Presidential Candidates on Health Care Issues: Bernie Sanders

Over the next few weeks, we’ll take a high-level look at the positions of the leading nominees for President when it comes to political issues potentially impacting physicians.

Is it possible to be an anti-establishment candidate when you’ve been part of the establishment for more than two decades? In the case of Vermont Senator Bernie Sanders, the answer is yes. His first term as a Congressman was as an independent, and as a politician, he has sacrificed friends and allies throughout his career by being critical of politicians on both sides of the aisle. In a political environment in which the word “socialist” is a label to avoid, Sanders embraces it, openly describing himself as a “democratic socialist.”

He voted for the Affordable Care Act, considering it an improvement over the old system, but stating loudly and often that it did not go far enough in improving access and care for all citizens. Should Sanders pull off a minor miracle and beat Hillary Clinton for the nomination and then go on to win the national election, what would his presidency look like for health care?

Overall: Sanders is on record that “Obamacare” was a “small victory” for the uninsured, and a big part of his campaign is based on the idea of creating a “Medicare for all” (ie, a single-payer system for every American). “The United States must join the rest of the industrialized world and recognize that healthcare is a right of all, and not a privilege. Despite the fact that more than 40 million Americans have no health insurance, we spend almost twice as much per capita on healthcare as any other nation,” Sanders wrote in his Agenda for America. Under his system, health care would be publicly funded but privately delivered.

Where would that public funding come from? Sanders financing via various tax revenues, credits and subsidies. His draft plan includes a new healthcare income tax, an employer payroll tax, a surcharge on high-income individuals, and a tax on securities transactions, a funding structure that seems vague at best. Sanders is counting on universal health care to control health costs, an area of disagreement with many on the other side of the aisle.

Abortion: Alongside fervent beliefs on equal pay for women and extensions of paid family leave, Sanders is strongly pro-choice. “The decision about abortion must remain a decision for the woman and her doctor to make, not the government.” While Planned Parenthood has been in the GOP crosshairs, Sanders vows to expand funding for the organization.

Other issues: Sanders has strong positions on expanding mental health services to all, expanding Medicaid coverage, and curbing prescription drug prices through controls on generic pricing and drug reimportation. Sanders is also a big supporter of community health cancers, which provide affordable primary care and mental health counseling.