Abdul El Sayed discusses Medicare for All with Brian Tyler Cohen (13 minutes), YouTube Podcast – Brian Tyler Cohen, January 17, 2026
Brian Tyler Cohen: And so, first and foremost, I understand that that when people think about Medicare for all, it still feels like it’s sorted into the very progressive camp, but from the folks that you’ve spoken with who are not necessarily super far-left, does it feel like this is a moment where there’s actually an embrace of something like Medicare for all?
Abdul El Sayed: You know, once you get past the left-right framing that all of us try to put our politics into and you actually go out into communities across the country, and I’ve been doing this up and down my state, you realize that most folks don’t really ask whether or not this is too progressive for me. They’re asking, “Does this actually solve a problem I really have?”
And even when you go back to the passing of the ACA … President Obama called it a starter home. And we have outgrown the starter home. And to me, the big failure, right, … is that it relied on a profit motivated health insurance industry to provide the bulk of the American public healthcare. And when you have profit motivated insurance and profit motivated healthcare providers, at some point all that profit comes from somewhere, which is your and my back pocket. And we’ve now come to a place where that has become unsustainable. …
We’ve just created a system where private health insurance can profit off of providing insurance to people when they’re their healthiest. And they don’t want to do it, you know, when they get sicker. They’ve created these advantage programs where they’ll take Medicare dollars, pocket them, and then use prior authorization to gatekeep seniors from their healthcare. They do that, but the whole thing’s a money grab, right? And so we don’t need private health insurance. If people want private health insurance, great. But you shouldn’t have to rely on it because it’s fundamentally unstable and it’s created this tiered system that creates challenges for people when they actually just want to get the care that they need.
BTC: Yeah. And by the way, I lived in France for a couple years after college and they have they have socialized health care, but then they also have a private offering. They call it a “mutuelle”, but it would be the same thing. I mean, you can buy extra health coverage if you want it, but otherwise, everybody’s covered. I remember I have two herniated discs in my spine. It’s a long time wrestling injury, and so I needed uh I did like electric stim and deep tissue massage and whatever just to like keep me in in one piece. But I remember finding a doctor in France who did that for sports medicine and whatnot. And I remember going and asking how much how much it would cost and everything gets reimbursed if you lay money out. And they said it would cost like would cost like €2.80. And I was like €2.80, and they were like but you’ll get it back. And she thought I was upset that I was going to have to lay out the money. She thought I was upset that I was going to have to like pay €2.80 and not that I was expecting her to say that it was going to cost like $275, you know.
AES: So we don’t have to live this way. Yeah. You know, that’s the funny thing about it, right, is that the idea that you would want to do something similar to somebody in a different country is somehow so terrible. …It’s crazy to me, right? Every country in the world has a military. Some militaries run better than other militaries. But nobody’s like, “Well, that country has a poor military, so our military is going to be trash, too.” You never hear that argument.
So my point is, look, we’re the United States of America. We have never settled for less than the best except for when it comes to healthcare. We’re okay with middling to complete shit infant mortality rates. … We don’t have to live like this. There is no reason why we cannot build the best health care system in the world.
[ Full transcript here. ]
Comment:
By Jim Kahn, M.D., M.P.H.
There is ongoing documentation in news media and reform newsletters on the failings of US health insurance – such as HealthCare un-Covered on ACA subsidy challenges and JustCare on Medicare Advantage gaming and rising drug prices. That’s essential, highlighting the futility of our chaotic approach.
But it’s also the perspective opponents of true reform want us to adopt – focused on nudges to our current dysfunctional system. Rather than highlighting system overhaul.
So … I was thrilled to hear the discussion between Abdul El Sayed (public health physician and candidate in the Democratic primary for US Senator from Michigan) and Brian Tyler Cohen (actor turned highly successful political podcaster). For half of their interview, they focused on Medicare for All. It’s worth a full listen (or a read … transcript link above).
I followed up with Abdul. He elaborated on his (and our) vision for Medicare for All: “Everyone in, nobody out. Medicare would be there for you regardless of your circumstances, whether you have additional private insurance or not. It’s guaranteed, always present, and any additional private insurance would be on top of Medicare. … And Medicare should cover every piece of healthcare folks could need.”
He elaborated: “I imagine that most folks would opt not to pursue additional private coverage for that reason. That said, if the idea of “choice” is what is keeping some folks from supporting M4A, I’m open to keeping their private option open as a matter of guaranteeing public insurance for everyone.”
This Medicare for All vision aligns with what dozens of other wealthy nations do. First, assure that everyone has the same comprehensive benefits, provided publicly or via not-for-profit private insurance. Then, permit supplemental insurance that adds specialized benefits or perks like private hospital rooms.
As Abdul said in the interview, “There is no reason why we cannot build the best health care system in the world.” Single payer.
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