Featuring Michael Lighty, a founding Fellow of the Sanders Institute, who has organized, advocated and developed policy for single-payer Medicare for All nationally and in California for nearly three decades. Most recently, he was the healthcare constituency director for Bernie 2020.
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What are the prospects for single payer in California? What role might the Healthy California for All Commission play in the future of the state’s healthcare system? What about Gov. Gavin Newsom and the Legislature? Michael Lighty, founding fellow of the Sanders Institute and former healthcare constituency director for Bernie 2020, and host Brenda Gazzar discuss who and what California single-payer supporters should focus on in 2021.
What Now for California’s Medicare for All Movement?
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(10-second Talk back music)
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.
So what’s on the horizon for California’s Medicare for All movement amid the coronavirus pandemic? I spoke to Michael Lighty, a founding fellow of the Sanders Institute, and a longtime Medicare for All advocate, to find out.
Welcome to Code WACK!, Michael.
Lighty: Thank you, Brenda, it’s great to be back.
Q: Do you think that the populace in America is now more supportive of Medicare for All than in any other time in history? Is that true or not?
Lighty: Well, I don’t know if it’s true, relative to say the ‘40s. But yes, I think it is true. We have really transformed the whole healthcare debate. The healthcare debate is essentially about Medicare for All, if you think about it. If we continue to play offense, and we successfully call out the industry for its profit-making, death-creating policies, then, you know, I do think we have even more of an opening. But the Democrats can no longer front for that industry that literally has made like over $10 billion in profits during the pandemic. Why is that OK?
Q: $10 billion?
Lighty: Yes, yes. Just between Kaiser and United Health in the second quarter, it was $11 billion. So I’m being generous. It’s probably substantially more than that.
Q: Got it. Do you want to talk about the Healthy California for All Commission that Gov. Gavin Newsom set up to explore a healthcare system that provides coverage through unified financing, including possibly Medicare for All? I believe they’re on hiatus now? What’s the latest with that?
Lighty: Well, the hiatus is definitely the latest. I think what we have to understand the California Commission to be, it is not what single payer advocates would want it to be. But it is a forum to bring over the skeptical middle, to bring over some key players who it’s going to be very tough to succeed without their support and if we had their support, it’d be a lot easier to win — people from the healthcare foundations, people from the policy apparatus. So it’s worth investing in, in my view, because there are sympathetic advocates and policy analysts and powerful people who run powerful wealthy foundations from the labor movement and from other sectors.
It’s not dominated or really kind of overwhelmed, in any way, by the insurance industry, They’re not part of it. And we don’t maybe talk about that enough, right?
I recognize the limitations and look, the limitations are profound. You got the lead analyst who basically did an article this year, on how Medicare for All is equivalent to Repeal and Replace, and the Democrats should stay away from it. And he’s the one giving the analysis on the financing schemes. What a coincidence that he didn’t mention savings, which is at the heart of the whole program, and he was called out by Commissioner (William) Hsiao , who has set up like six national health care systems. So we’ve got some very good advocates. CNA (the California Nursing Association) has done a very good paper on the deficiencies of the Commission but it’s a vehicle and they are going to produce something that the legislature is going to take seriously, and so do we.
Q: How long is the commission on hiatus for? Do you know?
Lighty: Until February, I think.
Q: So you see the commission as a tool or vehicle to persuade the middle ground of the benefits of Medicare for All?
Lighty: Yes, exactly. Because the upside is big. If you’re actually able to get the commission to say, yeah, we’re going to move to single payer, then that shows a level of consensus that we haven’t achieved prior. Now if we fail to do that, we’re kind of where we are, right? It’s kind of like yeah okay the usual place. But if we can make progress, I think, the upside is real.
Secondly, though, of course, it’s unreasonable to think that the Commission, because of course it’s staffed by the Governor’s appointees and kind of driven by that, that it’s not going to reflect his views. So putting our perspective, putting the demand to the governor for a waiver request is essential. And so we’ve got to do the grassroots organizing to essentially move the governor to initiate a waiver and to then move the Commission to validate that. So it seems to me it’s a piece.
Ultimately, it comes down to the legislature so ultimately we’re gonna have to move key players in the legislature and of course, the chairs of the health and senate committees are ex-officio on the commission. And you can tell their deliberations drive to a certain extent what the staff responds to and what the consultants respond to, so you can’t really separate all this. It has to be everything is everything, from the Governor, the Commission and the legislature.
Q: Right, which leads us to our next question. What do you think California single payer supporters should focus on in 2021?
Lighty: I do think it is moving the government to do a waiver. I think it’s getting the best possible outcome from the commission because if the commission is devoted to policy, we’ve got the policy case. And then it’s moving key decision makers in the Assembly, in particular. I’m more optimistic about the Senate. I think it’s quite remarkable that Josh Newman is going to be back in the Senate, during the SB 562 fight. He was told not to vote for 562. He voted for 562. Despite the pending recall. He acted on principle and I think that that is the kind of principal acting that we need and I hope Josh continues to do it.
Q: Right, Josh Newman was a state senator who was recalled in 2018, and elected again in November. And SB 562 was the Healthy California Act, which would have created a comprehensive and universal single payer healthcare coverage for residents in the state — but it never went anywhere.
Lighty: And I do think that the Assembly is more the issue but when you’ve got, I don’t know, over 60 Democrats, you’ve got to figure that there’s 41 that we can move and I think it’s going to take some grassroots organizing , so I do think we have to focus on that. I personally believe that the governor is the linchpin here and I believe that’s the best focus, particularly in the short term, before the Commission resumes.
Q: So how open do you think the governor is right now to Medicare for All?
Lighty: I think he’s open. I think it’s up to us to prove its political viability. We’ve got to demonstrate support. I totally get it. He is someone who has his feet in all camps, right? Because he’s got relationships with business. He’s got relationships, obviously, with the medical industrial complex and its professional associations but of course he got tremendous support from the California Nurses Association, and I was there for part of it. And he has very good relationships with the teachers unions. He supported Prop. 15.
Q: Right, Prop. 15 would have increased commercial property taxes to fund local governments and schools but it didn’t pass in November.
Lighty: He’s difficult to classify ideologically but where he’s always come from with single payer is the obvious solution because it works better. And so he is ultimately a sophisticated policy guy. And so he understands, I think, that we have the right policy in single payer. Where it stands politically is a separate question and ultimately, it’s kind of on us, isn’t it?
Q: Thank you, Michael.
Find more Code WACK! episodes at Progressive Voices.com and on the PV app. You can also subscribe to Code WACK! wherever you find your podcasts. 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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