Skip to main content

Sign up for our newsletter.

Quality journalism. Progressive values. Direct to your inbox.

This #GivingTuesday, whatever is your first priority, your second priority has to be independent media.

2021 has been one of the most dangerous and difficult years for independent journalism that we’ve ever seen. Our democracy is facing existential threats including the climate emergency, vaccine apartheid amid deadly pandemic, a global crisis for biodiversity, reproductive freedoms under assault, rising authoritarianism worldwide, and corporate-funded corruption of democracy that run beneath all of this. Giving Tuesday is a critical opportunity to make sure our journalism remains funded so that we can stay focused on all your priority issues. Please contribute today to keep Common Dreams alive and growing.

Please Help This #GivingTuesday -- Though our content is free to all, less than 1% of our readers give. We’re counting on you. Please help Common Dreams end the year strong.

Very quickly, peace of mind will overwhelm that forgotten desire to keep your private insurance.(Photo: Joe Newman via Public Citizen/flickr/cc)

Very quickly, peace of mind will overwhelm that forgotten desire to keep your private insurance.(Photo: Joe Newman via Public Citizen/flickr/cc)

'Medicare for America' Will Not Get Us Where We Need to Be

The incremental approach to healthcare reform is an approach the nation can no longer afford. Only Medicare for All will do.

Michael Lighty

With so much written about the politics and some about the policy of Medicare for All, it seems we’re having a real debate about the key issues.

But appearances deceive.

Instead, it’s more of a struggle over the semantics of “Medicare” – #M4A - is it for America or is it for All? Proponents of “Medicare for America,” the latest talking point elevated to policy – “you can keep your private insurance!”  - claim that it provides universal coverage, and thus insures everyone has healthcare.

But is universal coverage guaranteed healthcare?

To address that question means actually debating the role of US based private insurance, it’s business model, relationship to the healthcare industry and finance sector. This approach reveals much more about the bi-partisan politics and policy choices of healthcare reform.

If proponents of Medicare for America had to honestly address the primary elements of the health insurers’ business model, it would be tough to defend:

  • unnecessary insurance company profits ($5.8 billion in 3rd quarter, 2018)
  • huge executive salaries ($81 million for UnitedHealth CEO in 2018);
  • reliance on high tax subsidies ($262 billion for employer plans in fiscal 2017-18);
  • regular denials of care (1 in 5 claims denied in ACA plans per KFF study, 2019);
  • escalating premiums to generate enormous revenues invested on Wall Street, benefiting shareholders;
  • largest lobbying operation on Capitol Hill ($3.5 bil in lobbying, $710 million in campaign contributions during ACA period) - healthcare financing is the worst example of “crony capitalism” (Angus Deaton, 2015 Nobel Laureate in Economics).

So then, do you continue to enrich the insurance companies by promoting the growth of for-profit Medicare Advantage plans (as the Medicare for America proposal calls for), and subsidize their revenue model with unregulated premiums and high out of pocket costs (a $5,000 “limit” as proposed is a lot to the 78% of people living paycheck to paycheck, and the 40% who don’t have more than $400 in the bank).

A real debate would be about regulating the insurers vs eliminating their role as profit-making intermediaries. Either defend the commercial health insurance business model, or explain how your M4A changes it.

If the real goal of Medicare for America is to unwind these practices, the incremental approach undermines the prospects for success. As we saw during the four year roll-out of the Affordable Care Act vs the efficient, ten month transition to Medicare, lots of lies can be told, the industry can game the system, and opposition can organize. Rather than contort policy into some hybrid, multi-payer regulatory scheme that generates complexity, fragmentation and waste, as it enshrines profit-making and high out of pocket costs, let’s stop the care denials and the insurance company dictates to doctors and patients.

Medicare for All represents the best M4A way: lead and be swift. Don’t tell... show. Yes, your premiums are gone, your co-pay to see the doctor is eliminated, you don’t have to worry about your deductible or wait for insurance company approval to get that test.

Very quickly, peace of mind will overwhelm that forgotten desire to keep your private insurance.

Ahhh, freedom.


Our work is licensed under Creative Commons (CC BY-NC-ND 3.0). Feel free to republish and share widely.
Michael Lighty

Michael Lighty

Michael Lighty has organized, advocated and developed policy for Improved Medicare for All nationally and in California for 30 years. He is a founding Fellow of the Sanders Institute, and worked for 25 years at California Nurses Association/NNU. 

... We've had enough. The 1% own and operate the corporate media. They are doing everything they can to defend the status quo, squash dissent and protect the wealthy and the powerful. The Common Dreams media model is different. We cover the news that matters to the 99%. Our mission? To inform. To inspire. To ignite change for the common good. How? Nonprofit. Independent. Reader-supported. Free to read. Free to republish. Free to share. With no advertising. No paywalls. No selling of your data. Thousands of small donations fund our newsroom and allow us to continue publishing. Can you chip in? We can't do it without you. Thank you.

New Climate Study Predicting More Rain Than Snow in the Arctic 'Rings Alarm Bells'

"There are huge ramifications of these changes," said the lead researcher, "all of which have implications on wildlife populations and human livelihoods."

Jessica Corbett ·


Durbin Introduces Amendment to End 'Legacy of Cruelty' by Closing Guantánamo

"It's time at long last to face reality and... close the detention facility at Guantánamo. Let's put this dark chapter behind us once and for all."

Brett Wilkins ·


As Executives Hike Prices, US Corporations Rake in Biggest Profits Since 1950

"Prices are high," said Sen. Sherrod Brown, "because corporations are raising them—so they can keep paying themselves with ever-larger executive bonuses and stock buybacks."

Jake Johnson ·



47 Groups Urge Congress to Avert 'Human Rights Failure' by Blocking Biden's Saudi Arms Sale

"The Biden administration in its very first weeks committed both to center human rights in foreign policy and to end U.S. complicity in the war in Yemen. Allowing this sale to stand breaks that commitment."

Brett Wilkins ·

Support our work.

We are independent, non-profit, advertising-free and 100% reader supported.

Subscribe to our newsletter.

Quality journalism. Progressive values.
Direct to your inbox.

Subscribe to our Newsletter.


Common Dreams, Inc. Founded 1997. Registered 501(c3) Non-Profit | Privacy Policy
Common Dreams Logo