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Is Medicare-for-all an idea whose time has come?

  • 18 September 2017


Healthcare reform has been a major issue on the political battlefield in the United States since the election of Obama, rising to a crescendo with the election of Trump. But the battlefield has shifted substantially in the past nine months.

The failure of Republicans to repeal and replace Obamacare has highlighted growing public support for this law and seen political and public sentiment move further left than could ever have been predicted, so that the idea of a single payer system is now openly canvassed.

Former presidential candidate Senator Bernie Sanders will take credit for this, but in fact many champions have pushed for the United States, the only developed country without universal health care and always the outlier in terms of healthcare costs, to adopt a single payer system.

Seventy-two years ago, at the end of World War 2, and as the United Kingdom was implementing National Health Insurance, President Harry Truman sent a message to Congress proposing a new national healthcare program. But compulsory health insurance became entangled in the issues of the Cold War, and its opponents were able to make 'socialised medicine' a symbolic issue in the growing crusade against communist influences in the United States.

For conservatives, socialised medicine is still a bogey man, but with a majority of Americans now having health insurance provided with government assistance, one that is much less potent. After the introduction of Obamacare and the realisation of its benefits, modest and limited though these might be, there can be no return to the status quo that existed prior to 2010. Indeed, Obamacare can be seen as the first step on the road towards a single payer system.

Last week saw the extremes of conservative and progressive views on healthcare reform on display. Republican Senators Lindsey Graham and Bill Cassidy released their legislation to repeal and replace Obamacare, in what they described as a last-ditch effort to enact the Republicans' commitment.

Almost simultaneously Bernie Sanders released yet another version of his Medicare-for-all plan. The last time he did this, in 2013, his bill had not a single co-sponsor. This year Sanders (despite not really being a Democrat) was surrounded by his 16 Democrat co-sponsors, including Senators Kamala Harris, Al Franken, Cory Booker, Kirsten Gillibrand, Tammy Baldwin and Elizabeth Warren. Several of these are possible presidential candidates for 2020.


"Americans increasingly see healthcare as a universal right and a majority of Americans now believe it is the responsibility