Everything You Wanted to Know About Medicare For All with Dr. Abdul El-Sayed

Today Ben interviews Dr. Abdul El-Sayed, physician, epidemiologist, professor, former executive director of the Detroit Health Department, and candidate for Governor of Michigan. Dr. El-Sayed is also the author of several books and publications, most recently Medicare for All: A Citizen’s Guide.


Show Notes

Dr. El-Sayed discusses how his desire to improve disparities in health led him to become a physician, only to learn that the system he practiced in was part of the problem. The fact that we allow our system to be wound around the axle of profits for major corporation rather than around the goal of healthcare for everyone, is what led him into healthcare activism, advocacy, research and writing.

Rebecca in Illinois wrote in to ask about using Medicare (with all the public perceptions and misconceptions about the current program) as the model for the universal, single payer system we want. Dr. El-Sayed notes that most people on Medicare actually like the program because it actually assures that they’ll actually have coverage when they need it, as opposed to private insurance.

Medicare has been intentionally choked off and privatized by the health insurance industry so it’s not as high a quality product as it could be. If Medicare is mediocre, it makes private Medicare Advantage products more attractive to younger, healthier (thus cheaper to insure) seniors. “If Medicare is not what it should be, ask yourself why.”

Dr. El-Sayed suggests the Medicare for All label might need to be reassessed. Our opponents have twisted the conversation about M4A to the point where we need to decide if the benefits of using a catch-all label that everyone understands still outweighs the negatives the opponents have added to the narrative.

An activist in Virginia asks how the legacy of slavery has impacted and shaped our current for-profit healthcare system. Dr. El-Sayed refers to Heather McGee’s book The Sum of Us, in which she writes about how racism thwarts our capacity to invest in collective public goods. For example, 13 states (most in the former Confederacy) have still refused to extend Medicaid, even though it would mean an influx of Federal dollars and greater access to healthcare for all low income residents. For many white voters, the aversion to investing in services that might benefit Black and brown people means they’re also voting against programs that would benefit themselves.

One of the challenges of the progressive movement is that we’re great at talking with each other but not that great at talking to folks who don’t see the world the way we do. We make assumptions about their morals and shake our fingers at them, which never works. Instead we need to ask them about their health insurance situation, to learn more about the challenges they face in getting the care they need. Then ask them why they think that’s happening, who is benefiting from that, and how do they keep getting away with it? That makes the issue less abstract and more personalized.

People on the Left also really like to debate, which isn’t as valuable as empowering people by giving them information that may eventually lead them to our side.

James in Illinois asks how we can overcome the power of big business. Dr. El-Sayed says that over time organizing will win out over advertising. The greed of the healthcare industry is pushing people to our side every day. Our job is to give those new folks the language to describe the solution we need. So organizing is the only way forward.

Dr. El-Sayed addresses the need to avoid reproducing the inequities of our healthcare system in our movement. That means recognizing those most affected by this system can’t participate in the traditional 9 to 5 frame that assumes everyone can attend a meeting at 7:00 pm. The circumstances that cause them to suffer at the hands of our healthcare system also preclude them from being part of traditional organizing. Their stories are the most powerful thing we have and we have to adjust our work to put them front and center in the movement.

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