to us like a giant, bloodsucking tick.

And it’s not like we haven’t tried. As I pointed out in The Hidden History of American Healthcare: Why Sickness Bankrupts You and Makes Others Insanely Rich, Presidents Theodore Roosevelt, Franklin Roosevelt, Harry Truman, Jack Kennedy and Lyndon Johnson all proposed and tried to bring a national healthcare system to the United States.

“Dollar” Bill McGuire, a recent CEO of America’s largest health insurer, UnitedHealth, made about $1.5 billion dollars during his time with that company. To avoid prosecution in 2007 he had to cough up $468 million, but still walked away a billionaire. Stephen J Hemsley, his successor, made off with around half a billion.

And that’s just one of multiple giant insurance companies feeding at the trough of our healthcare needs.

Much of that money, and the pay for the multiple senior executives at that and other insurance companies who make over $1 million a year, came from saying “No!” to people who filed claims for payment of their healthcare costs.

This became so painful for Cigna Vice President Wendell Potter that he resigned in disgust after a teenager he knew was denied payment for a transplant and died. He then wrote a brilliant book about his experience in the industry: Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans and has a great Substack newsletter, Health Care Un-Covered.

Companies offering such “primary” health insurance simply don’t exist (or are tiny) in almost every other developed country in the world. Mostly, where they do exist, they serve wealthy people looking for “extras” beyond the national system, like luxury hospital suites or air ambulances when overseas. (Switzerland is the outlier with exclusively private insurance, but it’s subsidized, mandatory, cheap, and non-profit.)

If Americans don’t know this, they intuit it.

In the 2020 election there were quite a few issues on statewide ballots around the country. Only three of them outpolled Joe Biden’s win, and expanding Medicaid to cover everybody was at the top of that list. (The other two were raising the minimum wage and legalizing pot.)

The last successful effort to provide government funded, single-payer healthcare insurance was when Lyndon Johnson passed Medicare and Medicaid (both single-payer systems) in the 1960s. It was a hell of an effort, but the health insurance industry was then a tiny fraction of its current size.

Medicare For All, like Canada has, would save American families thousands every year immediately and do away with the 500,000+ annual bankruptcies in this country that happen because somebody in the family got sick. But it would kill the billions every week in profits of the half-dozen corporate giants that dominate the health insurance industry and heavily subsidize the GOP.

Bernie’s efforts — which were entirely sensible and would have saved the nation and our working class people trillions of dollars in the years since 2016 — were defeated by a coalition of the insurance industry, Republicans, and a handful of bought-off Democrats who went along with the GOP’s charge that it was “socialism” and therefore a bad thing.

You know, like our “socialist” fire departments, or public highways, Social Security, Medicare, Medicaid, SNAP benefits, FEMA, CDC, etc., etc.

While the corporate Democrats, neoliberal Clinton “Third Wayers,” and corporate “problem solvers” are still with us and enthusiastically taking money from their corporate masters, their day in the sun is fading rapidly.

Zohran Mamdani, Alexandria Ocasio-Cortez, Ro Khanna, Mark Pocan, Elizabeth Warren, Pramila Jayapal, Jasmine Crockett, Sheldon Whitehouse, Chris Murphy, Ron Wyden, Jeff Merkley, and other genuine progressives in Congress have captured the public’s attention even as they strive to push leadership in a more forward-looking direction.

This confluence of voter anger against our bizarre profit-driven healthcare system and public affection — enthusiasm, even — for genuine progressives makes this the perfect moment for Democrats to embrace a single-payer solution.

If Democrats don’t want to go for broke with a plan like Bernie’s, they could at least crack the door wide open by advocating a public option within the ACA.

When President Obama was pushing his plan, the single vote that killed the right of Americans of any age to buy into Medicare came from Connecticut’s sellout senator, Joe Lieberman, after he got a huge infusion of insurance company cash.

That was fifteen years ago, almost an entire generation, and things have changed a lot. The health insurance industry has become more predatory, massive consolidation and intrusions from private equity have driven healthcare costs sky-high, and people are starting to wise up to the privatized Medicare Advantage scam.

It’s time for a bold change in the Party’s position on healthcare.

Democrats are looking for a simple message that will resonate with voters and prove that they’re on the side of working class people while Republicans are all-in for the plutocrats. They should look to the progressives’ healthcare positions.

Voters are sick and tired of both Republicans and “centrist” Democrats with their hands in lobbyists’ pockets, too timid to take on the issues that are ripping American families apart. That are bankrupting a half-million families every year, something that doesn’t happen in any other developed country in the world.

Fully two-thirds of Democrats — the party’s base and more — want their party’s leadership to be more aggressive. To lead instead of following. To tell the truth and not cower when Republicans scream, “Socialism!” To promote bold solutions to real problems.

As we head now toward the midterm elections next year, affordable healthcare via a public option to buy into real Medicare at any age should be at the top of that list.

“Healthcare for All” isn’t a slogan: it’s a test of who we are as a nation. It asks whether we believe in shared humanity over corporate profit, and whether our politics can still serve the living instead of the lobbyists.

The promise that could heal America isn’t abstract; it’s written in the stories of every family that is one accident, one diagnosis, or one pink slip away from ruin.

If Democrats have the courage to run on this truth — that survival shouldn’t depend on wealth and status — they won’t just win elections. They’ll change for the better what it means to be an American.

Louise’s Daily Song: “The Promise that Could Heal a Broken Nation”

The song that was inspired by this article is here.
My reading this article as an audio podcast is here.
My newest book, The Last American President: A Broken Man, a Corrupt Party, and a World on the Brink is now available in bookstores nationwide.
You can follow me on Blue Sky here: https://bsky.app/profile/thomhartmann.bsky.social