Tag: Bernie Sanders

Pivotal Moment In American History: Sen. Bernie Sanders Unveils Medicare-For-All Bill With 15 Co-Sponsors

On September 13, 2017, Senator Bernard Sanders introduced S.1804 – a bill to establish a Medicare-for-all health insurance program, with 15 co-sponsors. Sanders Institute Fellow and Director of Public Policy for National Nurses United spoke with Amy Goodman of Democracy Now! on the pivotal piece of legislation. According to a June poll by the Kaiser Family Foundation, some 53% of Americans support a national health care plan.

UPDATE: As of September 14, 2017, there are now 16 co-sponsors for S.1804.



Vermont Senator Bernie Sanders is slated to introduce universal healthcare legislation today, aimed at expanding Medicare coverage to include every American. In a New York Times op-ed published today, Sanders wrote, “This is a pivotal moment in American history. Do we, as a nation, join the rest of the industrialized world and guarantee comprehensive health care to every person as a human right? Or do we maintain a system that is enormously expensive, wasteful and bureaucratic, and is designed to maximize profits for big insurance companies, the pharmaceutical industry, Wall Street and medical equipment suppliers?” Fifteen senators have already signed on as co-sponsors. The introduction of the Medicare for All Act comes after Republicans repeatedly failed to push through their legislation to repeal and replace the Affordable Care Act. The Republicans’ efforts sparked sustained grassroots protests, led by disability activists and healthcare professionals. We speak with Michael Lighty, director of public policy for National Nurses United and the California Nurses Association. National Nurses United has long advocated for a Medicare-for-all system.


AMY GOODMAN: We begin today’s show in Washington, D.C., where Vermont Senator Bernie Sanders is slated to introduce universal healthcare legislation today aimed at expanding Medicare coverage to include every American. In a New York Times op-ed piece published today, Sanders writes, quote, “This is a pivotal moment in American history. Do we, as a nation, join the rest of the industrialized world and guarantee comprehensive health care to every person as a human right? Or do we maintain a system that is enormously expensive, wasteful and bureaucratic, and is designed to maximize profits for big insurance companies, the pharmaceutical industry, Wall Street and medical equipment suppliers?” unquote.

Under Sanders’ legislation, all children under 18 and all adults 55 and older would qualify for Medicare during the program’s first year. The remainder of adults would be phased in over four years, until everyone is covered by Medicare. Fifteen senators have so far signed on as co-sponsors, including New Jersey Senator Cory Booker, Massachusetts Senator Elizabeth Warren, California Senator Kamala Harris. This is Senator Sanders speaking at the People’s Summit in Chicago in July.

SENBERNIE SANDERS: Think back five years ago. There was, at that point, widespread belief that the Affordable Care Act, so-called Obamacare, was about as far as we could go as a nation in healthcare. That’s about it. Past Obamacare, can’t do any more. Today, as you know, that view is radically changing. Nurses, thank you for your help on this. Today, all over our country, the American people understand that there is something profoundly wrong when we remain the only major country on Earth not to guarantee healthcare to all people as a right, not a privilege. And there is also something profoundly wrong when millions of Americans cannot afford the prescription drugs that their doctors prescribe. And what the American people from coast to coast are catching onto is the function of healthcare is to provide quality care to all people, not to make billions in profits for the insurance companies or the drug companies.

AMY GOODMAN: The introduction of the Medicare for All Act comes after Republicans repeatedly failed to push through their legislation to repeal and replace the Affordable Care Act. The Republicans’ efforts sparked sustained grassroots protests, led by disability activists and healthcare professionals.

For more, we go to Washington, D.C., where we’re joined by Michael Lighty, director of public policy for National Nurses United and the California Nurses Association. National Nurses United has long advocated for a Medicare-for-all system.

Michael, welcome to Democracy Now! Talk about what has happened just in the last two weeks, from zero senators co-sponsoring to—what are we at now? Fifteen and counting?

MICHAEL LIGHTY: Fifteen and counting, Amy. And it’s a beautiful day. It’s an exciting day for this movement to guarantee healthcare for all. We have literally seen, in the last two weeks, the ascension of this movement for improved Medicare for all. It’s something we haven’t really seen, even going back to the Hillarycare days, where this groundswell is organic. It’s a prairie fire across the country. We’ve seen, just one example, 2 million impressions on Twitter on RoseAnn DeMoro, our executive director’s demand for these senators to sign on to Senator Sanders’ bill. So, this groundswell—we had town halls in California this week. We’ve had hundreds of people come out demanding this reform. It is extraordinarily popular.

And I think we have overcome an amazing amount. The political establishment on the Democratic side, and certainly on the Republican side, did not want this to happen, and yet here we are. And it reflects the fact that Medicare for all, an improved Medicare for all, is more popular than the Affordable Care Act and more popular than the repeal of the Affordable Care Act. It works. Medicare works. And so, here we are. I think it’s really an amazing day. Americans should have a lot of hope, I think.

AMY GOODMAN: I wanted to go to just who is supporting this. Senator Sanders introduced single-payer healthcare three times before. This is the first time he’s had any co-sponsors. California Senator Kamala Harris was the first to sign on. That seemed to break the ice. And at last count, 15 Senate Democrats co-sponsored, including New Jersey’s Cory Booker, New York’s Kirsten Gillibrand, Richard Blumenthal and Chris Murphy of Connecticut, Jeff Merkley of Oregon, Elizabeth Warren and Ed Markey of Massachusetts, Al Franken of Minnesota, Tammy Baldwin of Wisconsin, Sheldon Whitehouse of Rhode Island, Brian Schatz and Mazie Hirono of Hawaii. However, Democratic leadership has yet to jump on board. Senate Minority Leader Chuck Schumer, House Minority Leader Nancy Pelosi have both declined to support the bill. So, talk about the significance and whether it matters whether the leadership leads or simply follows and gets on board if it gets support.

MICHAEL LIGHTY: Well, I think what’s extraordinary is that the majority of the Democratic caucus in the House has signed on to HR 676. Seventy percent of Minority Leader Pelosi’s constituents support improved Medicare for all. I think she just doesn’t get it. The only way to maintain the gains of the Affordable Care Act is to extend and build on that foundation by eliminating the insurance company premiums, deductibles and copays, and really guarantee healthcare for all through the Medicare system. That and the fact that she hasn’t signed on yet, I think it’s a matter of time.

AMY GOODMAN: So, Michael Lighty, lay out what you understand—and have you spoken to Bernie Sanders?—what you understand he’s doing today, what exactly this bill calls for.

MICHAEL LIGHTY: Well, this bill calls for a system where we literally take the healthcare industry model of revenue and profit and transform our healthcare into a system based on the morality of caregiving. And that is a fundamental difference, where, as he said in the clip that you showed, Amy, these healthcare players—the pharmaceutical companies, the insurance companies, hospital corporations, medical device manufacturers and, behind them all, Wall Street—are profiting on human suffering. And that is going to end, because we’re going to guarantee healthcare regardless of one’s ability to pay. Yes, everyone contributes, but the patient care that you get will be based upon what you need, not what you can afford. And that’s a fundamental transformation in the healthcare system in this country. And people are desperate for that security. Frankly, a third of the country or more has deductibles of greater than $2,000 a year. This bill eliminates that. The cost sharing that’s endemic to Medicare will be gone. And those are barriers to care. The insurance companies looking over your shoulder, if you’re a doctor or a nurse, when you’re caring for a patient or deciding how long they should stay in the hospital, that’s gone, that kind of interference. Doctors and nurses put in charge of healthcare, patients getting the care they need, people having real health security, that’s what Senator Sanders is doing today.

AMY GOODMAN: So, talk about the phasing in. I mean, we’re talking about Medicare for all, the idea that this extremely popular program of people 65 years and older have Medicare, just dropping that age to zero to include the entire population. But it’s not happening all at once.

MICHAEL LIGHTY: Well, it is important to recognize that part of the issue within healthcare is that we have a lot of people concentrated in Medicare who, of course, need a lot of services. So it’s a very good idea to include young people, who have less intense healthcare needs. So, putting zero—that is, at birth—to 18-year-olds in the plan is a really good thing to kind of stabilize the system initially, and then also cover those who are 55 and older. Those are the ones with the greatest need, who have the hardest time finding insurance that can actually cover what they need as healthcare. So those two things make sense. And that’s a huge chunk of the population. Then, when you get to between 18 and 55, you’re really dealing with the employer-based insurance system. And it’s appropriate to take some time to unwind that. We hear a lot about how invested people are or how complicated that might be. I don’t think it’s necessarily complicated, but it does take some time to unwind that system, that has been the basis of healthcare since World War II. So I think a few years to do that is perfectly reasonable.

AMY GOODMAN: I want to turn to President Trump speaking about healthcare in July during a lunch with Senate Republicans.

PRESIDENT DONALD TRUMP: We have no Democrat help. They’re obstructionists. That’s all they’re good at, is obstruction. They have no ideas. They’ve gone so far left, they’re looking for single payer. That’s what they want. But single payer will bankrupt our country, because it’s more than we take in, for just healthcare. So single payer is never going to work. But that’s what they’d like to do. They have no idea what the consequence will be. And it will be horrible, horrible healthcare, where you wait on line for weeks to even see a doctor.

AMY GOODMAN: Michael Lighty, your response? Michael, your response? We’re talking to Michael Lighty, director of public policy for the National Nurses United and the California Nurses Association. I’m going to give it one more try to see if Michael can hear us. Michael, can you hear me?

MICHAEL LIGHTY: Yes, I can. Sorry.

AMY GOODMAN: Can you respond to President Trump?

MICHAEL LIGHTY: I can hear you, Amy, yes.

AMY GOODMAN: Can you respond to President Trump? We’ll go to break. We’ll come back to you. Michael Lighty is—

MICHAEL LIGHTY: Well, respond to President Trump—

AMY GOODMAN: Yes, to respond to what he’s saying.

MICHAEL LIGHTY: Basically, President Trump has said he likes Australia. Well, this is very similar to the Australian system—no cost sharing, guaranteed healthcare for all, elimination of the role of the insurance companies. So, this is something that, in fact, President Trump should welcome. This is not the Affordable Care Act. This is not something that we’ve, obviously, instituted before, so it’s an opportunity for him to do something actually positive for the country and for everyone, as a whole. So I think that the—really, the opportunity here is to bring folks together. This is a publicly financed, privately delivered reform that actually represents kind of the best of what we can bring to this issue, because we’re going to be putting doctors and nurses in charge. That’s what we hear from the right all the time: We need doctors and nurses, clinicians in charge, and we need patient-centered care. Well, this is exactly it. This is the kind of great healthcare system that we could create in the U.S.

AMY GOODMAN: Michael Lighty, I want to thank you for being with us. Of course, we’ll follow up on this tomorrow, because Senator Bernie Sanders, the former presidential candidate, is introducing Medicare for all today, at least expected to. A couple of weeks ago, as usual, he had no co-sponsors. He’s introduced it a few times before. But today, just in the last few weeks, begun with Kamala Harris, the senator from California, one after another, Democratic senators signed on. And at last count, it’s 15 Democratic senators supporting the Medicare-for-all bill. Michael Lighty, director of public policy for National Nurses United and the California Nurses Association, thanks so much for joining us.

When we come back, the second meeting of the so-called election integrity commission takes place at Saint Anselm College in New Hampshire. We’ll get the latest. Stay with us.

No Way To Pick A President? Here Are 6 Other Ways To Do It

Every four years, Iowans are deluged with the talking points, the stump speeches, the polls and, of course, the ads. They also hear that they shouldn’t be first. Iowans are too white, too old and too few to merit first-in-the-nation status, say the critics. But if Iowa shouldn’t be first, who should be? For more than a century, reformers have been proposing ideas for how to change the primary system. And they’ve been failing. And they’ll probably continue to fail.

No one is going to persuade state and party machinery to change the current primary system anytime soon. However, these ideas can at least help show what works (and what doesn’t) about the way things are now. Here are just a few of the ideas people have proposed over the years:

1. Pick A New State

The gist

Just what it sounds like: let someone else go before Iowa and New Hampshire.

Who has promoted it

Someone new every cycle. Time and the Washington Post’s The Fix blog (twice!) have weighed in in the past year, as has this thread of redditors. (NPR’s own Asma Khalid will have her own best-first-state analysis coming out soon.)


People generally have two big criticisms of Iowa’s first-in-the-nation status (and New Hampshire’s, as well): (1) that the states are not representative of the rest of the country, and (2) that they’re too tiny. Were a state like California or Texas or Florida or New York first, a much bigger share of the U.S. population would get a shot at shaping the presidential race early. And with any of those states (and plenty of others) you get more diversity; Iowa and New Hampshire are two of the whitest states in the country, as well as two of the most rural.


Iowa’s smallness is in some ways a feature, not a bug, in that it allows less well funded candidates a fair shot (see: Rick Santorum, 2012, and Mike Huckabee, 2008). The state’s caucus “ensures that there is at least one place where a candidate with a compelling message has a shot at winning, regardless of money or national fame,” as the Des Moines Register’s Kathy O’Bradovich argued in October.

There’s also more to being representative than race and ethnicity. A 2009 paper by the University of Iowa’s Michael Lewis-Beck and Missouri’s Peverill Squire found that Iowa was the most representative state economically at the time, as well as relatively representative (12th out of 50 states) when a broad range of social, demographic and economic factors were included.

In addition, simply picking a new state wouldn’t solve all of the problems with the current system. In 2008, the scramble to hold early caucuses and primaries led to a massively front-loaded calendar. Scrambling the states into a new order wouldn’t have stopped that struggle from happening.

2. National Primary

The gist

Let people nationwide cast their primary ballots all at once.

Who has promoted it

Rep. Richard Hobson in 1911 and a lot more people since then. Well over 100 bills and resolutions have been introduced in Congress since then to try to create a national primary.


A national primary would eliminate worries about one or two states having outsize sway by virtue of voting super early. Not only that, but it would make a complicated calendar way less complex and stop the constant shifting of dates.

And by eliminating a bunch of confusion, it might make primaries “more accessible to the average voter,” which could in turn make for “more moderate candidates who are more representative of their constituents,” as Pacific Standard’s Shanna Pearson-Merkowitz wrote in 2014.


It would make money and name recognition even more important than they already are. Instead of having to focus early on buying ads in Iowa (or whichever state might otherwise go first), a candidate would have a whole nation of media markets to try to hit. That means a less well funded candidate who currently can stand a chance in the small early states right now would be at a huge disadvantage.

It could also disadvantage a grass-roots-fueled candidate like Bernie Sanders. The Vermont independent leads or is closely matched with former Secretary of State Hillary Clinton in the two early states of Iowa and New Hampshire this year, but he trails by double digits in most national polls.

In addition, this kind of plan could mean that candidates would focus only on the highest-population states, leaving smaller and largely rural states without many cities — and therefore fewer delegates — all but abandoned. That’s what Alabama’s then-Secretary of State Beth Chapman wrote at U.S. News in 2012.

3. Rotating Regional Primary

The gist

Don’t want to give a couple of states all the early-voting power, every single election? A rotating regional primary would break up the U.S. into a few segments and let each take a turn going first. Under perhaps the best-known rotating primary plan, put forward by the National Association of Secretaries of State in 2008, there would be four regions (East, Midwest, South and West), with each taking one primary slot (in March, April, May or June). The order of regions would then rotate in each election cycle.

Who has promoted it

RNC Chairman Reince Priebus, the National Association of Secretaries of State, the National Lieutenant Governors Association and plenty of others.


A scheduled system like this would get rid of the date-wrangling that led to a superearly nominating season in 2008. This is the first reason that the secretaries of state association gave in its 2008 proposal, pointing out that 37 states voted before Feb. 29 that year, while only nine did so in 2000.

It also could give voters more time to get to know the candidates and give more informed votes, not to mention potentially giving more voters a say in who eventually gets nominated, the group argued.

Finally, it could make campaigning more efficient — no longer would candidates have to hop from Iowa to New Hampshire to South Carolina for a few months. And as the University of Arizona’s Barbara Norrander has argued, it would make campaign ads more efficient. (Consider the border-residing Minnesotans and Illinoisans currently being subjected to Iowa’s campaign ads).


Here’s one weird twist: The secretaries of state proposal still puts Iowa and New Hampshire first, “based upon their tradition of promoting retail politics.” That defeats the purpose of reforming the system to some degree, keeping those two demographically unrepresentative states at the front of the calendar.

But leaving that aside, there are other potential problems with rotating regional primaries. While the plan seeks to equalize states’ participation in primaries, whichever region goes last in any given cycle runs the risk of being meaningless; it’s possible the winners will already be apparent by the time the final contest rolls around.

Certain candidates would also probably benefit more in any given election based on which region goes first, as political scientists Steven Smith and Melanie Springer wrote in 2009. Texas Sen. Ted Cruz, for example, could potentially benefit far more if this primary season started with South, and Vermont Sen. Bernie Sanders could get a big initial boost from a Northeastern primary. Not only that, but knowing that her or his region would be first in the next election, a strong candidate in one region could “block out a strong candidate from another region,” as former Ohio GOP Chairman Bob Bennett argued.

And maybe taking things a few states at a time isn’t such a bad idea, argues Norrander.

“Most would agree that face-to-face meetings between the candidates and real voters are a good component of the current system,” she writes. “Because of the large size of each region, candidate strategy will consist of television advertising and tarmac campaigning.”

4. The Delaware Plan

The gist

Let the little states go first. The Delaware Plan separates states into four groups, each with 12 or 13 states, as explained by voting-reform advocacy group FairVote. Group 1, consisting of the smallest-population states and territories, votes first, followed by Group 2 one month later, and so on.

Who has promoted it

Most notably, the RNC considered the Delaware Plan in 2000.


The point of the Delaware Plan was to keep the nomination season from growing shorter and shorter, as states fought to go earlier and earlier, as USA Today reported in 2000. That year, the season was so short that two-thirds of the states ended up “without a voice,” the paper reported.

The Delaware Plan tries to equalize states: Smaller states naturally have a smaller voice, but they’d get amplified by being earlier. Meanwhile, the powerful larger states’ voices would be turned down a bit by being later. And because a candidate couldn’t win the nomination very early, it would prolong the primary season, giving people longer to learn about the candidate and make their decisions.

In addition, it could equalize candidates to some degree — candidates with lots of grass-roots support could likewise gain ground in the small states and potentially then be able to compete in the bigger states, as FairVote argues.


Smaller states tend to be less urban than the rest of the country, not to mention whiter, as Smith and Springer wrote — meaning this plan wouldn’t exactly solve the issue of early states not being representative.

They also add that starting with 12 states that aren’t geographically grouped would create some super-inefficient campaigns, as opposed to the way that a regional plan might make campaigning easier.

In addition, starting off with so many states at once could still favor better-funded candidates, Norrander points out.

5. The Ohio Plan

The gist

This is a sort of compromise between the Delaware Plan and the rotating regional plan. The Ohio Plan would have let four current early states (Iowa, New Hampshire, South Carolina, Nevada) go first, followed by a group of 15 small states and territories.

After that, three bigger groups of states would take turns holding their primaries. Each of those groups would have had at least one high-population “anchor state,” as Brookings’ Elaine Kamarck explains.

Who has promoted it

The Ohio Plan was proposed by Bob Bennett, the then-chairman of the Ohio GOP, before the 2008 election.


Bennett argued that his plan would be more acceptable to big states than the Delaware Plan while maintaining the kind of retail politics influence that small states — and the current early states — allow. In addition, keeping South Carolina and Nevada early would add more diversity early in the process than the Delaware Plan.


The plan would still maintain some of the cons of the secretaries of states’ and Delaware plans — despite the early participation of South Carolina and Nevada, there are still a lot of very white states with early influence. In addition, candidates would have to hit a lot of geographically far-flung states at once.

6. Graduated Random Presidential Primaries (Aka ‘The California Plan,’ Aka ‘The American Plan’)

The gist

It’s a little like the Delaware Plan in the sense that smaller states would go first. However, it’s way more complicated.

So here goes: There would be 10 caucus periods, each lasting two weeks. States with fewer congressional districts would go first, followed by states with a few more in the next period and so on.

This would be according to a particular formula: States with a total of eight districts would go first, with the states being randomly selected. So, for example, Kansas and Mississippi, which each have four districts, might be in the first round. The next round, the number of districts would total 16. The next, 24.

But after that, the numbers get less straightforward. To keep the biggest states like New York and California from always going nearly last, the plan allows for some bigger district totals to go earlier. The order for all 10 caucus rounds would be eight, 16, 24, 56, 32, 64, 40, 72, 48 and then 80 districts, according to FairVote.

Who has promoted it

The Democratic National Committee considered it in 2005, and FairVote has advocated for it as well.


It maintains many of the benefits of the Delaware Plan, potentially making the primary season longer (and therefore, potentially more informative) and giving more states the opportunity to have a say — all without leaving all the biggest states for last.


Once again, there’s the potential for some really inefficient campaigning. Imagine candidates having to hop from Alaska to Idaho to West Virginia to Rhode Island for the first round of caucuses. That could give better-financed candidates a leg up.

Also, it’s complicated — but compared with what? As Smith and Springer wrote, the American Plan “surely would be no more complicated than the current schedule.”