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medicare for all
2028 Will Be Our Last, Best Hope to Propel a Real Leftist to the Top of the Ticket
As the mainstream Democrats sink in popularity and their base demands change, It’s critical that the left unites, well ahead of schedule, behind one, single candidate.
Apr 11, 2025
Imagine, if you will, the United States on January 1, 2028. President Donald Trump and his gang of MAGA goons have been drawing from the well of right-wing nativism for the past three years, generating spectacle after spectacle without managing to improve material circumstances for any but the wealthiest Americans. That well has now run dry, and the American public is getting restless. The United States has repeatedly skirted the edge of an economic recession; inflation remains high and unemployment is ticking up. The malaise of stagflation pervades every aspect of American life. Eggs and milk prices remain high, the stock market hasn’t really rallied again since the GOP pushed through its latest cut on taxes for the wealthy, and the big ticket items—homes, vehicles, education—are all more expensive than when Trump first took office, for the second time.
Amidst the chaos, Democrats have kicked their campaigning into high gear, with primary season nearly upon them. This is a primary without an heir apparent, and every Democrat within arm’s reach of a well-funded PAC has thrown their hat into the ring. At the top of the list are familiar names like Gavin Newsom, full of “I feel your pain” empathy for the right and spite for the left. He’s spent the second Trump administration honing his performance of antipathy for progressive social issues and rubbing elbows with the right-wing glitterati. Now he’s ready to convert on his “moderate” bona fides. There’s also Pete Buttigieg, here to remind us that no planes crashed on his watch as Transportation Secretary. Amy Klobuchar is back too although no one, including herself, can articulate exactly why.
Since the resurgence of the New New Left in the last decade, there has never been a wider gulf between the appeal of left-wing politicians and distaste for the Democratic Party establishment.
Despite the typical pomp that attends any party primary season, this campaign looks different than those in recent memory. For the first time in 12 years, more than a decade, Democrats do not have Donald Trump to run against. Whoever the Republican primary process churns out will surely promise to continue whatever erosion of democracy and civil rights Trump has accomplished in his second term. But that nominee is unlikely to carry the same boogeyman-like narrative weight that Trump has wielded to captivate the media for years. Democrats, then, will face a disconcerting prospect: They must run with a positive, projective vision for the country.
What Do the Democrats Believe?
Over the last few election cycles, the Democratic Party has struggled to present a cohesive vision of what it stands for in the 21st century. This is partly due to Donald Trump; the party has, in some sense, overdeveloped its anti-Trump messaging while neglecting the rest of its platform, like a tennis player with an oversized racket arm. Democrats have been saved from having to more carefully cultivate policy messaging because, for the last three cycles, they have simply run as the opposition to Donald Trump. This strategy has a 33% success rate.
The platform problems go much deeper than this, though. The party’s multi-decade pivot away from working class voters toward suburban, college-educated ones has failed to grow a winning coalition for the Democrats. It has, though, paralyzed the party on policy questions relating to income inequality and redistribution of wealth, arguably the most pressing of our present moment. The party cannot serve the interests of wealthy and upper-middle income suburbanites and the working class, simultaneously. Instead of striving to resolve this tension, the party has grasped at social issues in an attempt to trail the prevailing popular opinion of the moment. Where the party was “woke” and all in on ameliorating issues of racial injustice in 2020, just a few years later, some of the most prominent Democrats have joined right-wing Republicans in attacking trans people and migrants.
All this vacillation has run the party aground. Recent polling reveals that the party has reached its lowest point in popularity in at least the last three decades. Constituents do not trust congressional Democrats to stand up to Donald Trump and the GOP. We are only a few months into Donald Trump’s second term, and the Democratic Party already appears to be out of ideas. Leadership is at pains to point out how hamstrung they are by their minority positions in the House and Senate, but they have so far shrunk from any opportunity to use leverage they have against the Trump administration.
The last few months have made two things about the Democratic Party and its supporters abundantly clear: First, there is a real appetite among the party’s constituents to take a radically new tack in combatting Trumpism and, second, there is no inclination among party leadership to do so.
2028 Will Be the Left’s Best Opportunity
Against this backdrop, left electeds and candidates are once again garnering attention and enthusiasm. Sen. Bernie Sanders (I-Vt.) and Rep. Alexandria Ocasio-Cortez (D-N.Y.) have drawn crowds of tens of thousands for their “Fighting Oligarchy” tour, an astounding turnout in an off-election year for two politicians already firmly entrenched in their respective seats. Elsewhere, Zohran Mamdani, the democratic socialist running for mayor of New York City, has surged to take second place in recent polling, trailing only the disgraced, but universally known, Andrew Cuomo. Mamdani’s fundraising has been so robust that he recently implored would-be donors to canvass for him instead, becoming likely the only U.S. candidate for office ever to ask people to stop sending money.
Sanders and Ocasio-Cortez are the most well-known representatives of the left within the sphere of electoral politics. That they are driving massive turnout to their rallies amidst Democrats’ cratering popularity is a testament not just to the durability of their individual fandoms but to the appeal of left policy as well. (It’s also worth recalling that Sanders has long enjoyed some of the highest favorability ratings of any living U.S. politician.) Since the resurgence of the New New Left in the last decade, there has never been a wider gulf between the appeal of left-wing politicians and distaste for the Democratic Party establishment. This is why it’s critical for the left to seize on this imbalance well ahead of 2028.
A Path to Winning the Nomination in 2028
Since its resurgence in 2016, the left has now had the opportunity to observe the primary process (or lack thereof) in three presidential cycles. We should no longer harbor any illusions about how stridently the corporatist wing of the party will oppose a left candidate who appears poised to grab the Democratic nomination. Therefore, it’s critical that the left unites, well ahead of schedule, behind one, single candidate.
Established practice recommends that candidates wait until at least after the dust from the midterm elections has settled. However, the risks to a left candidate declaring before this point are minimal—if Republicans further cement their hold on Congress, it’s proof of the ineptitude of the current party leadership; if Democrats make advances, that’s evidence that the electorate (still) desires change. It’s true that a declaration of intent so far out from the primary contest would be a radical departure from the established modus operandi. But what would a left candidate actually lose in making their intentions known so early? For an established name it would give that person runway to flesh out their platform and expand on their existing base of supporters; for an up-and-comer, it would allow enough time for that person to introduce themselves to the American public and drive up their name recognition. In the era of total digital saturation, media could be had easily—and cheaply—via an infinite number of social media platforms, podcasts, YouTube channels, and so on.
Despite the fierce headwinds a left candidate is sure to face from the party leaders, the left does have one significant advantage: we already have an established political program. Whereas the Kamala Harris campaign was characterized by its almost total lack of prescriptive policy, a left candidate has a tested-and-true platform to run on. The basic tenets of this platform were established by the Sanders presidential campaigns in 2016 and 2020 and have been elaborated on through a series of federal, state, and local campaigns over the ensuing years. They have also been informed by the social movement struggles of the last decade, beginning especially with the Black Lives Matter uprisings after George Floyd’s murder and continuing through the ongoing Cease-Fire Now protests over U.S. complicity in the genocide in Gaza.
While individual candidates may riff on this platform a bit, there are some established, bedrock policies that should form the basis of any left campaign. These include support for single-payer, universal healthcare; acknowledgment that climate change is a real, existential threat; and efforts to massively expand union membership, including installing a radically pro-worker National Labor Relations Board. Also critical will be an immigration approach that ends mass deportations, a policy that is quickly coming to define the second Trump administration. In the realm of foreign policy, a left candidate for president would commit to ending arms sales to Israel and putting the U.S.’ diplomatic weight behind an immediate end to any military action against the Palestinian people. The left flank of the party should be prepared to line up behind the candidate who best represents this platform in 2028.
The Prospects
So, where will we find a perfect tribune of the left? Well, we won’t. The key is simply to find a candidate with enough mass appeal to corral the various left constituencies who will need to back the primary campaign. There are a few places to look for such a person:
The Traditional Route
The most obvious place to go looking for this candidate is among already-established career politicians. The advantages to this approach are obvious: These are people who already know how to run campaigns, have large pools of current and former staffers from whom they could build a campaign team, and have long-running connections with members of the political fundraising ecosystem. The startup costs for a member of this group would be substantially less significant than for an outsider.
The names in contention here are well-known among left politicos. Above the title is, of course, Ocasio-Cortez, who has dominated the progressive Democrat sphere since her shock win over Joe Crowley in 2018. AOC, if she entered the race, would be a formidable frontrunner. Recent surveys have shown that a plurality of Americans already believe her to be the de facto leader of the party, ahead of even Kamala Harris. She has also transformed into one of the party’s strongest fundraisers, a critical component of any successful campaign for president. And, she would be just 38 as the primary season kicked off in 2028, and 39 if she were elected, making her easily the youngest person ever elected to the presidency. Comparatively young candidates have easily capitalized on their youth to brand themselves as change candidates in the past, which is likely to be an especially compelling narrative as the then-81 year old Trump presides over his waning days in office.
The left best serves corporatist Democrats when we descend into internecine squabbles and leave the door open for multiple entrants to claim the “progressive” mantle.
AOC has her detractors as well, of course. Her occasionally uneasy relationship with parts of the left has sometimes destabilized her relationship with what would otherwise be her core constituency. As with Sanders in 2016 and 2020, though, it’s likely that a real attempt by Ocasio-Cortez to seize the Democratic nomination would rally many on the left as the prospect of installing a veteran of left-progressivism in the White House would prove too enticing to pass up.
Less well-known nationally in this group, but perhaps more serious about running in 2028, is Ro Khanna, representative from California. Khanna has built many of his progressive bona fides on being the Big Tech-whisperer of the left, someone who can harness the energy of Silicon Valley for good, not evil. (Khanna represents the district that includes much of Silicon Valley; it is the nation’s wealthiest Congressional district.) As such, he has been a strong advocate for digital privacy rights, an issue that is sure to have increasing salience amidst the destruction of personal privacy which the so-called “Department” of Government Efficiency (DOGE) is currently instituting.
But, Khanna has also taken stances that are more controversial among leftists. In the weeks before Trump’s inauguration, Khanna wrote favorably about DOGE, giving fuel to the idea that he is too close to Silicon Valley and its technocrats. He also raised leftists’ ire over his ties to Hindu nationalists and for lobbying for Indian Prime Minister Narendra Modi, who is a member with the far-right BJP, to address Congress in 2023.
A problem for both Ocasio-Cortez and Khanna is that, if they were to move directly from the House of Representatives to the presidency, they would be the first to do so since James Garfield, in 1880. This isn’t to say that it’s impossible for any candidate to make this jump, just that, over the last century and a half, more presidents have come straight from the ranks of television show hosts than they have from the U.S. House of Representatives.
Labor and Its Allies
A middle ground between recruiting a candidate through the political establishment and a more radical departure from the norm could be to turn to organized labor. Democrats have long counted union members among their most reliable constituencies (although there is some evidence that that association is weakening). Approval for labor unions is also at a high point since the mid-1960s, and labor leaders are becoming more prominent members of the political commentariat, if not quite yet household names.
Most visible among this group is probably Shawn Fain, the president of the United Auto Workers (UAW) since 2023. Fain was one of Trump’s most vocal critics during the presidential campaign, but has substantially moderated his approach toward Trump in the months since the election and has even spoken approvingly of Trump’s tariff policy.
While his occasionally conciliatory attitude toward the Trump administration may rankle some on the left, Fain’s unorthodox approach to the administration may work in his favor. He could use his unique politics to avoid being cleanly labeled as either a Republican or Democrat, and lead with his “pro-worker” brand instead.
Sara Nelson would be another strong contender from the world of labor. Nelson, who has been president of the Association of Flight Attendants since 2014, has been among the most visible and militant labor leaders of the last 10 years. She rose to prominence while advocating for members of her union during the 2019 government shutdown in Trump’s first term, and none other than Bernie Sanders lobbied Joe Biden to name Nelson labor secretary in his administration.
Nelson’s path to achieving widespread name recognition would be much steeper than Fain’s. While Fain is head of one of the most well-known U.S. labor unions with hundreds of thousands of members spread across multiple industries, Nelson heads a much smaller association. And, despite her status as a darling of left organizers, she is still broadly unknown to the wider electorate and, of all the aforementioned candidates, would have to spend the most time driving up her name recognition.
Any candidate who came from organized labor would need to also reckon with whatever labor activity is spinning up as 2028 approaches. Fain and the UAW are gearing up for a potentially massive labor action on May 1, 2028. While the left is sure to support a labor action of this size and scope, presiding over a large-scale strike and the possible months of subsequent negotiations could significantly complicate a labor-aligned candidate’s ability to simultaneously run a presidential campaign.
The Trumpian Tack
Finally, of course, a candidate could come from entirely outside of the political sphere. Since Donald Trump rode his golden escalator into infamy, many entertainers, commentators, and public personalities have toyed with the idea of running for the land’s highest office. The field here, at least for leftists, is a bit thin.
The comedian and host of The Daily Show, Jon Stewart, may be the likeliest pick in an unlikely scenario. Stewart has been propositioned as recently as the last presidential cycle. Although he quickly put that possibility to rest, 2028 will be a different game entirely. In 2024, Stewart was seen as a hail Mary option as Democrats anguished over their unease with keeping former President Joe Biden at the top of the ticket. In 2028, he may be a frontrunner in a wide open primary. Stewart would bring sky-high name recognition and a preexisting base of loyal fans with whom he’s nurtured a connection since the George W. Bush administration. He would also bring the media savvy and knack for comedic timing that Trump himself leveraged to paint his competitors in the 2016 Republican primary as hopeless dullards.
Drafting Stewart into this role is unlikely, and probably best viewed as a fallback, unless he expressed enthusiasm for the job. Assuming he’s not interested, the picture quickly becomes bleak. While the left has a vibrant and expansive ecosystem of podcasters, streamers, content creators, and commentators, growing any individual micro-fandom into a base of supporters large enough to win the Democratic nomination would be a Herculean task, to put it mildly.
A Coalition of the Willing
Finding the right candidate will only be half the battle. Critical, too, will be assembling a coalition of left leaders, organizations, and activists who will form the base of support for that candidate. Conversations among potential members of this group should begin quickly, and aim toward developing a consensus list of preferred candidates. Gaining broad buy-in for this strategy will be essential to getting any effort like this off the ground.
So, who would be part of this group? To be vague and a bit cowardly, I’d say that any person or group who supports the above-described platform should be part of this coalition. More specifically though, this coalition would have to draw together grassroots activists; significant parts of organized labor; and left-leaning, party-adjacent groups who lobby the party on matters of strategy and policy. These different groups would have to set aside interpersonal differences and agree to support whomever the coalition is eventually able to recruit to run, regardless of their personal affinity for, or proximity to, this person. This is a tall order, but members wanting to be part of this network should keep in mind lessons from the past: The left best serves corporatist Democrats when we descend into internecine squabbles and leave the door open for multiple entrants to claim the “progressive” mantle. If we want this effort to be successful, we must be resolute and unambiguous in our promotion of a single person.
We Are Coming to Save Us
The last few months have made it crystal clear that neither our institutions nor the grandees of the old Democratic establishment will save us from encroaching authoritarianism. Neither will appeals to restoring an old, vanished order or promises that nothing, fundamentally, would change with the Democrats in charge.
However, the Democratic Party cannot afford to drift, rudderless, through this Trump administration. It must present a strong counterpoint to the policies of this White House, and soon. One of the surest ways of doing that would be to appoint a new class of leaders who are more prepared to take on the rising fascist tide—a class of leaders who understand how grave, and late, the hour is for our democracy. If the corporatist class of the party will not make this pivot, leftists must do it for them. And, for our part, nothing could be a more concrete statement of the left’s intent for the next four years than to appoint a progressive champion well ahead of schedule.
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Trump Offers Medicare for All Supporters a Very Valuable Lesson
While it certainly was not Trump’s intention, his loony tariff scheme may have opened the door for universal healthcare system in a way that a normal presidency never would.
Apr 10, 2025
Although it surely was not intended, Trump’s tariff plan may have opened the door for the Democrats to push for and win Medicare for All(M4A), a longstanding goal for progressives. It does this in two ways. First Trump was able slip by this massive tax scheme with almost no attention from the media. Democrats should demand Trump treatment when they push M4A.
The second reason is that Trump’s tariffs show that it is politically acceptable to tax the middle-class. Trump’s tariff scheme is a tax increase for middle-income households of several thousand dollars annually. If that is politically acceptable, then surely much smaller tax increases that may be needed to cover M4A would surely be politically feasible.
On the first point, Trump did talk about tariffs in his campaign, but there was very little written about how big his tariffs would likely be and how large a hit they would be to middle and moderate-income households. For this reason, most people, including those who follow the news closely, were shocked by the size of Trump’s tariffs. This is why the stock market crashed immediately after Trump’s tariff speech. If investors had expected anything like the tariffs Trump is putting in place, the market would have already priced in the impact of the tariffs.
To be clear, the media did note Trump’s call for tariffs, but they never demanded or received any specificity from Trump. By contrast, any time Vice-President Harris put forward a proposal, like her plan for covering assisted living for senior citizens, the media demanded to know exactly how she would pay for it.
Democrats have to learn to be Trumpian in dealing with the media. They can say we will have M4A, in fact improved M4A that covers dental, vision, and hearing, and we will find ways to pay for it because we’re a rich country: end of story. The days where we just accept that the media demand higher standards from Democrats than Republicans must be over. Trump gets to say f**k you when he doesn’t feel like answering a question. The Democrats need to do this also.
The second takeaway is that it is apparently not politically deadly to talk about tax increases on the middle-class. Trump and every Republican in Congress are just fine with a huge tax increase on the middle-class in the form of his massive tariffs.
Since Trump’s tariffs have shown that a large tax increase on the middle-class is just fine politically, they need not fear putting forward a modest one to two percentage point tax increase in order to give people near-free health care.
In principle, most of the cost of M4A should be covered by lower payments for drugs and medical equipment, by bringing the pay of our doctors and dentists in line with their pay in other wealthy countries. We also will save hundreds of billions of dollars annually by getting rid of private insurers and replacing them with the far more efficient Medicare system.
But we are still likely to need additional revenue. Most of this money should come from the rich, who have been the big winners in the economy over the last half century. But it is likely that we won’t be able to get as much as we need exclusively from taxing the rich.
As our Modern Monetary Theory friends remind us, the purpose of taxation is to reduce demand in the economy and thereby prevent inflation. If we raise another $10 billion a year from increasing the taxes paid by Elon Musk, it’s not clear how much we will reduce demand. Musk will probably continue to consume at pretty much the same level as he did before the tax hike, although he may reduce his campaign contributions to right-wing candidates by some amount.
By contrast, if we raise an additional $10 billion in tax revenue from the middle-class, we can be pretty sure that we will be reducing demand by close to $10 billion, because middle-class people spend the bulk of their income. In the last two decades, Democrats have treated it as sacred first principle that they could never increase taxes on people earning less $400,000 a year.
Since Trump’s tariffs have shown that a large tax increase on the middle-class is just fine politically, they need not fear putting forward a modest one to two percentage point tax increase in order to give people near-free health care. Whatever they do put forward they can put in terms of the Trump tariffs. For example, they could put a ceiling on any middle-class tax hike, saying it will be no more than one-quarter of the tax hit from Trump’s tariffs.
In addition to being good policy, M4A should be great politics. People have come to like Obamacare over the fifteen years since it was made into law. It is now so popular even Trump doesn’t openly talk about ending it. The idea of extending Medicare to cover the whole population is likely to be extremely popular and it is a simple proposal that can be easily understood. M4A is a perfect bumper sticker slogan for cars and pickup trucks all across the country. It tells everyone what Democrats will do for them if they are put in office.
While it certainly was not Trump’s intention, his loony tariff scheme may have opened the door for Medicare for All in a way that normal presidency never would. If democracy survives, we may get some real gains as a result of the Trump presidency.
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Medicine Demands Trust—Dr. Oz Has Spent His Career Undermining It
If given the reins of CMS, Dr. Mehmet Oz will not only fail to improve healthcare for our seniors but also use privately managed care to actively harm Americans. The Senate must reject his nomination.
Mar 13, 2025
Medicine is about trust. As a medical student, I’ve been taught that trust in medicine is built on honesty, evidence, and a commitment to patient well-being—principles that should guide physicians and leaders in healthcare. But how can we trust a man who built a career on misleading patients to oversee healthcare for 160 million Americans?
Dr. Mehmet Oz, a former TV doctor notorious for promoting unproven “miracle cures,” has been nominated by U.S. President Donald Trump to lead the Centers for Medicare and Medicaid Services (CMS)—an agency that millions of seniors, children, and low-income families depend on for care. Yet, he promotes predatory Medicare Advantage programs and unscientific remedies that harm citizens. His nomination cannot stand.
As I take care of my own patients, I am consistently trained to practice evidence-based medicine and uphold ethical standards that prioritize patient well-being. Dr. Oz, in contrast, has used his platform to spread misinformation, undermining the very trust that medicine depends on. Formerly a well-regarded cardiothoracic surgeon, Dr. Oz began his journey toward harm over healing on the “Dr. Oz Show,” a nationally televised program on which he promoted unproven treatments that interfered with patients' appropriate medical care.
As the head of CMS, he would have direct influence over policies that could drive billions in profits for private insurers, companies that he has already aligned himself with.
Pennsylvania doctors even launched “Real Doctors Against Oz” to protest his 2022 U.S. Senate run, arguing that he was a “major threat to public health.” He skirted ethical responsibilities when he supported evidence-lacking recommendations to use hydroxychloroquine for Covid-19 while owning stock in the pharmaceutical companies that supply the drug and has been criticized by Congress for inappropriate claims he made about green-coffee extract as a weight-loss medication.
Dr. Oz will have an even more deleterious impact on seniors’ health, having expressed a clear intent to expand Medicare Advantage, privately managed Medicare. Medicare Advantage (MA) is rapidly reshaping senior healthcare at the expense of patient well-being. In Maryland, the proportion of MA enrollees to total Medicare beneficiaries has more than quintupled (5% to 27%) in the last decade. Seniors in these plans, especially those with significant medical conditions, are more likely to drop these plans and return to traditional Medicare because of increased denials of medically necessary care and delays accessing care due to narrow networks and increased bureaucracy. Becoming locked into a system where administrative bloat and corporate profits result in up to $140 billion in overpayments annually to Medicare Advantage companies would not only drain the Medicare trust fund but also harm seniors as cancer patients in Medicare Advantage face worse outcomes.
Even more concerning, Dr. Oz currently has a personal financial stake in the expansion of Medicare Advantage. His disclosure forms reveal he owns between 280,000 and 600,000 shares in UnitedHealth Group, the largest Medicare Advantage insurer. He has committed to divesting from these holdings if confirmed. Even still, as the head of CMS, he would have direct influence over policies that could drive billions in profits for private insurers, companies that he has already aligned himself with. Dr. Oz’s profiteering from these investments represents his prioritization of financial self-interest over patient well-being—and makes him uniquely unqualified to oversee public health programs.
Right now, we are pivoting sharply toward doing more harm at a time when we desperately need to pivot toward providing better healthcare for everyone. Medicare for All is supported by 69% of registered voters and provides truly universal coverage while cutting administrative overhead, reining in healthcare costs, and saving Americans thousands by removing the private insurance middleman. More importantly, it would make America healthy again; with prevention and primary care finally prioritized, Americans can enjoy better healthcare outcomes and quality of life.
As a Philadelphia anesthesiologist said in The New York Times, “I can’t believe he took the same oath that I did when we graduated… that oath is about first doing no harm.” As I prepare to take this same oath, I am appalled that someone who has so blatantly violated its principles could be entrusted with the health of millions. If given the reins of CMS, Dr. Mehmet Oz will not only fail to improve healthcare for our seniors but also use privately managed care to actively harm Americans. The Senate must reject Dr. Oz’s nomination. His long track record of misleading the public, pushing corporate interests, and prioritizing profit over patient health makes him wholly unfit to lead CMS.
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