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The default healthcare reform position for Democrats is now expanding public health programs like Medicare or Medicaid until, eventually, we've transitioned to a full single payer health system in the United States. Sen. Bernie Sanders is taking the left flank of that position, along with 16 others, in introducing Medicare for All, a bill that would transition everyone onto Medicare over four years.
It's a starting point toward a goal that he made clear in his speech introducing the legislation Wednesday, but one that Democrats across the spectrum share.
"There should be no question about what our goal is, which is to provide access to everyone," he said. "It's an idea whose time has come. We've been very cautious and careful and the Affordable Care Act has served many Americans well. In no way are we scrapping it. We're building on it. This is the next step to build on the ACA."
Sen. Al Franken (D-MN) agreed, describing the plan as a "starting point" and calling it "aspirational."
Even more centrists Democrats who don't support the Medicare-for-all plan have moved to the left as well, and several are calling for some kind of an expanded public option.
"I think it's great we're discussing it," Sen. Claire McCaskill (D-MO) told reporters, "and I certainly think we should allow people between 55 and 65 to buy into Medicare, but I think that [Sanders'] particular proposal is premature."
Yes, it may be premature, but it's the same goal McCaskill is promoting with Medicare buy-in, because that's the start to expanding Medicare incrementally. Many of the same senators lining up with Sanders are also supporting a bill from Sen. Debbie Stabenow (D-MI) (which McCaskill co-sponsors) to do just that. The point is using an effective, proven, and affordable system of healthcare delivery for more Americans and eventually for all Americans. It's not going to be a great leap from Stabenow's Medicare at 55 to Medicare for All.
Which is the point of this exercise. It's time to start the serious work and discussion—and public education and persuasion—to get us there.