Free Healthcare For All — Tax the Rich!
by Em Smith, Kshama Sawant, Calvin Priest
The private, for-profit healthcare system is killing us, and millions of working people know it. Tens of thousands of Americans die every year from lack of healthcare. There is huge anger at the billionaire and multimillionaire executives and shareholders of health insurance corporations and Big Pharma, who are getting rich from denying coverage to people who desperately need it.
Two in three Americans want universal publicly provided healthcare, with 90 percent support among Democratic Party voters. Support is also historically high among independent and Republican voters.
The Shocking Brutality of the U.S. Healthcare System
The U.S. healthcare system is a horror story of ravaged lives.
Every worker has had to deal with the maze of private healthcare plans, the guessing game of which insurance will cover what you need, the endless bureaucracy of every health insurance company even once you manage to get insurance, and the nightmare of being denied a claim.
Medical debt is the single biggest reason for personal bankruptcy, with more than 65 percent of bankruptcies being attributed to medical debt as the primary reason. According to Gallup, 82 percent of people worry about the cost and accessibility of healthcare, and public approval of U.S. healthcare quality is at a record low. Since the Democratic Party under President Barack Obama spectacularly sold out the movement for Medicare for All in 2009-2010, medical bankruptcies have continued unabated despite the so-called Obamacare or the Affordable Care Act. During that same period, the top five health insurance companies made over $370 billion in profit, the largest share of which went to UnitedHealth Group, which has seen annual profits increase by nearly 400 percent.
The widespread reliance on health insurance through the employer puts workers in a miserably precarious position. Getting fired or laid off, or even leaving your job voluntarily, usually means losing your healthcare. For unionized workers, healthcare is put on the chopping block by the bosses every time the union contract is up for renewal, and revocation of health insurance is often used as a strike-breaking weapon.
Then there are the costs. Between premiums, co-pays, deductibles, and out-of-pocket costs, American workers collectively pay more than a trillion dollars every year for healthcare out of their own bank accounts. But despite paying twice as much per capita for healthcare than other wealthy countries, the American working class has worse health outcomes. This includes a disastrous decline in life expectancy for Americans in recent years. Life expectancy still lags pre-pandemic levels, and Americans live four fewer years on average than working people in other industrialized nations.
So where does all our money go? Into the pockets of the uber-rich top executives and major shareholders of for-profit health insurance companies, Big Pharma, and for-profit hospitals.
The People’s Policy Project estimates over $500 billion in additional direct administrative waste from the bureaucracies required by health insurance companies to deny patients’ claims. And denying claims is how they make their profits: United Healthcare, the company whose CEO, Brian Thompson, was killed last December, allegedly by Luigi Mangione, denied 33 percent of all claims in 2023, for a total of nearly 4.7 million denied claims. These numbers show exactly why 70 percent of Americans said that health insurance companies were at least partly to blame for the killing of Thompson.
A Historic Opening to Win Free Public Healthcare for All
There is a huge opening to launch a serious fight to win free public healthcare — to take down the health insurance industry once and for all, and begin ripping the profits out of the U.S. healthcare system.
But neither Democrats nor Republicans — both parties of big business — will lead such a fight. On the contrary, their decades-long track record shows clearly that both are actively enemies of any movement to win free public healthcare. Far from allowing or leading on any progress in the interest of working people, both parties have repeatedly attacked even the basic public healthcare protections that American workers have won. The Republican Party is openly hostile to any public healthcare program. While the progressive establishment offers some lip service, the Democratic Party has also undermined efforts at winning Medicare for All. Unfortunately, most of the labor and NGO leadership is tied at the hip to the Democratic Party and has been unable and unwilling to make any breakthroughs, either.
Working people and rank-and-file union members need to build an independent fightback to win free public healthcare funded by taxing the rich, and urgently.
That’s why the members of Workers Strike Back and Revolutionary Workers have democratically voted to launch a “Free Healthcare for All — Tax the Rich” movement nationally, beginning with a ballot initiative campaign in Seattle. Alongside this, Workers Strike Back founder Kshama Sawant is running in Washington state’s ninth Congressional District as an independent antiwar, pro-worker socialist against Democratic Congressmember Adam Smith, who is one of the overwhelming majority of Democrats and Republicans in the U.S. Congress bankrolled by health insurance and Big Pharma corporations. Sawant’s campaign is calling for free healthcare nationally, and is also a crucial vehicle for building the Seattle ballot initiative campaign.
We need to win free healthcare for all nationally and tax the rich hundreds of billions of dollars to pay for it. To do so, we can’t afford to repeat the failed approach of Bernie Sanders, AOC, and most NGO and union leaders, who have led us back into the graveyard that is the Democratic Party.
We need an independent fighting strategy that has a proven track record, and which recognizes that in order to win against the billionaires, we need to defeat both the Democratic and Republican Parties.
Trump is a Con Man
Millions of working people voted for Trump out of a desperate hope that he could make things better. Trump was able to present himself as an alternative — whether on healthcare, immigration, or the war on Gaza — because of the stunning betrayals by the Democratic Party.
In 2024, Donald Trump declared that “Obamacare Sucks.” He promised to create a healthcare plan that would be “much much better and far less money.”
Trump is a con man and has done enormous damage to working and oppressed people in his first six months in office. But what he said about Obamacare is true — it sucks. While it did expand Medicaid for millions of people and allowed young people to stay on their parents’ insurance, these were only given as concessions to working people who were demanding much more: a single-payer healthcare system that would cover all Americans for free. Obama himself promised a universal public option during his 2008 campaign, and went back on that promise. Obamacare was created in close coordination with a private health insurance industry whose sole motivation was to defeat the single-payer movement and protect their own untold profits. Obamacare did nothing to fix the deep crisis in the healthcare system caused by the for-profit insurers.
Trump, who is a billionaire himself and nakedly serves the agenda of the super-wealthy, has no intention of making healthcare better for working people, either. Despite Trump and many Republicans pledging repeatedly to never cut Medicaid, they have done exactly that. In addition to a staggering trillion dollars in cuts to Medicaid, the Republicans carried out huge cuts to other critical health programs, including $536 billion in cuts to Medicare that will kick nearly 1.4 million low-income seniors off of the Medicare Savings Plan, raising their out-of-pocket healthcare costs by thousands of dollars a year.
The Democratic Party’s Vicious Fight Against Public Healthcare
Congressional Democrats refused to fight Trump and the Republicans’ massive cuts, ignoring the vocal demands from their base. Not one of the Democrats used their elected office to even call for a mass rally opposing the cuts. Meanwhile, Democrats have carried out billions in draconian budget cuts of their own around the country, including cuts to healthcare services for working and poor people.
Two months before Trump and the Republicans passed their spending bill, which includes a provision to “defund” Planned Parenthood and other abortion providers, Washington Governor Bob Ferguson and the state Democrats passed a budget that slashes abortion access funding by 55 percent. In three states — Minnesota, California, and Illinois — state Democrats have joined Trump’s war on immigrants by eliminating programs that currently provide Medicaid or similar coverage for over a million undocumented immigrants. As the head of one healthcare provider said of the cuts in California: “People are going to die.”
Trump’s cuts to Medicaid and Medicare were not the first, either. In 1997, the Democratic Party under President Bill Clinton led the Balanced Budget Act, which savagely cut Medicare and Medicaid by nearly $150 billion. The bill also opened the door to privatizing Medicare. (Adam Smith, Kshama’s opponent in her independent campaign for Congress, was among the Democrats who voted in favor of the bill.)
The Democratic Party has fought particularly viciously against working-class movements for free universal healthcare.
“Medicare for All” as a demand helped galvanize tens of millions of young people and workers to support Bernie Sanders’ Presidential campaigns in 2016 and 2020. In both cases, the Democrats maneuvered to crush that effort in the primary elections.
Some activists have attempted to win single-payer healthcare at the state level. But the Democratic Party also maneuvered to smother those campaigns.
In Vermont, under massive pressure from the working class, Democratic politicians were forced to pass a statewide single-payer healthcare bill in 2011. But the Democrats passed it without any plan to fund the new program even though it was very clear how it ought to be funded — by taxing the rich! A refusal to tax the rich is a commonly used sleight of hand by Democrats to thwart the progressive causes they claim to support. What occurred in Vermont was directly from this playbook.
In 2014, Vermont’s Democratic Governor Peter Shumlin, backed by a Democratic majority in the state House of Representatives and Senate, threw up his hands and rescinded the single-payer law. This was done with all the requisite show of lament by the Democrats, and we-told-you-so pronouncements from liberal media that working people needed to learn the “sobering lessons” about the “extraordinary difficulty” of transforming the “naive” idea of public healthcare into a reality. At no point did the Democrats or liberal media or anyone from the progressive establishment so much as verbalize the question of taxing the rich to fund the single-payer program.
In the state of California, the Democratic Party was even more blatant in sabotaging the effort for single-payer, not once but twice, in 2017 and 2022. The leadership of the California Nurses Association/National Nurses Organizing Committee (CNA), the largest affiliate of the National Nurses United, helped lead campaigns for the California Guaranteed Health Care For All (CalCare) bill, an extremely popular universal healthcare proposal. Both times, the CNA introduced the bill jointly with the state Democrats. Both times, the Democratic Party had the Governor’s mansion and a supermajority or near-supermajority in both houses of the state legislature. And both times, a leading Democrat blocked the CalCare bill and refused to bring it to a vote. In 2017, it was Democratic state Assembly Speaker Anthony Rendon and in 2022, it was Assemblymember Ash Kalra, the very sponsor of the bill, who pulled the plug.
Gavin Newsom, California’s Democratic Governor, played an equally rotten role. In 2018, Newsom pledged on the campaign trail to create a single-payer system for California, saying: “I’m tired of politicians saying they support single-payer but that it’s too soon, too expensive or someone else’s problem.” As soon as he was elected, he backed away from it. And then when his fellow state Democrats quietly stamped out the bill in 2022, Newsom “remained mum.”
Why have Democrats fought so hard against movements for free public healthcare? Because the Democratic Party, like the Republican Party, is a capitalist party that represents the interests of the wealthy, not working people. It’s a party of the bosses who see any form of public healthcare as a direct threat to their profits (and they’re right). They buy out the politicians in both parties, particularly those in the Democratic Party, whose base strongly supports publicly funded healthcare. In 2024, Blue Cross Blue Shield gave nearly twice as much in campaign contributions to Democrats as Republicans. Democrats are also the favored party of Big Pharma, though both parties rake in millions from the industry. Healthcare industry CEOs overwhelmingly donate to Democrats. The California Democratic Party has received many millions of dollars from health insurance and Big Pharma. It was likely not a coincidence that when Shumlin scuttled the Vermont bill, he was the chairman of the Democratic Governors Association, whose leading donors included UnitedHealthcare, Blue Cross, AstraZeneca and the pharmaceutical industry’s trade association.
Despite all this, AOC and Bernie Sanders have refused to break from their strategy of working inside the Democratic Party. Sanders endorsed Hillary Clinton, then Joe Biden, then Kamala Harris. AOC has done the same. Their “Fight the Oligarchy” tour has revived the slogan of “Medicare for All” in name. But their only message is for working people to vote for the Democratic Party in the 2026 midterm elections, which is the opposite of a strategy to win healthcare.
In April of this year, Democrat Pramila Jayapal introduced a bill in Congress for Medicare for All. Once again, in characteristic performative fashion, neither Jayapal nor AOC nor Sanders nor any politician from the progressive establishment even brought it to a vote or built any public momentum around it.
Workers Need to Build Independent Campaigns Against Both Democrats and Republicans
Throughout history, working and oppressed people have won major breakthroughs by carrying out militant fights independent of the capitalist parties, even in the midst of major attacks from big business and their politicians.
In the 1930s, in the depth of the Great Depression with 12.8 million workers unemployed in the United States and fascism rising internationally, the most significant breakthrough for working people happened with three major offensive fights: general strikes by workers in Minneapolis, Toledo, and San Francisco. All three of these strikes were led by revolutionary socialists. Their demands included wage increases, shorter hours, and union recognition. They resulted in major victories that inspired a powerful strike wave across the country. The labor movement took a giant step forward, which not only laid the basis for more offensive fights, but also strengthened the movement to defend against attacks from big business and the right wing.
Likewise in the 1950s, as McCarthyism was chasing socialists out of labor unions and as a resurgence of the KKK and White Citizens’ Councils led to the terrorizing of Black communities including the murder of Emmett Till, the most significant breakthroughs were offensive ones. The Montgomery Bus Boycott forced the Supreme Court to desegregate buses and sparked a decades-long Civil Rights movement that broke the back of the brutal system of Jim Crow segregation. The movement won the first civil rights law since Reconstruction in 1957, and many more victories in subsequent years. These victories forced the right wing into retreat and helped prepare the ground for other powerful movements, including the Vietnam antiwar movements, gay rights movement, and a new wave of labor struggles
Unfortunately, the vast majority of the union leadership has spent the last several decades giving the progressive Democrats cover — or worse. Most of the union leadership refused to even endorse Sanders’ campaigns in 2016 and 2020. In contrast, they unequivocally endorsed out-and-out corporate Democrats like Clinton, Biden, and Harris — in most cases without even a vote of union members.
Working-class anger against both the Republicans and the Democrats is at a historic high. Congressional Democrats are even more unpopular than Trump! There has been a “stampede” of working-class voters away from the Democratic Party because of all their betrayals. “Of the 30 states that track voter registration by political party, Democrats lost ground in every single state between the 2020 and 2024 elections — and often by a lot.” As an elections analyst described it, it is like the Democratic Party has gone into a “death cycle.” A CNN poll shows that 63 percent of Americans want a new party, but they reject another billionaire-backed party like the new right-wing party proposed by Elon Musk. What Americans want is a new working-class party.
Yet, most labor leaders and other leaders on the left are still engaged in keeping the Democratic Party on life support. Rank-and-file workers need to reject this and fight to build independent campaigns that can win concrete demands.
Lessons from Kshama Sawant’s Ten Years as an Independent Socialist Representative
Kshama Sawant ran her first election campaign for the Seattle City Council, in 2013, as a vehicle to build mass support for a $15/hour minimum wage and taxing the rich, and she became the first socialist in nearly 100 years elected to office in the city. Kshama and her fellow socialists immediately went into action, launching the 15 Now campaign that mobilized tens of thousands of workers and forced the hand of the Democrats and their corporate masters. Within six months of Kshama taking office, our movement won. That minimum wage is now the nation’s highest at $20.76/hour, due to the inflation adjustments we won.
Kshama was the lone socialist on the Seattle City Council between 2014 and 2023, with all other councilmembers being Democrats. During that decade, Kshama and her office won countless historic victories for working people. In addition to the minimum wage increase, our movement won the Amazon Tax that raises hundreds of millions of dollars annually for affordable housing, the nation’s strongest resolution calling for a ceasefire in Gaza, the first ban on caste-based discrimination outside of South Asia, free abortion, and a long list of unprecedented renters’ rights including a $10/month cap on late rent fees, a ban on winter evictions, a ban on school year evictions for children and public school workers, and a three-months-rent compensation paid by any landlord who carries out a rent increase of 10 percent or more that forces the tenant to move.
Every single one of these victories was initially opposed by a large majority of the Democratic City Councilmembers, including often by the self-described progressives. Kshama won the victories because she used her office to build independent movements and went to war against the Democratic establishment, rather than trying to appease it.
The CNA’s fight for CalCare, while extremely well-intentioned, resulted in defeats due to the Democratic Party’s betrayals and because the union’s leadership failed to take the most crucial step that is necessary for victory: breaking from the Democratic Party and waging an independent, offensive campaign against the rich and both their parties.
This would have meant carrying out fighting tactics that could make the Democratic politicians fear the working class more than the billionaires. First and foremost, it would have required the Calcare movement’s leadership to not put any faith in the Democratic Party politicians. It would have meant organizing mass protests that could put real pressure on the Democrats, as well as bold public comment in the legislature meetings, exposing each Democrat by name and publicly shaming those doing the bidding of the billionaires.
A crucial tactic to win the bill in the legislature would have been collecting hundreds of thousands of signatures for a ballot initiative campaign as a credible threat, with the clear message that the CalCare movement would go directly to the voters if the Democrats refused to approve the bill.
All of these tactics, including ballot initiative threats where we collected tens of thousands of signatures, were crucial in our 15 Now and Amazon Tax victories in Seattle. Seattle’s Mayor at the time, speaking on behalf of the big business and Democratic Party establishment, publicly acknowledged that the legislation passed under pressure from the credible threat of our 15 Now ballot initiative, which “had the potential of passing.”
Last but not least, winning would also involve running strong campaigns of independent working-class candidates against the Democrats who sold out. This is integral to any serious working-class fightback. As a California newspaper noted after the 2022 CalCare debacle, “even the threat of losing” labor endorsements “in the upcoming election cycle was not enough to persuade the Assembly’s Democratic supermajority to advance the bill.” This is for the simple reason that the Democrats do not feel any threat unless the labor movement launches independent, serious working-class challenges against them, as Democrat Adam Smith now faces with Kshama Sawant.
Independent Campaigns for Local and State Ballot Initiatives:
A Battering Ram to Win Free Healthcare Nationally
Workers Strike Back has begun building for a ballot initiative in Seattle to win free public healthcare citywide, including full coverage for dental, vision, abortion, and gender-affirming care. This would be paid for by a $5 billion expansion of the Amazon Tax — a tax on the city’s wealthiest businesses, not working people
Winning free healthcare in a major U.S. city would act as a battering ram in the fight for universal public healthcare nationally. It would be a demonstration to working people of Workers Strike Back’s slogan: “When We Fight — We Can Win.” And it would decisively break the impasse caused by the failure of progressive Democrats like Bernie and AOC to put forward a real strategy to win Medicare for All.
Canada’s free healthcare system (which is called Medicare, and covers everyone in Canada) began as a local victory led by militant socialists and workers independent of the pro-capitalist parties. They won it first in Saskatchewan, which at the time had a population of about 900,000 — not much bigger than Seattle. That victory emboldened workers in other provinces, who fought and won similar victories. Ultimately, the strength of the movement forced a conservative government to implement Medicare nationally.
Similarly, the $15 minimum wage victory won by Kshama in Seattle spread nationally, inspiring workers in dozens of cities and states to fight and win wage increases. Today, over a third of all workers in the U.S. live in a jurisdiction with at least a $15/hour minimum wage. By 2027, it will be almost half of all workers.
American workers need powerful examples like these in our fight for free healthcare.
Seattle is one of the wealthiest cities on Earth. A recent report revealed that Seattle has 11 billionaires and 130 individuals worth more than a hundred million dollars. The Seattle area is home to some of the wealthiest corporations in the world, including Amazon, Microsoft and Boeing. Just the five biggest employers in Seattle raked in $170 billion in profit in 2024. Meanwhile, tens of thousands of renters and working people are struggling to get by, and Seattle has the third-highest rate of homelessness in the country.
A $5 billion a year tax on the richest corporations in Seattle would be a small fraction of the massive wealth that exists in the city. And for working people, free healthcare would quite literally save lives. It would also dramatically advance the fight for free healthcare nationally.
How We Can Win
Winning free healthcare in even one U.S. city will be a massive uphill fight. The Democratic Party and big business will do everything they can to stop us. After all, the very existence of the trillion-dollar health insurance industry relies on working people not winning victories like these.
Big business will spend millions of dollars to try to stop our ballot initiative. They will carry out a campaign of fear and confusion, telling workers that big corporations will flee the city if we make them pay for free healthcare. They will wage war on our movement — in the courts, in the media, and in the Democrat-dominated City Council and state legislature — to try to keep our initiative off the ballot in the first place, and to overturn it if it passes.
We need to build a movement strong enough to withstand these attacks.
In 2021, corporate landlords and rich Republicans funded a right-wing recall campaign to remove Kshama from office, using racist attacks and voter suppression along the way. Democrats and big business tried their best to stop all of our renters’ rights victories, the $15/hour minimum wage, and the Amazon Tax. After they failed to stop them, they filed lawsuits and made repeated attempts on the City Council to reverse them.
Again and again, their attacks failed, and we won, as Workers Strike Back has done with the recent Hands Off $15 and Hands Off Renters’ Rights campaigns. We adopted a bold and offensive strategy to defend our victories. We held press conferences to expose the rotten agenda of the Democratic Party. We mobilized working people to City Council public comment, where we called out the Democratic politicians by name, exposed their lies, and declared that they should be thrown out of office if they followed through on their attack.
In all our fights, we were clear about who our enemies were, and we fought like hell against them. Kshama used her office not to build her careerist relations with the Democratic politicians, but instead to mobilize thousands of working people to fight to overcome the Democratic Party’s opposition. We organized rallies, marches, mass meetings, packed City Hall, and built maximum pressure for our demands. We exposed the Democrats at every turn. We organized to win support from unions and other organizations, by organizing rank-and-file members.
Importantly, we didn’t treat our Seattle fights as local campaigns — they were national. When we fought against the right-wing recall, we raised over a million dollars from 12,000 donors from all 50 states, Washington DC, and Puerto Rico. That campaign had 1,500 volunteers who knocked on 120,000 doors. We involved thousands of working people in our fights. We were serious about working-class fundraising. All of Kshama’s election campaigns, and the 15 Now and Tax Amazon, were funded by working-class donors and volunteers who gave everything they could, whether that was hundreds of dollars, the loose change in their pocket, or a few hours of volunteering every week. We knocked on thousands of doors and broke fundraising records in every campaign. We fought to convince every person to get involved in our campaign, to get every donation, and to win every vote.
Our fight for Free Healthcare for All will be buttressed by our campaign to elect Kshama Sawant to the U.S. Congress. Kshama’s opponent, Democrat Adam Smith, is an arch-warmonger in addition to being a loyal servant of the billionaire class. As chair and ranking member of the House Armed Services Committee under Joe Biden, Smith approved tens of billions of dollars to fund the genocide in Gaza. Throughout his 28 years in office, Smith has spent trillions of taxpayer dollars on the military and wars, money that could have gone towards funding free public healthcare for everyone. Under Bush and then Obama, Smith voted to bail out the big banks, while leaving millions of working families in the lurch during the Great Recession. Smith has received millions of dollars in campaign donations from weapons manufacturers and the pro-genocide Zionist group AIPAC. One of his key funders is the American Hospital Association, which has staunchly opposed single-payer healthcare.
Just as Kshama’s previous election campaigns served as platforms to build the fights for 15 Now and the Amazon Tax, her independent campaign for Congress is a platform to fight for free healthcare for all funded by taxing the rich, to end the genocide in Gaza, to stop the deportations, and for rent control. These demands and Kshama’s fighting approach have already inspired more than 2,000 people to get actively involved by donating and volunteering, and thousands more to sign petitions.
By building Kshama’s independent, anti-genocide, pro-worker campaign, we can begin building the forces that will be needed to defeat big business, the health insurance companies, and the Democratic Party in the fight for free healthcare in Seattle. And if we win, we will use our victory to bring the fight to Congress.
It would be powerful if, in parallel with our fight for free healthcare for all in Seattle, CNA and other labor and community organizations supporting CalCare were to launch their own independent ballot initiative in California. If they did so, Workers Strike Back would throw itself into this fight, and the two campaigns could reinforce each other and overcome the opposition of both parties of the billionaires.
Working people are furious at both the Democrats and the Republicans. Trump’s approval has reached historic lows among U.S. Presidents. The Democrats’ approval is in the gutter. We urgently need a new mass party for working people. But a new party won’t come out of thin air. It will come out of mass movements that can mobilize tens of thousands of people to fight.
These are exactly the kinds of campaigns we need to build. We need thousands of working people to get involved and give whatever they can. Donate also to our fighting campaign to elect Kshama Sawant to Congress. If you’re in Seattle, join us for doorknocking, tabling, and postering shifts. If you’re outside Seattle, sign up to phonebank with us, or start petitioning in your community. Crucially, become a member of Workers Strike Back today.
Winning free healthcare for all in Seattle would send shockwaves around the country, and it would put the fear of the working class into big business and their politicians. It will be a massive fight, but there is a historic opening to win. It’s time to go on the offensive.
