We Need a Mass Movement Demanding Real Social Security and Medicare for All

The rising fortunes of presidential candidate Bernie Sanders, the self-described democratic socialist US senator from Vermont, in the Democratic presidential primaries, provides a unique opportunity for organizing a new radical movement around key political goals including a national health care program for all Americans, not just the elderly and disabled, and a national retirement program that people can actually live on.

The elements are there already. Sen. Sanders is calling, on the stump, for expanded Social Security benefits, which with the collapse of employee pensions and the destruction of retiree savings in the Great Recession and the ensuing “lost decade” of the stock market, is badly needed. He is also calling for expanding and enhancing the Medicare program to cover everyone from birth to death, much as is done in Canada and in every other modern nation on the globe except the US.

The key here is to build a movement around these two programs that might work in parallel with the Sanders presidential campaign, but that would remain separate from it so that, when the election is over, win or lose, that movement will continue. If Sanders were to win the presidency, as is looking increasingly possible if polls can be believed, and if, as some polls also suggest, his win were to end up helping Democrats to retake both the Senate and the House, then having an independent movement in place would be critical. Such a movement militantly demanding Medicare for all and enhanced Social Security benefits would put intense pressure on both a President Sanders and a new Democratic congress to deliver. Meanwhile, if Sanders were to lose, a having a strong, well organized movement in defense of both programs would become even more urgently important.

Better yet, Sanders is a movement veteran, not just someone like Obama who supposedly did a little stint as a “community organizer.” Sanders’ entire political life dating back to his college days has been about fighting for more income equality, and improved lives for the poor, minorities and working people. One can criticize his record of support as a member of congress for most of the US government’s imperial policies abroad, and even for most of its illegal wars, but domestically, at least, his record of support for fairness and for more racial and economic equality, for worker rights and for women’s equality is pretty much unassailable.

What this means is that as long as he is running — which looks like it could be right through to November — then win or lose he will be pressing for those issues of strengthening Social Security and for replacing Obamacare — that huge, cumbersome gift to the insurance industry — with an expanded and universal version of government-run Medicare. If a movement built around those two issues were to organize marches and rallies and Occupy-style actions in Washington, DC and around the nation, a candidate Sanders could be counted on to appear at them and to support them as he looks to build voter support.

At the same time, a movement fighting for Medicare for all and for expanded and improved Social Security would keep the media more honest, preventing the spreading of the kind of treacherous lies such as just spewed out by Sanders’ main opponent Hillary Clinton. A recipient of millions of dollars in “donations” from the health insurance industry, she has been allowed by a supportive corporate media to claim, largely unchallenged, that Sanders’ Medicare-for-All plan would mean “dismantling Obamacare, dismantling CHIP programs (state programs that offer health insurance to poor children), and dismantling Medicare and Medicaid,” and that his plan would end up “making health care more expensive for most people.”

Her assertions are lies, and Clinton knows it when she utters them. She knows Sanders would only be dismantling Obamacare because his plan to expand Medicare would eliminate the need for private insurance, both for individuals and for employers. He would clearly not eliminate Medicare, as he wants to make it universal, not just available to the disabled and those over age 65 as it is today. He would eliminate Medicaid, the miserly and bureaucratic state insurance program for the poor, but only because Sanders would have those people instead covered by the much more expansive benefits of Medicare. The same for children who currently receive insurance through CHIP. And Sanders’ scheme would be cheaper for everyone because even though Medicare for All would be funded by higher payroll taxes, nobody would be paying premiums to insurance companies for health insurance anymore. Neither woul employers, who would instead be pressed to provide savings to employees in the form of higher wages.

The reality is that the US is far and away the world’s biggest healthcare spender both on a share-of-GDP and on a per-capita basis. According to the Commonwealth Fund, based upon Organization for Economic Cooperation and Development (OECD) data, the US spends the most on health care among the top 13 high-income nations of the world: Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States, and yet its health outcomes, for example life expectancy and infant mortality rates, are worse.

In 2013, the OECD data shows [1] (see chart) that the US spent 17.1% of Gross Domestic Product, which is a measure of all economic activity in the country, on health care. That was 47% higher, or nearly double the 11.6%, spent by the next biggest spender on health care: France, which has a medicare-for-all style system. It’s 60% higher than the percentage of GDP spent on health care in neighboring Canada, which has a system of universal insurance actually called Medicare. and it is nearly double the cost of the British National Health System which, more like the US Veterans Administration system, actually employs its medical workers and owns the hospitals, and devotes a paltry 8.8% of GDP to health care costs.

As for per-capita health spending, the situation is even more dramatic. Including public health spending by states, local governments and the national government, employer spending, and spending by individuals and families, the per-capital annual spending on health care in the US in 2013 according to the OECD was $9,086. The next highest country was Switzerland (ironically the only other of these countries that relies on private insurers to cover most of its citizens, though with stipulations mandating no profits on basic plans, which all health insurers must have on offer), at $6,325 per person — just two-thirds of what Americans spend. In France, the figure was $4,361 and Canada $4,569. Both those figures ae less than half the US per-capita health expenditure (see table for the rest).