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We Can Do So Much Better: It's Time for Medicare for All
The shortcomings of US healthcare are painfully apparent throughout Rep. Casten’s district, so why won't he co-sponsor the Medicare for All Act?
May 14, 2026
Ten years ago, when reflecting on his signature legislative achievement, President Barack Obama famously encouraged Americans to think of the Affordable Care Act as a “starter home.” For as much good as the ACA did—expanding coverage to millions, offering policies to people with “preexisting” conditions—it is clear that the foundation of this starter home is starting to crack.
As an emergency medicine physician who has practiced throughout the Chicagoland area for nearly 50 years, I have seen these fault lines up close. Health insurance corporations like Blue Cross Blue Shield and UnitedHealthcare have strayed far from their nonprofit roots, and now routinely delay and deny care for everyday Americans. Put simply, these insurers have an incentive—and even a duty—to skim hundreds of billions of dollars off the top.
Earlier this year, the Chicago City Council recognized this dynamic when it passed a resolution calling for a single-payer national health program, also known as “Medicare for All.”
The resolution passed without objection from any of the city’s 50 aldermen, and concluded by saying council members “enthusiastically support the Medicare for All Act of 2025 and call on our federal legislators to work toward its swift enactment.”
Under a single-payer national health program, Americans would no longer need to worry about what treatments their insurance would cover, what doctors they would be allowed to see, and how much they would be charged out of pocket.
Every representative whose district includes Chicago has already co-sponsored the Medicare for All Act in the US House, and every likely replacement for retiring members of Congress has promised to do the same, with one exception. Rep. Sean Casten (D-Ill.), whose district includes parts of the Garfield Ridge and Clearing neighborhoods west of Midway Airport, has committed to staying in the “starter home,” even though it is coming apart at the seams.
The shortcomings of US healthcare are painfully apparent throughout Rep. Casten’s district, where more than 40,000 of his constituents lacked health insurance before the expiration of enhanced ACA subsidies and the implementation of federal Medicaid cuts. That’s to say nothing of his constituents with sky-high deductibles and limited provider networks who cannot afford to use the coverage they do have.
During my years in the emergency department, I have seen the awful impacts of delayed care. When I practiced at Michael Reese Hospital many years ago, it was distressingly common for me to treat young men with kidney failure. Why? Because their high blood pressure went untreated due to a lack of health coverage to pay for doctor visits and simple medications. They waited until their health issues became unbearable—and much more expensive to treat.
We can do so much better than this, and growing numbers of Americans—including 90% of Democrats in a recent Gallup poll—are starting to demand that we replace our “starter home” with a much more durable healthcare system.
Under a single-payer national health program, Americans would no longer need to worry about what treatments their insurance would cover, what doctors they would be allowed to see, and how much they would be charged out of pocket. I enjoyed a glimpse of this during my 20 years at the Captain James A. Lovell Federal Health Care Center in North Chicago, where I was able to care for veterans, active-duty members of the US military, and their families—without worrying about what their insurance would cover or whether they could afford to pursue treatment.
As Dr. Claudia Fegan, who recently retired as the chief medical officer of Cook County Health, testified before the Chicago City Council, a system like Medicare for All is well within our grasp.
“We already spend enough money on healthcare in this country,” Dr. Fegan said, “we just allow too many people who do none of the work of delivering healthcare to take profit from it. By eliminating the waste and greed of private insurance, we can afford to cover everyone in our country for all necessary care, and end the scourges of surprise bills, skipped medications, and medical bankruptcy.”
Rep. Casten has declined to co-sponsor the Medicare for All Act during his four terms in office, but his position has become increasingly lonely within the Democratic Party, the Illinois Congressional Delegation, and the US medical profession.
Thankfully, it is never too late to do the right thing.
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Despite Proven Fraud, Trump to Boost Payments to Privatized Medicare Advantage by $25 Billion
"Privatized Medicare plans are denying patients the care they need, while defrauding the government of billions a year," said one advocacy group. "Donald Trump is giving them even more taxpayer money."
Apr 08, 2025
The federal agency now headed by former television host Mehmet Oz announced Monday that it is substantially boosting payments to privately run Medicare Advantage plans, a boon for an industry notorious for overcharging taxpayers and denying patients necessary care.
The Centers for Medicare and Medicaid Services (CMS) said it is jacking up payments to Medicare Advantage (MA) plans by more than 5% for 2026—an increase of over $25 billion. That's more than double the increase proposed by the Biden administration.
Health insurance company stocks jumped in response to the news of the Trump administration's payment hike, with shares of UnitedHealth Group—the largest provider of Medicare Advantage plans—rising more than 6% following the CMS statement.
Oz, whom the Republican-controlled Senate confirmed in a party-line vote last week, previously reported holding tens of millions of dollars worth of stock in companies with interests before CMS, including UnitedHealth.
Social Security Works, a progressive advocacy group that campaigns against Medicare Advantage,
said Monday that "privatized Medicare plans are denying patients the care they need, while defrauding the government of billions a year."
"Trump is giving them even more taxpayer money," the group wrote on social media. "Trump-Musk don't care about 'efficiency.' They care about stealing our money."
"Medicare Advantage is wasteful and inefficient relative to traditional Medicare and everyone knows it."
One industry analyst, Chris Meekins of the financial services firm Raymond James, told Axios that the payment boost for Medicare Advantage "leads one to believe that DOGE"—the Elon Musk-led advisory commission also known as the Department of Government Efficiency—"does not care about MA."
Healthcare writer Natalie Shure
called the payment increase a clear "illustration that this administration's goal is upward wealth distribution and the dismantling of public goods, not 'efficiency.'"
"Medicare Advantage is wasteful and inefficient relative to traditional Medicare," Shure added, "and everyone knows it."
The CMS announcement came weeks after Oz told Sen. Elizabeth Warren (D-Mass.) during his confirmation hearing that he is concerned about and prepared to "go after" Medicare Advantage upcoding, the practice of making patients appear sicker than they actually are to reap larger government payments.
The Wall Street Journal reported Monday that the Trump administration did opt to "stick with a Biden administration policy change that limits certain billing practices that have boosted payments to Medicare Advantage insurers," despite industry objections to the policy.
But Oz's record, including his past support for a proposal dubbed "Medicare Advantage for All," has led watchdog groups to doubt that he intends to aggressively take on large-scale overpayments and fraud in the program. According to one estimate from 2023, Medicare Advantage plans are overcharging U.S. taxpayers by up to $140 billion a year.
Robert Weissman, co-president of Public Citizen, warned after his Senate confirmation that Oz will "seek to further privatize Medicare, increasing the risk that seniors will receive inferior care and further threatening the long-term health of the Medicare program."
"Dr. Oz is joining a team of snake oil salesmen and anti-science flunkies that have already shown disdain for the American people and their health," said Weissman.
In addition to Oz and Robert F. Kennedy Jr. at the Department of Health and Human Services, which oversees CMS, Trump appointed former Medicare Advantage lobbyist Don Dempsey as associate director for health at the Office of Management and Budget, another signal that the administration intends to be an ally to the MA industry.
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UnitedHealth Exemplifies How the Industry Prioritizes Profit Over Care
The provider has—for good reason—become the most powerful lightning rod for patient and medical staff critiques of how private insurers operate.
Feb 01, 2025
Healthcare is big business in the United States. So big it can be hard to wrap your head around.
America’s largest healthcare company, the UnitedHealth Group, pulled in over $100 billion in revenue in just the fourth quarter of 2024 alone. For the full year, the giant’s insurance division, UnitedHealthcare, just reported record revenue of $298.2 billion.
These staggering revenue totals actually fell below investor expectations. Right after the announcement, UnitedHealth Group shares slipped 6% on the New York Stock Exchange.
The outpouring of anger after the December killing of UnitedHealthcare CEO Brian Thompson—anger not at the shooting but at the company Thompson represented—shows just how many Americans are currently suffering under our privatized healthcare system.
That tells you a lot about what’s important in the healthcare industry: profit, not care. Health insurance companies in particular can only profit by paying out less in claims than they collect in premiums. And that means denying patients coverage for the care they need.
Just outside the New York Stock Exchange, victims of our for-profit healthcare system—doctors and patients alike—recently braved freezing temperatures to call out the suffering that engineered UnitedHealth’s exorbitant earnings.
One of those demonstrators, Jenn Coffey, has been battling complex regional pain syndrome (CRPS), a condition so incredibly painful that it’s often called the “suicide disease.”
UnitedHealth denied her the prior authorization needed to have her critically important treatment adequately covered. “UnitedHealthcare would rather leave me in torture than grant me the peace my infusions bring,” says Coffey. “I’m asking for a life worth dignity. I’m left begging for a life worth living.”
Several other speakers shared their deeply personal experiences with a healthcare system that far too often treats patients as disposable.
Dr. Toutou Moussa Diallo, a New York-based researcher and healthcare activist, detailed how insurance denials led to subpar treatment for his broken ankle that only made the initial injury more debilitating. Nephrologist Cheryl Kunis shared the story of a patient who died after UnitedHealthcare refused to cover a PET scan of a malignant neck tumor.
These experiences amount to much more than isolated one-off incidents. The outpouring of anger after the December killing of UnitedHealthcare CEO Brian Thompson—anger not at the shooting but at the company Thompson represented—shows just how many Americans are currently suffering under our privatized healthcare system.
The ongoing campaign protesting how UnitedHealth does business began well before Thompson’s headline-grabbing killing. The Care Over Cost mobilization, led by People’s Action, has been organizing rallies protesting America’s biggest private insurers for years.
UnitedHealth has—for good reason—become the most powerful lightning rod for patient and medical staff critiques of how private insurers operate. The company’s gargantuan profits rest on decisions that regularly exploit patients at every opportunity.
Just a few snippets from recent news accounts offer a vivid picture about how UnitedHealth goes about making its billions.
UnitedHealth Group’s pharmacy benefit manager, Optum RX, marked up some cancer treatments by over 1,000%. UnitedHealthcare systematically limited access to critical treatments for children with autism to cut costs. And along with two other insurers, the company intentionally denied nursing care to patients covered by Medicare Advantage—all to maximize profit.
And how has the UnitedHealth Group been spending all its ill-gotten gains? One telling stat: UnitedHealth Group CEO Andrew Witty pocketed an astonishing $23.5 million in 2023 compensation.
As the rally in front of the New York Stock Exchange ended, protesters called on UnitedHealthcare to publicly release its claim denial rates, oppose federal tax cuts that would result in Medicaid service reductions, and end the company’s care-denying prior authorization requirements.
Those eminently reasonable demands for the company. Meanwhile, the rest of us should consider whether we want healthcare to be a tool for the public good—or just private profit.
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