A Bold Demand to Liberate the US From the Medical-Industrial Complex

On July 5, 1852, Frederick Douglass addressed the Rochester Ladies’ Anti-Slavery Society with an oration called, “What to the Slave Is the Fourth of July?” In 1852, the United States was a young country, only 76 years old, and given its youth, Douglass held out hope for the country that put him and 3 million Black men, women, and children in chains. He called Congress and judges “inhuman, disgraceful, and scandalous.” He accused the church of being the “bulwark of American slavery, and the shield of American slave-hunters.” Still, he held out hope. He admired the rebels of the American Colonies, respected their grit to side with the oppressed against the oppressor. He did not despair for America.

This year, as we celebrate the nation’s 250th anniversary, we find ourselves in dark times. We are heirs to a political system willing to promote wars, sanctions, occupation, slavery, and genocide around the globe, while accepting the mass suffering of a healthcare system that keeps many in chains in our own country. Violence abroad and austerity at home are part of the same ideological structure. Despair is understandable, but not inevitable.

On this 250th anniversary of the Declaration of Independence, we declare it is time for the people to rise up, organize, take control of the healthcare system, and run it in the interest of the people instead of in the interest of profit. It is time we declare our independence from the medical-industrial complex keeping us in chains.

What is the medical-industrial complex? A sprawling alliance of insurance companies and middlemen stealing from the public coffers, pharmaceutical companies holding us hostage, private equity and venture capital owning the delivery of care, profit-generating “nonprofit” health and hospital systems, compromised academic centers and endowed non-governmental organizations, unprincipled medical organizations that choose expediency over patients, and all politicians who accept financial contributions to work for the industry instead of for the people. Their profits depend on keeping healthcare commodified and the rest of us in chains.

Historic public support for a national health program, free from insurance companies and financed through progressive taxes, presents us with a new opening for National Single Payer Improved Medicare for All, free from profit.

Our lives depend on declaring our independence from their profits.

Historic public support for a national health program, free from insurance companies and financed through progressive taxes, presents us with a new opening for National Single Payer Improved Medicare for All, free from profit, guaranteeing all necessary medical coverage for everyone through community-governed delivery, permanently resolving our healthcare crises, lowering costs, and ending medical debt.

But instead of bold proposals, corporate Democrats and their allies are working overtime to come up with “anything-but-single-payer” solutions. Derailment by such Democrats might be a larger challenge than barriers posed by the rest of the medical-industrial complex.

Senate Finance Committee ranking member Ron Wyden (D-Ore.), and 11 Senate Democrats, announced a new initiative to lower the cost of healthcare and improve health coverage for American families. What is this “bold, meaningful change the American people seek”? First, blame Republicans for cost increases (as if Democrats were not also guilty); make healthcare simpler for families by keeping health insurance corporations still in charge of our healthcare; and then take on corporate greed by creating flimsy new guardrails, because naturally, corporations will suddenly decide to play by the rules!

The Center for Health and Democracy, which usually provides credible analysis, went off the rails, putting their money behind “Medicare by Choice,” a warmed-over version of the public option, which allows everyone the option of purchasing traditional Medicare regardless of age, and even allowing employers to select Medicare by Choice as their employees’ workplace benefit. Sadly (and somewhat opportunely) we have a natural experiment that shows us just how well a public option (i.e., traditional Medicare) would fare in the marketplace (i.e., Medicare Advantage). Spoiler alert: not well at all.

Any version of the public option would fail to reap administrative savings or control costs necessary to provide comprehensive universal coverage. A public option would preserve the Machiavellian system of thousands of private insurance plans; Medicaid; CHIP; the federal exchanges; Medicare Part A, B, and Dl MediGap; and Medicare Advantage—a hodgepodge system that has failed to either provide necessary health coverage for all or control costs.

A public option would add even greater complexity to this overwhelmingly complex system. Importantly, a public option would not lead to single payer, as magical thinking would have you believe, but toward a jaded triaging of patients according to their profitability, with profitable individuals going to the private plans and the unprofitable, chronically ill patients shunted to the public plan.

A profit-driven system cannot be repaired with incremental fixes. We have the hard facts from a century of failed attempts to prove it. Derailments offer Democrats an off-ramp in 2028, away from National Single Payer Improved Medicare for All, free from profit. These and similar proposals are guaranteed to set the burgeoning healthcare movement back another 15 years, just like the Affordable Care Act. In 2009, even the Congressional Progressive Caucus favored the public option over single payer. It makes no sense to replay this failure again.

These are the four bold demands we make to declare our independence from the medical-industrial complex:

1. Demand that our government recognize healthcare as a human right.
2. Demand the elimination of private health insurance and the banning of for-profit delivery of care.
3. Demand the enactment of a publicly financed, national single payer program that provides comprehensive coverage to everyone from cradle to grave and the passage of improved H.R 3069 Medicare for All, free from profit.
4. Demand that healthcare delivery be transformed from profit-seeking ventures into services organized to serve the people of our country, a system in which all caregivers are freed from corporate control.

If you wish to declare your independence from the medical-industrial complex, sign the Declaration as an individual or as an organization. We will inform your member of Congress that a constituent has signed the Declaration. Then join us October 14, 2026, for a virtual National Town Hall to hear how we will achieve our demands.

Let us not squander this opportunity to put national single payer on the nation’s agenda. Frederick Douglass did not despair, "The doom of slavery is certain. I therefore, leave off where I began, with hope.” Let us likewise use this opportunity to build an uncompromising movement capable of confronting the medical-industrial complex directly and achieving what we deserve and already pay for: National Single Payer Improved Medicare for All, Free From Profit.