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Start free trial →The Ezra Klein Show · Ideas & Essays · September 2026
Abdul El-Sayed, the Democratic nominee for U.S. Senate in Michigan, answers Ezra Klein's question on The Ezra Klein Show about whether Medicare for All should be a floor and a ceiling for coverage or only a floor.
Sure.
…health insurance in Canada, right? There are other countries like France that have a baseline public insurer and then supplemental insurance on top of that. So when you think about the ideal healthcare system, do you think about a floor and a ceiling? Do you think about a floor and not a ceiling?
…about it as a floor. And to get at the question explicitly, imagine it to be like public schools. No matter where you live, you have a public school system that is there for your kid. You pay taxes into that system. That system is always going to be there for you. You may enroll your kid, you may not enroll your kid. That is still there for you, right? You are guaranteed a public education. Medicare for all is that guarantee. Everyone's enrolled, everyone pays in. If you would like to have a private insurer above that, you're welcome to do that. But our goal is to build a floor so high that most folks would be like, why would I? This covers everything I possibly could need. The other important differentiator here is that when we're talking about Medicare for All, we're not talking about health care. We're talking about health insurance. One of the things that people don't appreciate about our current system is that the current system actually chokes off innovation in the healthcare provision side. So just to put in…
One of the things I think I'm seeing here is something I'm sort of seeing more broadly in the Democratic Party right now, which is, I remember watching this form in 2006, 2007, before the Affordable Care Act, where you had a lot of parts of the party beginning to converge on roughly what was the…
So let me say the fastest way to get to Everest would probably be to drop out of an airplane onto the top of Mount Everest. So I don't want to give up on the idea that we might have momentum into the first day of 2029 with a new president who's like, I'm ready to go on this. The nature of the…
are in Medicare Advantage plans.