‘We Ain’t Gonna Get It’: Why Bernie Sanders Says His ‘Medicare for All’ Dream Must Wait

Lambert here: Not even a hearing on single payer, apparently. It’s not just that the health care system is “dysfunctional”; our ruling and governing classes are dysfunctional, utterly, at all levels and across the board. Well, except for an orgy of looting and corruption. Adding, I’m generally pretty happy with KHN’s neutrality, but Allen’s second word: “railing.” What a scum-sucking tell. Hey, and how about some hearings on Biden’s Covid policy of mass infection without mitigation?

By Arthur Allen, KHN Senior Correspondent, who writes about the FDA and the pharmaceutical industry as well as covid-related topics. Originally published at Kaiser Health News.

After railing at the injustices of U.S. health care for decades, Sen. Bernie Sanders in January became the new chairman of the Senate Health, Education, Labor & Pensions Committee. The job gives the health care industry’s biggest Washington nemesis an unprecedented opportunity to shape health care reform in Congress. But the sort of radical changes he seeks could prove elusive. Even Sanders concedes there are limits to the powers of his position.

President Joe Biden’s State of the Union address Tuesday night showed how much of Sanders’ platform has moved into the mainstream of the Democratic Party, with Biden at times sounding like his former Democratic primary foe, lashing out at Big Pharma and its “record profits.” Biden bragged about measures taken to lower drug prices and halt surprise bills during his term thus far, and he urged Congress to pass a federal expansion of Medicaid.

Still, the radical changes Sanders seeks could prove elusive. During an interview with KHN at his Senate office recently, the independent from Vermont spoke about the prospects for lowering drug prices, expanding access to primary care, and his ultimate goal of “Medicare for All.”

The interview has been edited for length and clarity.

Q: What do you hope to achieve as chair of the HELP Committee — in terms of legislation, but also messaging and investigations?

What I ultimately would like to accomplish is not going to happen right now. We have Republicans controlling the House. And many of the views that I hold, including Medicare for All — I think if we had a vote tomorrow, we’d get 15 to 20 votes in the Senate and would not win in the House. I realize that. But I happen to believe our current health care system is dysfunctional.

We spend twice as much per capita on health care as other countries and 85 million people have no insurance or are underinsured. It is a dysfunctional system that to my mind needs to be fundamentally changed to a Medicare for All system — but we ain’t gonna get it [“Never, ever come to pass.” –Hillary Clinton]

Q: What can you actually accomplish?

[From] a poll a couple of months ago just among Republicans. Top concern? High cost of prescription drugs. We’re long overdue to take on, in a very bold way, the greed and outrageous behavior of the pharmaceutical industry.

Q: So many parts of the system are messed up — patents, 340B, pharmacy benefit managers, insurance issues with formularies …

Right, there are a million parts to this problem.

Q: So short of a complete overhaul, what are the parts you think you can change?

Every year the U.S. government through [the National Institutes of Health] spends tens of billions of dollars on research. The Moderna vaccine was co-developed between Moderna and NIH and received billions of dollars in assistance, guaranteed sales, and you know what’s happened in the last couple of years. The CEO of Moderna is now worth $6 billion. All their top executives are worth billions. And now they are threatening to quadruple prices. This is a company that was highly supported by taxpayers of this country. And that’s one example of many.

What is the responsibility of a drug company that receives very significant support — financial support, intellectual support for research and development — to the consumers of this country? Right now, it is zero. “Thank you very much for your support. I will charge you any price I choose.” We have to end that.

That’s the starting point.

Q: But what’s the mechanism? “March-in” rights, whereby the government could force a company to share its license for a drug that was developed with federal investment, allowing others to produce it?

That is one approach. Threatened by people in George W. Bush’s administration, by the way. March-in is one option.

Reasonable pricing is another area. I have made two trips to Canada: once as a congressman from Vermont, took a bunch of working-class women across the border to buy a breast cancer drug; once as a presidential candidate, took people from the Midwest, and we bought insulin. The price was one-tenth of the U.S. cost in both cases.

Another area is primary health care. I have worked hard with other members through the Affordable Care Act and American Rescue Plan [Act] to significantly expand community health centers. FQHCs [federally qualified health centers] provide primary care, dental care, mental health counseling, and low-cost prescription drugs. About one-third of [people in Vermont] get primary care through community health centers.

Q: I was at a meeting of FDA and patent office people, hearing from biosimilars companies, patients, etc., and a lot of what they were saying is that the U.S. Patent and Trademark Office can’t do that much about patent thickets, and it’d be good if Congress did something.

That is one of the disgraceful tools that pharma utilizes to make sure we pay high prices and don’t get generics. Yes, it’s certainly something that we should be looking at.

Q: Other priorities?

The crisis in the health care workforce. We don’t have enough doctors, nurses, dentists, mental health counselors, pharmacists. The nursing crisis is enormous. We have a hospital in Burlington, moderate size by national standards, largest by far in Vermont. They told me they are going to spend $125 million on traveling nurses this year. One moderate-sized hospital! Meanwhile we have young people who want to become nurses, and we can’t educate them. We don’t have enough nurse educators. I think we get bipartisan support for that issue.

Another thing I want to look at is dental care. Not enough dentists, too expensive, whole regions don’t have them.

Q: Did you agree with President Biden’s decision to end the public health emergency in May?

[Frowns] I have some concerns. [Sanders appeared to be the only member of Congress wearing a mask during Biden’s speech on Tuesday.] It’s going to dump a lot more people into the uninsured again. 

Q: And things like vaccines would not be covered anymore.

They’d go on the market. Our friends at Pfizer and Moderna want to quadruple the prices. So if you’re hesitant now about getting vaccinated, and it’s free, what about when it costs you $125?

Q: As you say, drug prices are a big concern for everyone. But among Republicans there seems to be more inclination to push on pharmacy benefit managers, or PBMs, as opposed to drug companies. Is that an area where there could be legislation?

You’ve got the insurance companies, the PBMs, and pharma. Everyone wants to blame the other guy. And yet they’re all culpable. And we’re going to take a hard look at it.

Q: Is Dr. Robert Califf, the FDA commissioner, a good interlocutor for you?

A lot of work has to be done with FDA. Let’s just say I think it’s important that we take a hard look at what they’re doing. They have some responsibility for pricing. It’s part of that mission that they haven’t exercised.

Q: What about the 340B issue? Accusations that hospitals are gaming the system.

Yes, it is something. One of the first things [I did] when I was mayor of Burlington from 1981-89 was take away the tax-exempt status of the hospital. Because I did not believe they were fulfilling their responsibility to serve the poor and working families. We had a lot of discussions, and the situation improved. Right now the criteria to receive tax-exempt status is extremely nebulous. That’s an issue somewhere down the road I want to look at. If you’re not going to pay taxes, what are you, in fact, doing?

Q: Do you have particular allies in either party?

I talked today with a conservative GOP senator who will work with me on issue X, but not issue Y. It depends on the issue. If we’re going to be successful, we’re going to need bipartisan support. And there is that level of support. I’ve talked to now four out of the 10 or 11 Republicans on the committee, and I’ll talk to the rest.

Q: Do you have a policy for dealing with the lobbyists?

I don’t have lobbyists flooding through my door. These lobbyists are effective, well paid, and they help shape the culture of where you’re going. My culture is shaped by going out and talking to ordinary people. I’ve talked to too many elderly people who cut their prescription drugs in half.

I’m not worried about the lobbyists. Worry about the people who are dying because they can’t afford prescription drugs.

I don’t have to have some guy who makes seven figures a year telling me about problems of the drug companies. They have to explain to American people why they made $80 billion last year and people can’t afford medicine.

Q: Are you going to bring in pharma executives for hearings?

We’re looking at all options.

Print Friendly, PDF & Email
This entry was posted in Guest Post, Health care, Politics on by .

About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.


  1. The Rev Kev

    ‘But the sort of radical changes he seeks could prove elusive.’, ‘Even Sanders concedes there are limits to the powers of his position.’, ‘Yes, it’s certainly something that we should be looking at.’, ‘I think we get bipartisan support for that issue.’, ‘And we’re going to take a hard look at it.’, ‘That’s an issue somewhere down the road I want to look at.’, ‘We’re looking at all options.’

    Not trying to pick on the guy but the quotes above show what a Sanders Presidency would have looked like. Said years ago in a comment that if it ever happened, that he would have been hamstrung from the get-go by both parties as well as the bureaucracy and would have never gotten much done. At least Trump had part of his party and a lot of billionaires behind him. Sanders would have had none of them, especially not any Progressives. Are the later backing him now as he takes up the position of Chairman of the Senate Health, Education, Labor & Pensions Committee?

    1. Arizona Slim

      Which is why I think Medicare for All will more likely come from the Republican side than the Democratic side. I think that some big Republican businessman (or woman) will run for President on a ticket that emphasizes the burden that healthcare costs put on American businesses as compared to their foreign counterparts.

      He or she will win in a landslide that will leave Democrats in even more disarray than before.

        1. hunkerdown

          They are smart enough to know a fake competition when they’re put in charge of one. Even MTG learned quickly to stick to virtue signalling and preserve the Holy Order of Capitalism.

          1. Rip Van Winkle

            Here’s a start from memory at my neighborhood car repair place –

            Post prices conspicuously at beginning of consultation.

            Customers billed for actual changes at same price, no matter form of payment or intermediaries.

            Consent to treatment and costs agreed in writing in advance. Any subsequent changes likewise.

            Any problem caused by treatment is at the expense of provider.

            Documentation is itemized and without jargon.

            OEM vs. generic disclosed.

            1. hunkerdown

              If pretentious PMC rule-making performativity worked in favor of all, it would have by now. The prime capitalist value of alienation doesn’t care about In This House rules. It prices them, markets them, and moves on as it were.

              1. JBird4049

                >>>If pretentious PMC rule-making performativity worked in favor of all, it would have by now.

                And this refers to all public assistance, Social Security, Medicare, Medicaid, disaster relief, anything helping the needy or the desperate. Gatekeeping via rule-making. Propaganda as well with the gatekeeping.

      1. GramSci

        Some Wall Street Republican manufacturer might try this tack, but he’ll run up against the gig economy, the off-shored industries, and the local Chambers of Commerce, all of which prefer to operate with disposable workers.

      2. digi_owl

        Can’t see it happen unless corporate health insurance costs grows massively over a short period. That insurance seem to be one of the few carrots left in an increasingly brutal job market.

        1. Samuel Conner

          Perhaps at some point the debilitation of the labor pool (due to poor health generally, perhaps accelerated by Long COVID) will become so severe that the corporate influences on Congress will become concerned about population health. One suspects that this is already an issue for US military planners.

            1. Bsn

              No, the only answer is a complete revolution, Chris Hedges level. And I’m writing this knowing that Chat GDP (or whatever it’s called) will record my comments and they “may be held against me” in a corporate court of law.

        2. Mo

          Not gonna happen IMHO. Corporate America is already requiring employees to pay for more of their health insurance. HSA’s are big. I can’t imagine they would spend any effort delivering something that would help all Americans.

      3. GramSci

        Some Wall Street Republican manufacturer might try this tack, but he’ll run up against the gig economy, the off-shored industries, and the local Chambers of Commerce, all of which prefer to operate with disposable workers.

    2. DJG, Reality Czar

      Indeed. Given that Sanders made the ritual denunciation of the diabolical Putin and has since had nothing to sy about ending the proxy war, which is only the most dangerous and pressing issue of our times, I’ll quote T.S. Eliot and The Hollow Men:

      Between the essence
      And the descent
      Falls the Shadow
      For Thine is the Kingdom

      For Thine is
      Life is
      For Thine is the

      This is the way the world ends
      This is the way the world ends
      This is the way the world ends
      Not with a bang but a whimper.

      What is news in this interview? That the Moderna execs cashed in? Reported here at Naked Capitalism already. That Biden is whimsically ending the health emergency in May and dumping millions of people on the insurance companies? Reported here already.

      And that business about not having the votes. Twenty in the Senate? Losing in the House?

      Bernie’s career is over. This interview is more an admission that he can’t do anything than that health care in the US of A will get attention and improvement after his annunciation of a parade of horribles.

      Next up: How being chair of the committee on labor means that he doesn’t have the votes to get rid of anti-union laws…

      Don’t call him a sheepdog. That’s not the problem here. The problem is that he is no longer effective. At least we don’t have to see the same visible moral decline of Pelosi, grasping at stocks, tearing up speeches, and posing in kente cloth.

      But he is whimpering, nonetheless.

      1. Eclair

        Yes. And still, nobody, not KHN or Sanders, mentions the US decline (starting pre-CoVid) in life expectancy. And nobody points out the appalling fact that the wealthiest people in the US live, on average, more than 20 years longer than the poorest people. And that gap is widening.

        But, by gum, we can sure shoot down them weather balloons!

      2. Mo

        My feeling as well. The old guy is rambling on about something he did in Vermont in the 80s. That’s 40 years ago! And the story about the bus trip to Canada again! Yeah we’ve heard that one already grandpa.

        And the vote count? Ever heard of Force the Vote?

        1. JohnnyGL

          Party 1st, policy comes a distant 2nd.

          Also, the party hates being embarrassed and hates taking tough votes, so none of that, either.

      3. JohnnyGL

        My biggest frustration is his refusal to do anything that would make democrats uncomfortable or look bad.

        I guess he doesn’t want these reforms all THAT badly.

      4. JohnnyGL

        “And many of the views that I hold, including Medicare for All — I think if we had a vote tomorrow, we’d get 15 to 20 votes in the Senate and would not win in the House.”

        –Shouldn’t we find out exactly who they are, instead of speculating? You know, hold a floor vote and see for real? Once we had a target list, remember when we were going to form lefty organizations that would coach, groom and cultivate primary challengers who would fight for M4A? Then Bernie was going to endorse them, help the fundraise and win?

        Oh, my bad. I guess we just dropped all that because Sanders lost the primary.

        The idea that it’s okay to just go back to the way things were in 2014 is a stark betrayal in my view. There is NO lefty challenge the Democratic Party. It’s been completely absorbed with Biden’s election.

        1. JohnnyGL

          Bernie, AOC, Jayapal, squad, etc. The leadership on the left has been completely derelict and abdicated the job to which they once aspired. The whole bunch of them no longer have any meaningful differences with democratic leadership. Yes, they pay lip service, but they won’t make any efforts to bring those professed beliefs to fruition.

          No more primaries, no more forcing anyone into uncomfortable positions, no more tough votes.

          Joe Manchin and Krysten Sinema remain unchallenged and Joe Biden doesn’t get pressed even to keep his campaign promises…$15/hr min wage, public option, etc. He was eager to drop all that stuff, and the left permitted him to do it!!!

          1. agent ranger smith

            A long-range patient Third Party could achieve something over decades, if decades still remain. It would have to be a kind of New Deal 2.0 Party and it would have to restrict itself to a Few Big Things in its platform. It would have to agree ahead of time that any officeholder it could get elected would only be bound to support these Few Big Things and would be free to vote His/Her Conscience on every other Bright Shining Culture War Object and Culture War Squirrel that would get him/her elected in his/her State or District.
            Would members/supporters of such a party be satisfied with that approach?

            Supposing they would, they would have to understand that the Democratic Party is their primary obstacle for now, and they would have to accept the goal of exterminating it from political existence. They would have to further accept that this would mean several decades of One Party Republican Rule at every level for the next few decades while the Third Party spent those decades either succeeding or failing to become the Next One Party Ruler after that in order to impose its Few Big Things agenda against every opponent of that agenda.

            My Few Big Things would include:
            1: Abolition of Free Trade and withdrawal from/abrogation of every single Free Trade treaty, agreement, and/or organization.
            2: Repeal of the key anti-New Deal Laws so as to restore the legal status quo ante the passage of those laws. And also the de-writing of the anti New Deal rules.
            3: Restoration of the New-Deal to Eisenhower tax laws and tax rates.
            4: Recognition of Three New Freedoms . . . Freedom of Hate Speech, Freedom of Recreational Drugs, Freedom of Personal Guns.
            5: National Greenism in One Country. The progressive abolition of economic contact with any country which applies less stringent conservation measures, Hansen Carbon FeeTax-Dividend Plans than our own, etc.

            Such a Party would get my vote if I decided its leaders and members were serious about “exterminating” its enemies and opponents from power and public existence and the public square. Such a Party-Movement would have to accept the risk that the Republicans might institute a Permanent and Perpetual MAGAnazi Gilead Republic Dictatorship in the meantime, and such a government would be the last government America ever has.

        2. chris

          Here here.

          I would at least like to see some of this much discussed “fighting for” behavior. I’d at least like to see an on the record vote letting me know who, specifically, is against Medicare for All in both parties. There should be no shame in publicly identifying with a position that so many people in power obviously hold. So why won’t they make it official?

          Better yet, just vote to give the President the authority to do all the things you’ve decided to let him do. Go on the record! Why lie about funding war and a million other atrocities? Have the courage to publicly share your donor’s convictions…

      5. JohnnyGL

        “The problem is that he is no longer effective. “

        The real problem is that he’s no longer even trying. It’s an awful betrayal just going back to the way things were in 2014 as if the left didn’t just put up 2 consecutive massive demonstrations of power, organization, and fund-raising capacity.

        We’ve just showed how much potential we really have!?!?! And what are we doing now?!?! Nothing!!?!?!

        The left’s obsession with its own assumed powerlessness is so fatalistic, it’s unfathomable!!!

    3. digi_owl

      Basically why all the hoopla over the presidential election means jack all, as congress still has the final say.

      And congress has all kinds of ways to become deadlocked.

      The best system money can buy…

      1. JohnnyGL

        No way, congress is malleable.

        Biden mostly got his agenda through, same with Obama. Congress as an obstacle is a complete excuse.

    4. EAC

      I think that he would have had a momentum, and we cannot estimate what he could have gotten done with that. We don’t know exactly what the house and senate would have looked like if we had seen a Sanders’ candidacy. Also we have seen powers that Biden has, but will not exercise. Now we are in a different environment, so it is all speculation.

      1. JohnnyGL

        Who are we kidding? Biden got exactly what he wanted. He clearly didn’t want $15/hr min wage.

        He really wanted his bipartisan infrastructure plan, he got it.

        He didn’t want BBB and was happy to see it stripped down and reformed into the “inflation reduction act” via Joe Manchin.

        1. Aumua

          Well $15 minimum wage IS a reality in many places now at the state and local levels, and do you really think it would be if it hadn’t have been for Sanders? Yeah it sucks we don’t have it federally yet, but credit where credit is due.

    5. Anon

      So your argument is that it’s better to have people in power who move effectively, in the wrong direction? I’d rather a hamstrung Bernie than an enabled Trump/Biden.

      1. giandavide

        the argument seems to be about the lack of credibility of sanders. the weird and ossessive belief he’s a socialist match perfectly the obsessions of republicans about jews. indeed it’s not a case that usa entered in a world war for miscalculations and now they’re shooting at ballons, sanders is part of all that

    6. t

      The motion to condem all forms of socialism as super bad and extra terrible indicates that the ruling class has been paying attention and they have noticed that actual voters may think a better world is possible.

      1. gcw919

        Ro Khanna, from Silicon Valley, one of the “Progressives,” voted for the motion to condemn Socialism. I wrote to him asking about Social Security and Medicare being “Socialist,” but quel surprise, no response.
        (I also wrote to Gov.Newsome, our Senators in Calif., and my local Assembly member and Congressman, about the extortionist gas prices being charged by San Diego Gas and Electric (Sempra), our monopoly utility, and haven’t heard from any of them. Of course, come campaign time, I’ll get plenty of requests for donations.)

        1. agent ranger smith

          What if millions of disgruntled former DemParty voters all sent in one envelope per voter, with 2 cents in each envelope?

        2. Daniil Adamov

          Are Social Security and Medicare socialist? In everyday American discourse, maybe. Historically, though, the modern welfare state was created to oppose socialism, and many socialists recognise as much.

          At any rate, perhaps the Democrats just see no reason to shackle themselves ideologically to something they oppose in reality.

  2. Soredemos

    The defeat of even lukewarm American leftism from 2016 on was total. They crushed us, utterly. The establishment had to work a bit for it, pull out some stops, but they did it. Then they went on to parry every major Sanders endorsed idea, up to and including universal healthcare in the middle of a million dead pandemic. Breathtaking.

    Personally, I’m at the Ian Welsh stage of just kind of shrugging. We (as well as the UK in particular) kind of deserve whatever we get going forward. We were presented with off ramps multiple times, and we spat in their faces. You can make all kind of analyses of tactical mistakes, of how for example Corbyn didn’t take a firm Brexit stance and was out of touch with many voters because of it, but in the end a plurality of UK voters decided the openly, ludicrously evil Tories were the best choice. If voting is a right, is there not some corresponding responsibility, a reasonable expectation that voters be non-morons and take citizenship seriously?

    1. digi_owl

      Corbyn seemed completely unprepared for both being party leader, and for how vicious the Blairite camp would be.

      Thus he had no clear plan to de-fang them, and so found himself between a rock and a hard place come election time.

    2. bdy

      A lot of false assumptions about functional democracy are rolled up in the “us voters did this to ourselves” take. We have no one but the rich and powerful to blame.

      1. Soredemos

        Sorry, but I don’t buy this anymore. At the end of the day voters keep genuinely making very obviously moronic choices. If voting couldn’t bring about real change, there wouldn’t be so much time, money, and effort dumped into manipulating voters. And voters keep letting themselves be manipulated. It’s common for people to opine that politicians all suck and are all lying, but then these same people keep voting for the most obviously worst politicians. At a certain point explanations stop being that and just start being excuses. And I’m not going to play the game anymore where voters are treated like idiots or very small children with no agency in anything. Fool me once and all that. At some point after you get lied to and deceived over and over again, the common point of failure is you.

        I should note, by the way, that in the end I still believe in democracy, both as a principle and as a matter of practicality because elites have consistently shown themselves to also be morons so just leaving things to our ‘betters’ is not a viable solution either. “Even so, democracy” is what my username amounts to, but after a while the ‘even so’ is doing a lot of heavy lifting.

        I want more and better democracy, down to at least regional Soviets and maybe even direct plebiscites on many issues. But even within the narrow confines of a parliamentary or otherwise ‘representative’ system, we had multiple chances to vote for a guy who was running on giving you freaking free healthcare, vs candidates who were…not. Personally, I’m paying something like $6,600 a year on pretty crappy health insurance. There are a lot of other things I could do with that $6,600. And I’m on the low end of the insurance expense scale. A candidate was running on literally ‘you will have more money at the end of every month’, and more voters said no than yes. Twice. Forget any moral arguments or appeals to better angels of our nature, just a purely cynical bank account argument was in Sander’s favor and he still lost. People allowed themselves to be turned against him and his plan, or suckered into myriad obviously fraudulent knockoff alternatives.

        (I’m sure no one here needs to be reminded, especially given the above article, but none of the faux Medicare for All ‘alternatives’ floated by any of the other candidates amounted to anything. It was all just lies. Voters had one choice to make things better: Sanders and M4A, and a majority of them said no. So now we, and our health and bank accounts, reap what the majority sowed)

    3. giandavide

      corbyn case was very different from those of sanders. sanders is a biden friend while corbyn was the object of an hate campaing by his party establishment. no senses to do a such kind of antipropaganda for sanders, cause he’s a liberal like his party colleagues

  3. upstater

    New York State passed single payer in the legislature during the Cuomo administration, but the state senate had a functional republican majority with blue dog democrats. When both houses got their super majorities, the single payer legislation wasn’t even voted on… that Lucy and the football thing.

    There are bills introduced [A.6058/S.5474] but will they even get a hearing, much less a vote? Now the Legislature is “negotiating” with public employee unions that oppose single payer, all of whom have gold plated work and retirement health insurance. Hocul is silent. The unions are opposed to single payer. Here’s a recent article (most MSM and NYT are silent):

    Lawmakers, labor unions negotiating single-payer health care bill

    So it ain’t gonna happen… greed and corruption win.

    1. hoonose

      States cannot do their own UHC solution because states cannot create money as at the Federal level. Seniors alone would crush any state’s budget.

  4. timotheus

    Based on Bernie’s history, I’d expect a few wins here and there on cross-aisle issues like drug pricing, boosting nurse training opportunities, and maybe reining in hospitals’ abuse of their nonprofit status. (Grassley was big on that.) He is skilled at that sort of thing and knows the procedural stuff. The bigger picture remains grim.

    1. Charger01

      I love that the labor shortage described by Bernie is watered down to an educational crisis. If he wanted to accurately summarize the situation, doctors/nurses/dentists are getting burned out. Either due to the pandemic, mismanagement by their employers and/or the slow avalanche of increasingly complicated means and methods of insurance companies trying to avoid paying for services. My family dentist has (no kidding) three people to handle his insurance/paperwork nightmare. In a 8 seat dentist office! This is the symptoms of a sick system that cannot be reformed with so many players protecting their turf in the game. It really makes me frustrated that the one time champion of the working class can only see the immediate “nurse shortage” and fails to connect the dots to the larger crisis that caused the “shortage”.

      1. elkern

        The (or at least one important) root cause of the burnout *is* the fact that USA doesn’t train enough Doctors, etc. Our entire health care “system” was staffed for Efficiency, because that’s financially optimal. Efficiency always comes at the expense of Resiliency; when Covid hit, we didn’t have enough extra trained people to cover the needs.

        US Medical Schools have (intentionally?) limited supply of home-grown Doctors for decades, maybe a century.

      2. hunkerdown

        If Sanders opines that underlying the labor crisis is a crisis of PMC reproductivity, we can write him off as a generic Democrat assigned to the role of Jiminy Cricket.

      3. JohnnyGL

        Exactly correct. Hospitals are complaining about having to cope with a crisis they themselves did so much to create through understaffing and holding down wages.

        None of this ‘educational crisis’ addresses the fact that tons of nurses are leaving the profession, many in their prime working years.

    1. Arizona Slim

      During this morning’s bicycle ride around Tucson, I spotted a car with a bumper sticker that said, “Just Vote Blue.”

      My response? NO!!!

  5. floyd

    I used to advocate for single payer but after Obamacare, the pandemic, the pathetic performance of the FDA, CDC, etc. I have no faith the US is capable of centralized healthcare that delivers for regular people. At the end of the day, too many Dems are more concerned about insurance companies profits, the number of jobs local hospitals provide and day trading Moderna. The perspective seems to be invest in JNJ and use the divys to pay for your healthcare. Aside from that let them eat cake!

  6. Alice X


    What I ultimately would like to accomplish is not going to happen right now. We have Republicans controlling the House.…

    Wellie, isn’t that the standard Democrat mantra, those bad old Republicans.

    It has been said that the role of the Democrat Party is to protect the bad old Republicans from the really, really bad socialists. The Democrats are really, really good at that, and Sanders is a Democrat.

    1. Aumua

      I’m not one to dogpile onto Bernie, and I give him as much slack as I possibly can but the problem is when it’s all said and done, the guy is a Democrat. I don’t care that he calls himself an independent, he’s a Democrat and he’s been one for decades, and that severely limits the good he can do. Just look at the way they bent him over in both presidential runs, and here he is today going right with the Democrat playbook “Well we can’t get it done now because Republicans control the house!”

      REALLY, man?? That’s what you’re going with here? No mention of how Democrats just had 2 years of complete control, and still couldn’t get it done. Can’t you criticize corporate Democrats and your good friend Joe even a little, now that he’s beaten Trump? Unbelievable.

  7. Ashburn

    I’ve come round to the idea that Bernie Sanders is just not a serious politician, as in one who is focused on gaining and using power. His pitiful performance against Biden in their last debate was shocking to me. If it were a boxing match he would have been accused of throwing the fight.

    However his biggest failure was his abandonment of the very movement he had built over two campaigns. Tens of millions of small donors who attended his rallies, knocked on doors, texted, emailed, fund raised, etc. A whole younger generation of people who truly believed in his program, only to see him abandon it in an instant when he endorsed Joe Biden, a lifelong neoliberal and neocon who opposed nearly everything Bernie claimed he stood for.

    If he had been serious he would have threatened Biden and the DNC with a third party run if they didn’t agree to serious concessions, and then follow through by keeping his movement sufficiently motivated to keep up the pressure. He not only did none of that, he actually divorced himself from the movement and shamed them with a scolding statement about not supporting Biden. It was an historic betrayal.

    I’m left with JFK’s quote: “Those who make peaceful revolution impossible make violent revolution inevitable.”

    1. Paul Art

      I have pondered about this and while I don’t want to let Bernie off the hook I always bump into this Pachyderm in the room with the sign “African Americans in the South reject Bernie”. It is hard to understand the African American vote especially in the South. I have still not recovered from the complete rout suffered by Stacy Abrams in Georgia. I don’t think you can win from the Left without securing the Black vote if the Blue Collars are still hung up over the “Socialist” label. So I conclude reluctantly that Bernie takes the pragmatic route of “whatever I can do with the bone the party apparatus throws me”. I would argue he has done a lot to keep Medicare for all in the news continually which is a big deal. Again, the problem is how we can get to Medicare for all without lowering the money that goes into the pockets of these Specialty Physicians and their Medical Insurance co-parasites.

      1. hunkerdown

        Why? Abrams is a neoliberal globalist. Nobody should ever let anyone affiliated with the neoliberal intelligentsia near power.

      2. JohnnyGL

        “It is hard to understand the African American vote especially in the South.”

        The Funky Academic (he’s on youtube) advocated for Bernie. But, he explained that when jaded, older black southern voters look at Bernie, they just see a goofy, un-serious politician like most people see when they look at Marianne Williamson.

        And, with the benefit of hindsight, they were probably closer to the correct view than I wanted to admit when I knocked on doors for Bernie in NH.

        After 2 strong presidential runs, he could be politically more powerful than he’s ever been in his whole career. Yet, he’s completely unaware and/or uninterested in using it.

    2. floyd

      Sanders is an actor like his young friend AOC. Back benchers have no power and won’t get it any time soon. And it’s depressingly unclear whether Congress makes any decisions on their own.

        1. Jeremy Grimm

          I am profoundly disappointed with Sanders — badly ‘Berned’ — but I cannot regard AOC as in any way comparable to Sanders. I hold such low regard for AOC I hesitate to mention Sanders and her with the same breath. I believe she has never proven more than a low comedy diversion jockeying for power and wealth with the rest of congress.

    3. KLG

      Obama did the same thing regarding his supporters, but that was no surprise. It was an eye opener for my daughter, who registered hundreds of likely Dem voters in her college town. I am a hopeful person, primarily because there is no other reasonable attitude (optimism and hope are not the same thing). I was yelled at here for taking Bernie to task during the campaign when he called Joe Biden his “good friend.” Yes, I understand US Senate tropes: “My good friend, the learned senior Senator from West Virginia,” but that applies only in the Senate and even then it is total bullshit 90 percent of the time. In a political fight of any significance, whether your opponent is your friend matters not. My recurring contribution to Bernie ended the next day. No, I did not believe Bernie would win, but solid foundations take are essential…In the late-1970s Michael Harrington’s “left wing of the possible” did have some meaning. Now, not so much. Alas.

    4. marym

      It seems unlikely that Sanders would imagine a third party candidacy would lead to a Sanders presidency, or alternatively that siphoning enough votes from the Democrats to ensure a Republican presidency would be a good thing. Even people who do claim the destruction of the Dems by further empowering Republicans would be a good thing don’t (as far as I know) seem to make a case as to how something good would happen.

      After Trump’s win in 2016, with a Republican congress, universal healthcare or universal health insurance was never on the table. They favored ending the ACA (including the Medicaid expansion) without proposing any alternative.

      1. JohnnyGL

        “It seems unlikely that Sanders would imagine a third party candidacy would lead to a Sanders presidency, or alternatively that siphoning enough votes from the Democrats to ensure a Republican presidency would be a good thing.”

        Where’s that Dune quote from Lambert about those who can destroy a thing can control it?

        Bernie could have credibly threatened a 2nd Trump term and legacy of shame for Biden, but he wouldn’t dare entertain the thought.

    5. JohnnyGL

      Yes, this is 100% correct.

      Bernie was unwilling to risk getting blamed for a 2nd Trump term. He was infected with Biden-love (inexplicably) and Trump derangement as much as anyone.

    6. ALM

      I completely agree. My Dasmascene disappointment with Bernie moment was his utter failure to acknowledge, let alone attend, the Medicare For All rallies in 2021 after campaigning on Medicare For All for years. He simply will not seriously challenge the Democratic establishment so he might as well register as a Democrat. I donated the maximum amount to his 2020 campaign. I want my money back.

      1. Arizona Slim

        True Confession: I also maxed out my 2020 campaign donation for Bernie. And I still have the campaign donor’s equivalent of buyer’s remorse.

  8. Paul Art

    The Healthcare industry provides 20 million jobs per a Census Bureau report
    https://www.census.gov/library/stories/2020/10/health-care-still-largest-united-states-employer.html. National average seems to be around 12% – https://www.beckershospitalreview.com/rankings-and-ratings/states-ranked-by-healthcare-as-percent-of-overall-employment.html
    Any change that seeks to lower the profit companies make in this sector could affect the number of jobs. It would be politically unpalatable and especially true in some states like Indiana which have a lot of jobs in the health sector. Senator Mike Braun (IN) certainly won’t get on board. This seems a lot like the Defense sector problem which although employs fewer people (3 million or so per Google) spreads the jobs in every state to make cuts politically hard. Ditto the fossil fuel industry. Coal miners and oil workers are not going to support anything unless they are weaned off their sustenance sources. The problem is systemic and cannot be tackled unless the industry is nationalized and then subjected to an industrial planning process that sees the employees relocated to other areas – in particular the Health Insurance employees now at United, BCBS etc. Bernie also gives the American Medical Association a free pass perhaps out of abundant caution – don’t wake the Ogre unless one is ready for the battle? Nursing and Doctor shortage can be almost instantly solved by the provision of a H1-B visa for Healthcare professionals. Talk to the “Body Shopper” companies like Infosys, Accenture, HCL, TCS to start a “Doctor Import” program similar to the Engineer import program they have been engaged in for decades now and devastatingly effective in crushing Software/EE engineer salaries. They would leap at the chance. Even better would be Telemedicine initiatives. When was the last time a Doctor actually touched you during an annual exam? Diagnosis is all tests now and the results are available online. Doctors in India or elsewhere could read these tests, talk to the patient via Video and Bob’s your Uncle. However nobody would offer good odds on Bernie making any dent in the Physician gravy train, they are just too powerful and too well organized. How many would also offer good odds on the Senior Citizen vote on this? The AMA would first send out ads like this: “Bernie Sanders wants to change you Doctor to someone in India who will treat you remotely via Zoom Call! Call your Congressperson to fight to retain your present Primary Care Physician”. The 2023 version of the Harry and Louise ads of the 1990s.

  9. ambrit

    We remember the sixties and the feeling of cautious optimism. Everything looked to be progressing. America was soon to become the shining City on a Hill that would lead the world into a great new age. We weren’t fools, just naive. The lesson here is that the forces of reaction are ever working to bring the mass of the people under their subjugation. The early union workers and progressives of all sorts had to physically fight for what they valued. We are now entering another Season of Struggle.
    Briefly, the elites are carrying out policies that may not be specifically designed to kill many of us off, but that is the practical outcome of those policies. Time to return the favour. The Radicals are right.
    Many will note that the Organs of State Security have developed and deployed “wunderwaffen” in order to forestall popular action. To this I will counter with Stalin’s remark that; “Quantity has a quality all its own.”
    For the rest of us: Stay safe. Hull down.

    1. LilD

      I’m working on a baby boomers lamentation song. Gonna be a Dylan style dozen verses probably as there are a lot of disappointing issues to have generational regret over

  10. pjay

    “Q: Do you have a policy for dealing with the lobbyists?

    “I don’t have lobbyists flooding through my door. These lobbyists are effective, well paid, and they help shape the culture of where you’re going. My culture is shaped by going out and talking to ordinary people. I’ve talked to too many elderly people who cut their prescription drugs in half.

    “I’m not worried about the lobbyists. Worry about the people who are dying because they can’t afford prescription drugs.”

    Well, perhaps Bernie isn’t worried about “the lobbyists.” But the medical-industrial complex is one of the most heavily lobbied industries in Congress. Campaign contributions, revolving doors up the wazoo, etc. Maybe they aren’t wasting time with Bernie, but you can bet that they are all over most of his colleagues. Why does Bernie think that Medicare for All would only get a handful of votes? For some reason this statement about “the lobbyists” triggered a flashback to a time when Bernie was not worried about “the damn emails.”

    Ironic that at this late stage in his career Bernie gets to chair *this* committee. I’m pessimistic about him even being able to whittle around the edges. Decades of neoliberal “reforms” have destroyed any mechanism for real progress in this area. Developed nations that have better health insurance than we do – i.e. pretty much all of them – are gutting their systems, too. As has been discussed many times at NC recently, the neoliberal virus is global – no effective vaccine.

    I’d be very happy if I was pleasantly surprised. I don’t think I will be.

    1. cnchal

      > “Q: Do you have a policy for dealing with the lobbyists?

      Bernie deliberately ignoring these venals is the tell. Putting Bernie in charge is like putting an employee in a room with nothing to do except while time away, sidelined.

      Bernie could have said, listen up, we are gonna tax lobbyists. When a corp hires a lobbyist, for every buck they pay them, they are gonna have to pay another buck in tax and neither buck becomes an expense that can be written off. For starters!

      Next up, all pharma advertising expense are not deductible from income and go from there and tax the shit out of corporate advertising and opulence.

  11. flora

    OK. Disappointing. I can imagine he’s under enormous pressure from all entities. If he won’t go after the insurance side of the health problem at this time, maybe he could take on the big food & big pharma dragons. Put forward regs to keep financial interests out of regulatory agencies. That alone would improve people’s health, imo. Anti-monopoly efforts. This tweet tread is an important explanation, imo, of how big food and big pharma are a big part of the problem. This fellow used to be a lobbyist for the Coca-Cola company.

    Early in my career, I consulted for Coke to ensure sugar taxes failed and soda was included in food stamp funding.

    I say Coke’s policies are evil because I saw inside the room.

    The first step in playbook was paying the NAACP + other civil rights groups to call opponents racist


    Carbonated sugar water – soda is eligible for food stamp purchase. No nutritional value. Rising obesity rates among children. / oy

  12. Kurtismayfield

    They are both so tied in to the internet and Twitter cycle I don’t think either of them can seriously contend against the system. They are completely reliant on it.

    You need a complete outsider not attached to any of the large corporate structures that we have in place in this country.

  13. Pablo

    The Business Community–the Big Ones like the Business Roundtable or the US Chamber of Commerce–LOVE private Insurance for Worker Healthcare. They win both ways. Employer based Healthcare gives the employer A LOT of leverage over their employees: “Lose your job, lose your healthcare” is what REAL Power looks like. AND, the high cost of Healthcare ALSO gives Employers the justification to NOT raise wages, so Private Healthcare Systems are a Win-Win’ situation for employers. If employees can ‘carry’ their Healthcare from job to job, employees can say “Take this job and shove it!” MUCH quicker than with an Employer based Healthcare system. Plus, employers in a Labor Market where the employees have their Healthcare independent of an Employer will have to raise wages to keep the good employees.

  14. Keith Howard

    It is common knowledge that the very steep escalation of the prices of prescription medicines is the biggest part of the ballooning of total medical expense since 1980. It is a terrible problem that directly affects a great many people, but not equally across different age cohorts. The issue is personally unnoticeable for young, healthy people who need no medicines at all. But the group of Americans who are victimized by the profiteering of the Pharma complex is nonetheless large. I am in that group. Background: I have standard Medicare as well as a Part D policy. In 2022, for the first time, I fell into the Doughnut Hole. I take a number of prescription medicines, but none of them would be thought shockingly expensive (hundreds or thousands of $ per month.) Still, my annual out-of-pocket total is appalling, and it only stands to increase in coming years. I really need to reduce what I spend on medicine.

    Having read a post by Yves a few months ago (https://www.nakedcapitalism.com/2022/12/pharmaceutical-drugs-at-cost-15-its-here-now.html)
    I took a look at Cost Plus Drugs. Well, to make a long story short, the cost saving is impressive, and the process is easy and smooth. Example: Azathioprine, an old generic for Imuran, under Part D a three-month supply cost me a co-payment of $141, and the insurance additionally paid $145; meaning nearly $300 toward the Doughnut Hole. Total price from Cost Plus, including $5 USPS shipping, $68, and completely sidestepping the wretched Part D program.

    Like everybody, I’m wary of Greeks bearing gifts, and Mark Cuban is reliably reported to be a jerk as well as a zillionaire. But this enterprise seems subversive in the best sense. If one can run a going concern selling drugs at cost + 15%, and a large cohort of Americans experiences a big reduction in their expense for medicines, won’t this create major support for an effort to have the US gov do the same thing? I have heard that Cost Plus reports a doubling of business volume each quarter. I would gladly hear from better informed commenters on this subject.

    1. katiebird

      I don’t know how knowledgable I am but I have checked the prices for the drugs on my list. Two of my prescriptions aren’t covered by my Part D any longer So my situation became almost dire. I’ve been checking Cost Plus Drugs every couple of months but they don’t carry a couple of them. For now, I’m having everything filled at CostCo Pharmacy and using either my Part D or GoodRX depending on which is lower. so Far GoodRx is save hundreds of dollars even on on prescription that is “covered” by my Part D. …. Even so, I spend a scary amount on prescriptions.

      1. ChiGal

        just experienced this for the first time having signed up with Medicare in December. my part D plan I chose because it covers Advair, which is the only expensive Rx I have. First fill and I am informed the cost is $600, the insurance having supposedly picked up $400. so $1k for a month’s supply?!!

        previously I had a high copay but closer to $100/mo. I paid an extra $50/mo for this plan because the others didn’t cover this medication period, which is completely bewildering to me—I have been on it for probably 15 years. As I recall, the cost for buying it sans insurance was prohibitive but nothing like $1k.

        I need to contact the insurance to confirm but haven’t yet because I am in shock and fear the worst. so thank you for mentioning the alternatives you have tried. I will likely be looking into them…

        1. katiebird

          It’s actually the generic of Advair that triggered my crisis. My plan covered it a year ago (which is why I chose them) but then they dropped it entirely. The mail-order pharmacy linked to my plan (Humana) is awful. The prices they post are the retail prices (heart-stopping) … you have to call to verify the actual billed price. Well, no more of that. I don’t have to fight with CostCo. Although the cashier was kind of shocked that I split my prescriptions between the insurance and GoodRX. Until she saw that insurance price!! The generic advair (Fluticasone Propionate) is $120 at Costco with GoodRX. Which is the best price I could find in Kansas City.

          *** Just checked Cuban’s Pharmacy. He DOES have the Generic Advair – $60.50!!! So. I guess I’ll be calling my doc to switch the prescription again. Wow.


            1. katiebird

              Thanks, ChiGal – I wish it was better though. I just double check all my drugs and that’s the only one I’m going to change. Still, it’s a pretty good change!!

    2. Susan the other

      I think Mark Cuban is a capitalist in the best sense of the word. And he knows it. We consumers are the captive prize. Our interests are bargained away with every bribe Pharma gives to politicians. But capitalism has no choice, ironically, but to give consumers good choices. Clearly our medical establishment is too dysfunctional to save itself, riddled with contradictions and profiteering. So that’s the place to start and take cover because an avalanche is coming. Bernie has made all the difference, imo, because he has relentlessly voiced an alternative to medical exploitation. Yes, we’ve got miles to go before we sleep but we will get there.

  15. Waking Up

    If you want to make sure “nothing fundamentally changes”, put Bernie Sanders in charge.
    I’m sorry, but this is pathetic at this point.

    1. Jason Boxman

      Seems so. He’s been dead to me since he endorsed Biden; Clearly I haven’t missed much. My last night out was actually his getting whacked in the super Tuesday primary way back when.

  16. Jason Boxman


    In the United States, the richest mothers and their newborns are the most likely to survive the year after childbirth — except when the family is Black, according to a groundbreaking new study of two million California births. The richest Black mothers and their babies are twice as likely to die as the richest white mothers and their babies.

    Sanders, actually in a position to hold hearings on this and other tragedies, in support of universal healthcare, not doing that, is kind of disappointing. If not now, when? Not really surprising at this late a date; As someone else commented, Sanders doesn’t seem eager or able to use whatever political power he might have, and as chair, it’s a lot. Too bad. But he wouldn’t have this position if the Democrat Party thought he’d use that power, which is what I said two years ago when he got his other chairmanship. Not happening unless he was gonna play nice.

  17. ArvidMartensen

    Two years ago I called Sanders out for a paper tiger and got slammed. An old fella, who folds under the least bit of pressure, while leaving his adoring followers to sink.
    And so here he pops up as Senate Health, Education, Labor & Pensions Committee Chair. HELP. Ya gotta love irony.
    And, sadly. he can’t do nuthin because “We have Republicans controlling the House.”
    Of course he is the Chair. This is straight outta the Obama playbook. When you have a majority, dither around and do nothing using various facile excuses.
    Then when you are hamstrung by losing control to the GOP in the mid-terms, suddenly have an action plan to HELP the disadvantaged and then make the GOP the bad guys for stopping Medicare for all and the rest of the hollow dreams.
    Oh, and put a tiger with no gums, let alone teeth, into the Chair role.

  18. chris

    And now, a superbowl commercial asking seniors to call the Whitehouse because they’re threatening to cut funding to Medicare Advantage… FML. I can’t stand that we’re not even allowed to reduce a system that is obviously fraudulent.

  19. Clonal Antibody

    Here is a long thread I did on twitter as to how Medicare for all can be given to everybody in the US without the need to pass any legislation in the Congress. The path to it is already in the ACA and it can be achieved through executive action.

    See the thread – it is long. I had originally posted it as a reply in a Bernie thread in 2020. Perhaps Bernie can have a hearing on this topic.

Comments are closed.