Congresswoman Pramila Jayapal on Medicare for All: 'I think we can win'

More than 50 years ago, President Lyndon Johnson complained that millions of Americans did not have “a full measure of opportunity to achieve and to enjoy good health." He said: "The time has now arrived for action.”

That action was a health insurance program for senior citizens called Medicare. This year, Congress is expected to hold hearings on whether it's time to expand Medicare to include every American. One of the chief supporters of Medicare for All is Washington state Congresswoman Pramila Jayapal.

RADKE: You're proposing a single payer health care system. Would private health insurance contracts be illegal?

JAYAPAL: No, not at all illegal. All insurance for every American would be provided through a government insurance system. And if private insurance companies wanted to exist and provide benefits that are not covered by our system they would be free to do that. Under our plan people would have much more choice because there wouldn't be in-network and out-of-network doctors and we would expand the existing Medicare coverage, which now only applies to seniors, to everybody. And we would add benefits to what's already covered. One of the biggest complaints about Medicare is it doesn't cover dental, vision and hearing. You have to buy a separate plan. We would include those pieces as well as mental health. And we've added long term supports and services for our folks with disabilities and our seniors.

RADKE: That's more progressive than Canada for example, right? The Canadian health care system doesn't cover vision, dental care, prescription drugs, rehabilitative services and home health services.

JAYAPAL: They do cover some of those things and then they have some additional payments that people have to make. Our plan would not have co-pays, premiums or deductibles. When you look at the cost of health care today, I think what a lot of people don't understand is even if you're covered by health insurance, either purchasing on the marketplace or in some cases employer covered insurance, families are still paying about $30,000 a year in medical costs. That's premiums, co-pays and deductibles. And the cost to employers is enormous. In our current system, employers are currently putting in about $650 billion a year in insurance premiums. And through taxpayer contributions and government contributions, about two thirds of the total cost of health care right now is being paid for by the government on Medicaid and Medicare. There are estimates that the United States has the most expensive health care system in the world of any of our industrialized countries. We spend about $3.5 trillion a year on health care costs. And that is projected to go up to about $5 trillion or $50 trillion over 10 years. That’s because there's no cost containment built into our system. So continuing to spend these enormous amounts of money are absolutely unsustainable.

70 percent of Americans believe that Medicare for All is a great plan and they support it. Some polls show that if you take away the private insurance plans people think the support drops and that you'll no longer be able to see the same doctor or hospital. That’s absolutely false. The only thing that the government would be doing is paying for the insurance plan that prevents people from having to bear the risk of unsustainable medical costs. The delivery system is the same.

RADKE: How do you assure people that they won't see what the Veterans Administration is infamous for -- chronic delays for people seeking care? That’s a lot of people's image of government provided health care.

JAYAPAL: I think the more comparable program would be Medicare because the majority of Americans love Medicare. If they have complaints about Medicare it's usually about what Medicare does not cover.

Our plan will come up with the right rates. We're going to negotiate for a very big marketplace and therefore we can get lower prices on pharmaceutical drugs. If you don't want to negotiate the price of a drug with the government then we will go to compulsory licensing and move that drug into generic production in order to keep costs down.

RADKE: How much would this new system save and how we would pay for the difference in who gets taxed?

JAYAPAL: Well, typically with a bill, you don't spell that out at the very beginning but of course that's the first thing everybody wants to know. Our system currently costs about $35 trillion over 10 years, going up to $50 trillion. The new plan is estimated to cost $32 trillion. So we would save trillions of dollars over the next decade if we were to move to Medicare for All. By our estimates, the average family would actually pay 14 percent less because so much is coming out of pocket today. We would be able to pay for two thirds of the system with the funding that we're already using because the government is already paying for Medicaid and Medicare and that would be pulled into the system.

There are lots of ways to come up with half a trillion dollars, including a tax on the wealthiest, including rolling back the GOP tax cuts, a financial transactions tax.

RADKE: When you combine the health industry lobby with the reaction of Americans who say they want to keep the insurance they have, and those Americans who don't want a tax increase, single payer health care does not have the votes to pass.

JAYAPAL: The question is will we have the political will to fight back? The pharmaceutical drug industry and the insurance industry are going to pour hundreds of millions of dollars into trying to make you think that this is not what you should have. I think we can win because people are with us this time.