Mr. Krugman has a really good column out today on Abdul El-Sayed’s support of Medicare for All and our healthcare “system” in general:

TL;DR: Our healthcare system is already more “socialized” than people think. And that’s not a bad thing.

It’s worth a full read. Some key highlights:

  • Government (through Medicare and Medicaid) pays out more than private insurers in our healthcare “system”

  • The government - directly and indirectly through tax breaks - pays for more than 2/3rds of Americans’ health insurance and healthcare costs.

  • Even with private employer-based health insurance plans (THE most popular way for people to have health insurance in this country), the government exerts significant regulatory oversight and provide significant financial incentives.

  • Private insurers are simply “middlemen” who provide zero added value while increasing administrative and total system costs (and, yes, as I’ve written before, Medicare Advantage is a scam)

  • Instituting M4A and paying for it through the tax code would actually be fairer and a “more progressive distribution of the cost… middle-income households would pay less as high-income households would pay more. And the U.S. would stop wasting large sums on pointless administrative costs.”

Of course, Republicans will attack El-Sayed by emphasizing his “foreign” name, his religion and subtly alluding to his skin color (even though he is the All-American Guy”) But healthcare is El-Sayed’s signature issue (and profession), so they will also yell “socialism” every time he mentions M4A.

So how to counter these healthcare accusations on the stump and take back Home Field Advantage?

My thoughts:

Pivot to Government Subsidizing Private Companies. Immediately turn the “socialist” accusation around to how for-profit insurers privatize profits and socialize costs. Something along the lines of “You know who is benefitting from the very socialism they scream about? Medicare Advantage corporate insurers who are paid by the government because they couldn’t make money insuring our parents and grandparents otherwise. You know who else cashes in? Private corporate employers and their CEOs who get a tax break for providing insurance to their employees.”

Point Out the Insanity of People Having to Literally Predict Their Future Health When Choosing Insurance (see my post: Choice. It's What's for Dinner). Something along the lines of, “You know what’s really crazy? People having to literally guess what their (and their family’s) health will be in the future so they can choose the proper coverage. Will someone in my family get sick or injured next year? What drugs will I need next year? Will I be somewhere “out of network” when I need healthcare next year? You know who doesn’t have to make these ridiculous guesses and choices? Every resident of every other developed country in the world.”

Point Out That Medicare is More Efficient Than Private Insurance. How about this: “Did you know that administrative overhead for Medicare and Medicaid runs at about 2-4%, while private insurers suck up around 15-20% for overhead and profit? That’s billions of dollars being diverted to “middlemen” private corporations, shareholders and CEOs instead of going to improve you and your family’s health.”

I’m sure there are more rebuttals and talking points. However, in my experience as a candidate, effective messaging on an issue relies on endlessly repeating a very few relatively short, easily understandable and directly relatable responses.

People tend to vote on what they believe directly impacts their lives. The previous bullet points are an attempt to take amorphous healthcare policy at the federal level and bring it into people’s homes and relate it to their base-level concerns. Hopefully, they also help someone like El-Sayed find a path to break into voters’ Circle of TrustTM.

The Bee Gees - Stayin’ Alive

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Kay W.3 months ago

Too, I would point to the failure of Medicare Advantage to argue against a privatized system. Medicare Advantage costs the government more. Republicans thought it would save money and it doesn’t. We’ve already tried a privatized approach, Medicare Advantage, and it failed.

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Scott H3 months ago

I seriously doubt Republicans thought it would save money. They simply wanted to funnel tax dollars to private health corporations and the only way to sell that grift was to proclaim "It saves money".

Plenty of Ostensible Dems use the same bullshit messaging techniques to sell their pet grift.

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Kay W.3 months ago

So funny. I read this and thought it was great, too. Like Krugman, I’m a recent convert to MFA. I wholly supported Obamacare but when you talk to people they want SECURITY in health insurance and I think the only way to get them a guarantee is MFA.

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Joe is Wypoxic3 months ago

Kay - I supported M4A in concept but argued that we need to find a practical way to get there. I've changed my view as well. I'm now in the camp of fighting for M4A now as the end goal. It's clear that being "practical" and looking for "incremental" change is not going to get us there. So I'm in the "let's go for it all" camp and we can compromise on the way there if need be...

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TBone Dinosaur3 months ago

I've been a supporter of this org for years, they do great work. I'd be surprised if AES is not a member.

Physicians for a National Health Program 17 N State St Ste 1330 | Chicago, Illinois 60602 312-782-6006 | [email protected]

PNHP is the only national physician organization in the United States dedicated exclusively to implementing a single-payer national health program.

https://pnhp.org/about/

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Joe M3 months ago

I think I'd add a "Global economic competitiveness" talking point to the list. The US is the only industrialized country in the world without universal healthcare. All of those countries have universal coverage at a lower cost than the current US system with better outcomes. Their companies are not spending time and money navigating the arcane mess of obtaining healthcare coverage for employees. I've been in meetings in a mid size manufacturing company where that navigation was discussed, and oh brother was it a confusing mess of minute details.

On top of the costs, the current system also makes it harder for individuals to go out and start businesses. I know plenty of people that toyed with the idea of starting up a business but felt trapped by the healthcare costs and availability. Yeah, the ACA helped but it's still a barrier.

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mister mixAuthor3 months ago

Yes! We have to come to grips with it not being 1970 anymore -- by which I mean that we aren't the only superpower, our power is limited because new cheap technology allows 2nd rate powers to challenge us (see: Iran). Part of it is getting real about being smarter and less "exceptional".

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Joe is Wypoxic3 months ago

Absolutely great point Joe! I used to talk about this all the time as a candidate. Every major business in the United States is in two lines of work: whatever product of service is their core competency and providing healthcare insurance and management for their employees. That’s absolutely anti-competitive in a global economy. Also, the cost of every automobile manufactured in the US as several thousand dollars of “healthcare” cost embedded in the price that other auto manufacturers in other countries don’t have. Again, absolutely anti-competitive in a global marketplace.

Thanks for reminding me of this. I’m going to add a short addendum to this post first thing in the morning with those points.

JW

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TBone Dinosaur3 months ago

I tried to stop a few friends from getting duped by the "Advantage" scam. Now they're mad at me instead of the system that duped them.

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TBone Dinosaur3 months ago

The "free groceries" card was great until that relied upon money abruptly ceased!

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Scott H3 months ago

https://www.medrxiv.org/content/10.64898/2026.07.22.26358689v1

Medicare for All:

  • would save 114,000 lives per year
  • would cut spending by over $1 trillion per year
  • eliminate premiums, deductibles and copays
  • eliminate restrictive provider networks and prior authorization
  • covers medical, dental, hearing, vision, mental health and long term care
  • If you're opposing Medicare for All, you're opposing saving American lives, saving families money, and cutting government waste.

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    TBone Dinosaur3 months ago

    Now they just use AI to deny claims and pocket the money formerly paid to admistrative human ghouls.

    I detest our for-profit system of preying on illness and infirmity for money and especially the private equity takeovers doing so much to further that goal.

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    Joe is Wypoxic3 months ago

    We need a hashtag for Private Equity like we have for Trump (#ETTD). Thoughts TBone?

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    TBone Dinosaur3 months ago(edited)

    Lemme ruminate on that! I've had a whirlwind of unbelievable bad luck for the past 2 days including a lightning strike that fried some stuff (luckily the most expensive things have surge protectors) and it feels like Everything TBone Touches Dies right now 😂

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    TBone Dinosaur3 months ago

    Private Equity Equals Vampires Everywhere!

    PEEVE is easy to remember.

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    mister mixAuthor3 months ago

    Good post. I think the healthcare system is another one where the expenses are socialized and the profits are privatized. IOW, a bunch of parasitical corporations skim the cream and leave taxpayers holding the bag.

    But you can't say that without being unafraid of offending corporations.

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    Joe is Wypoxic3 months ago(edited)

    Correct - its in my post - privatizing profits and socializing costs. Private health insurers exist for one reason only - to suck as much of people's and the public's money into their vortex as possible. They are the true "Vampire Squids" (don't hate me for quoting Matt Taibbi) of healthcare...

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    r po3 months ago

    TIL that the same thing happens with Medicare Part D and Medigap that happens with mortgages, where the servicer gets sold out from under you, replacing a corporate brand everyone knows with another new corporate brand nobody has ever heard of. Broker maintained a straight face as I laughed and said my European friends cannot understand this.