Featuring Michael Lighty, founding fellow of the Sanders Institute and former healthcare constituency director for Bernie 2020:
What’s holding the U.S. back from Medicare for All? (Hint: It’s not just Trump.) What about California? In this second episode in a podcast series with host Brenda Gazzar, Michael Lighty, founding fellow of the Sanders Institute and former healthcare constituency director for Bernie 2020, discusses the political obstacles to winning single payer and the essential connection to the issue of racial equity in health care.
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How to Win Medicare for All
—– TRANSCRIPT —–
Opening MUSIC – “Talk Back” 10 seconds, fade down
Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar. Today, we’ll talk about the obstacles in achieving Medicare for All on a national and state level.
Michael Lighty has organized, advocated and developed policy for single-payer, Medicare for All nationally and in California for nearly 29 years. He’s a founding Fellow of the Sanders Institute. Most recently, he was the healthcare constituency director for Bernie 2020.
Welcome to Code WACK!, Michael.
Lighty: Thank you Brenda. It’s great to be here.
Q: In our last pod, you talked about a reluctance on the part of national politicians to work toward Medicare for All. Why do you think that is?
Lighty: I think it’s a misunderstanding of the politics. I think there’s an ideological commitment to a private insurance system and I think there’s a donor network both at the political level and at the philanthropic level through foundations that are simply bought into an institutional politics that says the private sector is better, we can’t win it, right? We can’t overcome the power of the healthcare industry so we’re just going to come up with much more complex solutions as a workaround. It’s reinforced by Democrats who support it but don’t fight for it. It’s reinforced by think tanks on the liberal side who don’t promote it. What I say is if everyone who said they supported Medicare for All actually worked to enact it, we’d win it tomorrow. So we have a political problem, a problem of political will.
Q: Got it. Donald Trump is currently president and may be re-elected in the future. What do you think the prospects are for Medicare for All under a Trump presidency?
Lighty: Well, you know you got to figure they’re not good. I don’t know that that’s a reflection necessarily of his personal views. I don’t know that his personal views matter. But I’ve always said that if the right set of CEOs had his ear and laid out the case I wouldn’t put it past him to say, yeah, we’ll call it TrumpCare and we’ll do it but it’s not going to be that easy and it’s not likely because you have this whole set of forces on the Republican side. You don’t have great support in the Republican base for it. There’s strong majority support among Democrats over 70% and the Republican side varies between 25% and 40% depending on the poll but what you do see which is quite striking is working-class Republicans — and these, of course, are white folks because that’s the Republican coalition — support a federal guarantee of health care. They did so in 2016 on a majority basis when they voted for Trump, a majority of Republicans earning under $30,000 a year supported a federal guarantee of health care.
Q: Interesting.
Lighty: So if Trump were actually responsive to his working-class voters, he would support Medicare for All. But you have institutional players, you’ve got the healthcare industry and the pharmaceutical industry — with deep pockets there — and you’ve got religious opposition because they’re afraid it’s going to actually give women the health care they need.
Q: I see. California is one of the most liberal states and it’s so far failed to approve Medicare-for-All. What do you think it will take for it to happen on a state level?
Lighty: I think it takes political leadership. I think potentially we have a governor who will provide that leadership. He certainly ran on it. He set up this Healthy California for All Commission that is designed to establish single-payer financing. So there are some positive signals. We have a legislative leadership that’s not on board, and we have a deep-pocket industry that fights it every step of the way. But what we need is, we need the institutional players to come together — the business community, the foundations that are devoted to health care and the labor movement to align with grassroots activists to recognize that we are not going to solve racial injustice when it comes to health care unless we adopt single-payer financing. So it also has to be ultimately now a part of the Poor People’s Campaign, a part of the Movement for Black Lives, to recognize what activists in the streets are demanding, what advocates that you’ve had on your program have said, Medicare for All would help us address these disparities in those communities.
Q: Got it. So, what would that look like?
Lighty: So, it has to be a part of the larger racial justice movement, really the health justice wing…and it has to coalesce the institutional players who have been the real kind of power players when it comes to health care. So, for example, if we can save billions of dollars. . . that’s what gives us the money to fund public health.
Q: Right. There’s that 2017 study that was done by the University of Massachusetts Amherst that found that California could save as much as $37 billion if it moves to single-payer.
Lighty: That’s what reopens clinics and hospitals that the private insurance finance system has closed. The reason we don’t have hospitals in the inner city is because it’s not profitable. We go to single payer in California, we reopen those hospitals. Yes, we reopened St. Vincent in downtown L.A. during the pandemic, that’s what Medicare for All would do on a permanent basis. It would fund the public health infrastructure so we can do the outreach and the testing and the population-based health. It would create resources so that we can have a jobs guarantee, we can establish real food security, we can improve housing.
Q: Interesting.
Lighty: See, this is really the leading wedge because, of course, it improves everyone’s lives, it improves everyone’s health. It opens the door and provides resources for those other essential social safety net programs that determine health status. So it is part and parcel — it’s not just insurance reform — unlike the ACA (The Affordable Care Act). It’s a comprehensive approach to guaranteeing health care and addressing the social determinants of health.
Thanks so much Michael.
Find more Code WACK! episodes at ProgressiveVoices.com and on the PV app. You can also listen at heal-ca.org. This podcast is powered by HEAL California, uplifting the voices of those fighting for healthcare reform around the country. I’m Brenda Gazzar.
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