What's the number one policy you'd like to see the Democratic Party pursue?
You're a legislator now, you've been elected President,
what's your first initiative as President of the United States?
>> I mean, you couldn't do this unilaterally, but
I think one of the main policies that would improve a lot of these other issues
that we're talking about is health care.
Single payer health care, or at least in the very least,
in the short term, just reform healthcare
to a point where everyone has the coverage they need to get the care they need.
So the untreated mental illnesses that we're seeing on our streets right now,
that is a by product of a broken healthcare system.
I wanna fix that.
That would be, again,
the number one thing I would focus on if I had the power to really make that change.
>> So, I mean, obviously, I think that we all see the problems with the health care
system, It's sort of a weird Frankensteinian monster.
This sort of private public monster, in which virtually all medical care in
the United States is publicly subsidized at some level by Medicare, Medicaid,
by hospital reimbursements that are involved with local and state regulation.
The levels of regulatory thickets and the amount of administration,
the administrative costs for healthcare- >> I mean, it's a mess.
>> In the United States is extraordinary.
>> Yeah. >> It's extraordinary.
And I think that the big problem with health care is that it's such
a thicket now that no matter which side you come at it from,
you are going to get wrecked for even poking a stick into it, right?
The minute you poke a stick at it ooze comes out.
Because if you come out of from my side of the aisle, which is it needs more
privatization, we should get rid of the connection between your employment.
I mean, if I were coming at this tabula rasa,
you get rid of the connection between your employment and
your healthcare, it's absurd.
Why is your employer paying for your health care in the first place, right?
You should- >> So look, I agree with you on that.
I think a single payer system would do away with the need for
employers to provide coverage for their employees.
I actually hate the system where if you're working at a place that you might despise
and you wanna move on, or maybe you wanna start your own business, right?
You're less willing to do it if your healthcare is reliant on you staying at
the company you hate so much.
I think it's actually stifled a lot of economic growth.
I think there would be a lot more small businesses, successful small businesses,
if people had that freedom to just walk away knowing that they wouldn't lose
their health coverage as a result.
You get what I'm saying? >> Right, no, first of all,
I totally agree with you, I think that's why I would prefer to go back
to individual and community based insurance, right?
This is why the lack of social fabric really is a problem
because in my vision of a perfect healthcare world.
Essentially, because your neighbors and your community,
you don't want your neighbors to die, your community help subsidize your health care.
But I have very serious doubts about the national community subsidizing health care
at a large scale because I don't know that person in New York,
I don't know what their habits are.
I don't know what incentives they have to engage in the health care structure.
And you do see a wide variety of sort of models that have been used, right?
Singapore is much more privatized health care system than, for example,
Great Britain.
So they're a bunch of different ways to sort of slice this particular issue.
>> Yeah, it's interesting because we hear a lot of, I mean,
I feel like the right wing in America puts words in the mouths of Canadians and
people living in Great Britain, when it comes to their health insurance policy and
their nationalized health care.
But you talk to them, and they seem to love it.
So I'll give you an example.
So when Boris Johnson was running again for Prime Minister,
what was really interesting is how he kept emphasizing the need to bolster-
>> It's a third rail there,
you can' touch it there.
>> But it's a third rail because of how much the people living there love
their health care system.
And so there's freedom that comes along with that.
When you consider the fact that our life expectancy in the United States is
comparable to that of Cuba's, there's something broken in our system.
[LAUGH] >> Well, I mean, so first of all,
I mean whenever we get into these sorts of discussions,
you have to start looking at apples to apples comparisons in terms of
the demographics of the United States, our age.
The ethnic composition of the United States, because different ethnicities
actually have different health problems disproportionately.
You have to look at the poverty rate in different areas.
Obviously, the life expectancy in Vermont is significantly higher than life
expectancy in, say, Alabama.
And so that is a wide gap that is not really attributable necessarily to
healthcare quality because, again,
the same national system applies to both Vermont and Alabama.
The United States is also a country of 340 million people,
Cuba's a country of significantly fewer people.
So I mean, all of these,
this is why I sort of object to any attempt to use Norwegian models and
apply them to a significantly more diverse, heterogeneous and large country.
>> Well, okay, so let me get into that, because if you look at what's work,
cuz Cuba, I mean, obviously incredibly poor country,
especially with embargoes and all of that.
Donald Trump, declared it a state sponsor of terror, which led to other countries
feeling very uncomfortable doing any business with Cuba.
So it's health care system is severely under resourced.
But what they've done correctly is they focus most of their energy on
preventative care,
cuz preventative care is less costly than just allowing people to get super sick.
At that point, whatever illness they have is a lot more costly to deal with.
So they're like, all right, we don't have the resources,
we just got to make sure we really hone in on preventative care.
That's worked out really well for them, whereas in the United States,
people aren't getting the preventative care they need to prevent severe illnesses
because it's so costly, right?
So we need to do something- >> Well, I mean, first,
we should tell people to stop eating so much.
I mean, the United States is an extraordinarily fat country.
I mean, just by the stats, we're a very fat country.
And you compare us to Cuba, you compare it to anywhere in Scandinavia.
I mean, this is why during COVID people would say 40% of
the population has pre-existing health problems, and
meanwhile Sweden's like let it rip man, we're all in great shape.
So again, comparing apples to oranges is a very difficult thing.
When it comes to the NHS or Canada, the only pushback that I give there
is that you'd be hard-pressed to find a government provided universal system
of any sort that is widely disparaged by the people who benefit from it.
Meaning that if you have no available alternative, people who are on food
stamps, like the food stamp system, people who are on welfare, like the welfare
system, people who get student loans, like the student loan system.
People who get government subsidy mortgages like the government subsidized
mortgage system, once you make people dependent.
Which is why in the United States, as I say,
anytime you poke the status quo from either side, you get penalized, right?
People will say, I hate my health care, and then the minute somebody tries to
screw with their health care, they're like, we got to go after them.
>> I mean, I think Medicare is a good example of that, social security.
I mean- >> Yes, they're both gonna be insolvent,
but that's- [LAUGH] >> I don't think that's necessarily true.
>> We'll have to raise taxes pretty dramatically or lower benefits or
lower the retirement age- >> I mean, yeah-
>> Which is really what we should be
doing. >> I think you're gonna hate me for
saying this, but I think the cap on Social Security taxes should be lifted entirely.
[LAUGH] >> No, no, by the way,
that is at least an ideologically consistent position.
>> Yeah.
>> Meaning that if you are going to say that we need to maintain Social Security
as it currently stands, as a defined outcome plan as opposed to a defined
contributions plan, then of course you're gonna have to raise taxes.
My personal experience with sort of a Medicare for all system, is in Israel,
their emergency care is very good, and if you have cancer,
you are in serious trouble.
>> Interesting.
>> And this happens to be what the statistics kind of bear out.
The United States has the highest five year survival rate for
things like breast cancer.
If you have a serious disease, people are coming to the United States for surgery,
for treatment.
If you have a broken arm, you're probably better off in a nationalized health
care system because it's fairly simple thing to solve,
and it's not gonna cost you, quote unquote, anything, except indirectly.
>> But I think it's really important to differentiate the quality of care that is
available in the United States,
which I agree with you is fantastic if you can afford it.
And when it comes to your life or when it comes to a family member's life,
let's say you don't have the money up front to pay for the procedures or
the treatment that you need, right?
People are willing to go into debt because at the end of the day,
it's about your life.
And I am tired of seeing elderly individuals,
retired individuals in this country lose everything,
go bankrupt because of how broken our healthcare system is.
It needs to be fixed.
So on one hand, I agree with you, the quality of care is certainly here,
it's where people come to get the treatment they need,
but in a lot of cases Americans go bankrupt for this.