Welcome to Cricut Conversations. I'm John Favreau. Today we are asking the question,

can we have Medicare for all? To help us answer this, I'm joined by two experts in the

field, Dr. Adam Gaffney, a single-payer advocate in critical care physician who's an instructor

at Harvard Medical School, and my friend Andy Slavitt, who ran the Centers for Medicare

and Medicaid Services during the Obama administration and now runs the United States of

Care, a new nonprofit focused on expanding healthcare to all Americans. Gentlemen, thank

you for joining. I want to start with the substance of the single-payer debate and then

we can move on to the politics. Adam, you recently wrote a piece for a dissent magazine titled

Single-Pair or Bust, where you argue that single-payer is the only way to achieve truly

universal healthcare. Why do you think that is and could you lay out for us how such a system

would work? Absolutely. There's broad agreement that we need universal coverage, that we shouldn't

have uninsured people in this country. I know all of us believe in that and certainly a strong

majority of the country. Traditionally, the way to get there has been to create a public program

that covered the whole country and that if you want to cover everyone, you cover everyone,

publicly. There have been some alternative approaches. The idea of single-payer is very

similar to the idea of Medicare, the idea of what used to be called national health insurance.

So this is a public insurance plan that covers the entire country that leaves no one out and

that replaces existing forms of coverage, so things like private health insurance. This

kind of proposal goes back a long way. Truman proposed national health insurance afterward

or two. It was prominent again after the passage of Medicare. Many thought that Medicare could

be transitioned into a fully universal program and we're having a discussion again today in the

wake of the Affordable Care Act. So how would it work? I mean, we can talk about the finer details,

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