The politics of health care

Traveling-nurses-lose-work-when-Covid-funding-dries-up-0522-meme-by-MH-Illustration-Unsplash, The politics of health care, Culture Currents Featured News & Views
During the pandemic, many nurses traveled from one overwhelmed hospital to another, gaining valuable experience and expertise. Now, as Covid funding dries up, they’re out of work. With Medicare for All, funding wouldn’t fluctuate like that. – Photo: MH Illustration, Unsplash

by Barry Hermanson

Before the pandemic, Sen. Bernie Sanders, I-VT, introduced the Medicare for All Act of 2019. There were 14 original cosponsors of S.1129: Tammy Baldwin, D-Wis., Richard Blumenthal, D-Conn., Cory Booker, D-N.J., Kirsten Gillibrand, D-N.Y., Kamala Harris, D-Calif., Patrick Leahy, D-Vt., Ed Markey, D-Mass., Jeff Merkley, D-Ore., Brian Schatz, D-Hawaii, Tom Udall, D-N.M., Elizabeth Warren, D-Mass., and Sheldon Whitehouse, D-R.I., Martin Heinrich, D-N.M., Mazie Hirono, D-Hawaii,

On March 12, 2022, Sen. Sanders introduced the Medicare for All Act of 2022.

After more than two years of the pandemic, again, only 14 senators stepped forward to be original co-sponsors. Of the above list, Kamala Harris, D-Calif., was replaced by Alex Padilla, D-Calif., and Tom Udall, D-N.M., was replaced by Ben Ray Luján, D-N.M.

Sixty votes are needed to pass legislation like Medicare for All in the U.S. Senate.

Support for better health care in the House of Representatives is slightly better. H.R. 1976, the Medicare for All Act of 2021, lists 121 co-sponsors – a little more than half of the 218 votes it takes to pass legislation. 

In California, Assembly Bill 1400, the California Guaranteed Health Care for All Act, had 22 supporters, also a little more than half of the 41 votes needed in the 80-member body.

Instead of paying providers directly, Medicare pays third-party middlemen called Direct Contracting Entities (DCEs) to “coordinate” beneficiaries’ care.

The spring 2022 newsletter of the Physicians for a National Health Program recently arrived in my mailbox. The lead issue is direct contracting/privatizing Medicare. “Medicare DC is a pilot program developed during the Trump Administration that would change the way that Traditional Medicare pays for care. Instead of paying providers directly, Medicare pays third-party middlemen called Direct Contracting Entities (DCEs) to “coordinate” beneficiaries’ care. DCEs are allowed to keep up to 40% of these payments as profit and overhead, a dangerous incentive to restrict patient care.”

They also report: “Spending by health industry lobbyists increased in 2021.” The for-profit healthcare industry spends heavily on lobbying. The lack of legislative support at the federal and state level to remove profit from health care is proof of the effectiveness of this lobbying.

Filled a prescription recently? “Americans spend almost double what the rest of the world combined spends on drugs: The 20 highest-selling drugs generated $158 billion of global revenue in 2020, but due to our high drug prices, U.S. sales represented 64% of that total.” Spending to influence legislators, while very large, is dwarfed by the profits gained. 

Achieving better health care legislatively is a fight that will not be won until for-profit lobbyists can no longer buy votes from legislators. Fortunately, for residents of California, better health care can be won at the ballot box. Identifying 50 + 1% of California voters/supporters guarantees victory. It will not be easy. Identifying 9 million voters is an enormous task requiring staff and a budget of millions of dollars.  The millions spent to win better health care in California is small compared to the billions in savings Californians will enjoy in reduced health care expenses. 

Barry Hermanson is a Green Party of California Coordinating Committee member and a former small business owner. Contact him at or 415-255-9494.