House Budget Committee chair Paul Ryan, R-Wisconsin, proposes to undermine the integrity of the Medicare and Medicaid programs, with an eye toward enriching the insurance companies that so generously fund his campaigns.

The American people are not amused. They have sent a clear signal that they want to maintain Medicare and Medicaid.

And rightly so. despite the battering they have taken from misguided and malignant policy makers, the Medicare and Medicaid programs still provide the rough outlines for a single-payer health care program that keep costs down while expanding access to prevention and treatment for millions of Americans.

So, instead of gutting Medicare, as Ryan proposes, why not expand on what works.

That’s what Vermont Senator Bernie Sanders is proposing.

“The United States is the only major nation in the industrialized world that does not guarantee health care as right to its people. Meanwhile, we spend about twice as much per capita on health care with worse results than others that spend far less,” Sanders explained Tuesday, as he announced plans to introduce the American Health Security Act of 2011, would provide federal guidelines and strong minimum standards for states to administer single-payer health care programs. “It is time that we bring about a fundamental transformation of the American health care system. It is time for us to end private, for-profit participation in delivering basic coverage. It is time for the United States to provide a Medicare-for-all single-payer health coverage program.”

Sanders’ plan is the right response to America’s health-care crisis — and any country where tens of millions of citizens lack health-care coverage, where tends of millions more lack adequate coverage and where costs are skyrocketing because of insurance-company profiteering has a crisis.

Don’t get the independent senator wrong. He voted for the health-care reform legislation that passed Congress last year and that was signed by President Obama. He even improved that legislation by fighting to include funding for public-health programs and community clinics.

But Sanders also recognizes flaws in the 2009 reform — which, reformers note, keeps the for-profit private health insurance industry at the center of the U.S. health system. And the senator argues that the ultimate cure for what ails American health care is a “Medicare for All” approach that ends the profiteering and focuses on prevention and treatment of disease.

And he is not alone.

Congressman Jim McDermott, the Washington Democrat who has for two decades been one of the House’s steadiest backers of real health-care reform, will introduce a parallel bill in that chamber. Says McDermott: “The (2010) health care law made big progress towards covering many more people and finding ways to lower cost. However, I think the best way to reduce costs and guarantee coverage for all is through a Single-payer system like Medicare. This bill does just that – it builds on the new health care law by giving states the flexibility they need to go to a single-payer system of their own. It will also reduce costs, and Americans will be healthier.

The Sanders-McDermott initiative in Washington, DC, comes as the Vermont Legislature has taken steps to make the senator’s homestate the first in the nation to develop what advocates desctibe as a state-based variation on the single-payer approach. Vermont. Sanders applauds the move, and thinks it could serve as a national model. Others agree, while noting that Medicare provides another model.

Sanders and McDermott were joined at the announcement of their new “Medicare for All” push by Arlene Baker-Holt, executive vice president of the AFL-CIO; Jean Ross, co-president of the National Nurses United; and Greg Junemann, president of the International Federation of Professional and Technical Engineers. All three groups are encouraging this fight for real reform.

“Providing a single standard of high quality care for all is a priority for registered nurses who have seen their abilities to act as patient advocates made more difficult as for-profit interests control more patient care decisions,” says Ross, whose union has been in the forefront of the fight for single-payer. “We commend Senator Sanders and Representative McDermott for their vision and passion to help registered nurses create a more just healthcare system through the American Health Security Act and applaud our brother and sisters in labor for their support,”

Physicians for a National Health Program, the movement of doctors and medical students for real reform, welcomed the national legislation.

“At a time when the airwaves are filled with talk about cutting or even ending Medicare,” said Dr. Garrett Adams, PNHP president, “Senator Sanders has boldly stepped forward with the seemingly paradoxical proposition that the best way to financially strengthen the Medicare program is to upgrade it and expand it to cover everyone.”

Those millions of us who support a Medicare for All, single-payer, reform for the healthcare crisis in this nation have some work to do over the next few days. Senators are on their way to their home states for the one-week Thanksgiving recess – and they need a little up close and personal constituent attention before dinnertime on Thursday.

Senator Bernie Sanders of Vermont is a stalwart supporter of doing the right thing for his state, our healthcare system and this nation – and he has said repeatedly that moving toward a just and economically sound system is possible through Medicare for All, single-payer. In the purest sense of giving patients control over their own healthcare, single-payer gives us all control over our choice of providers – and it gives our healthcare professionals the freedom they need to advise us on the basis of health rather than payment source.

So, even though the current Senate bill is not what we want – Senator Sanders will offer an amendment that would be a substitute for that bill and is mirrored on S. 703, The American Health Security Act.

We need to make it clear before our Senators are immersed in their own holiday events and then in traveling back to Washington, DC, that we want them to support Senator Sanders’ amendment.

Call today, call tomorrow and keep calling until the home offices of the Senators close for the holidays – and many will stay open until Wednesday at noon. Tell the staff you want to talk turkey about the Senate effort.

Time is drawing short for our Senators to hear from us. Debate will begin on November 30 on the current Senate bill. Senator Sanders needs support. He has already told us that he does not expect a win on his amendment. But we are all laying groundwork for this nation to move in the right direction before long – we know that the current bills do not “bend the cost curve” enough and we know they certainly do not bend the death or bankruptcy curve nearly enough to make the bills what this nation needs.

Additionally, we want the legislation to contain language that will allow states that opt in to a single-payer system to be able to do so with the appropriate waivers from federal legal provisions which might otherwise present obstacles to doing so.

So, the ask of our Senators – each and every one, liberal, centrist or conservative – is two-fold and urgent:

1. Vote with and for Sanders’ S. 703 substitute amendment; and
2. Support state single-payer enabling language in the final bill.

Calls to DC won’t be effective this week. We can all return to that effort next week. Thanksgiving week calls must go to your Senators’ offices in your state. Look them up here, using your zip code.

Tell friends, neighbors and relatives. This year, talk a little turkey about healthcare. Ask folks how thankful they would be to have healthcare as a basic human right for their neighbors and for themselves. And then help them look up their Senators’ contact information and tell them how easy it really is to call and log your concerns and your expectations for an affirmative vote for the Sanders’ amendment.

Oh, and don’t forget to thank one another for caring enough to join in the struggle. It matters. Everybody in, nobody out. Thank you all for believing that together we can change this, because we can.