Medicare for All is one of the most hotly debated topics in the 2020 election. But what is it? And how will it work? We explain.


Health workers are watching bad politics destroy health care, but we can’t solve these problems in exam rooms. We need to solve them at the ballot box.

Health care professionals are not known for their political engagement. Our analysis of the Census Bureau’s Current Population Survey shows that among the college-educated workforce in 2016, those in health care reported lower voting rates (85%) than those in the education (91%) or legal (94%) professions. They were also less active than those in agriculture (93%), entertainment (89%), management (89%) and many other fields. Of all college-educated Americans in industries with typical incomes above $90,000, health care professionals had the lowest voter turnout. 

This fall, we need the health care workforce to vote in unprecedented numbers. They need to vote — and they need to help others vote.

One of us, Eitan, is a social scientist who has conducted research on physicians and their politics. According to the data he collected for that study, while over 80% of physicians agree that physicians have a professional responsibility to engage in public health debates, they aren’t typically active political participants. Most do not report participating in political or civic volunteerism. 

COVID fuses policy, politics, health 

Daniel, the other author of this op-ed, is a primary care physician who has missed a number of opportunities to vote because of long clinical shifts. He knows how politics can get in the way of patient care. Early in his career, he shared an exam room with a senior colleague who had put up a “Health Care for All” poster. Periodically, patients would nod at the poster and complain about “Obamacare” and excessive regulation. With only 15 minutes to spend with each patient, Daniel didn’t want to spend that time talking about politics. He switched exam rooms. 

Health care is a politically diverse field. Among physicians, for example, there are specialties, like surgery, where nearly all the doctors are Republican. In other fields, like psychiatry, the doctors are nearly all Democrats. But in most specialties, including primary care and emergency medicine, there’s a 50-50 split.

Health care workers on April 15, 2020, in New York City. (Photo: Johannes Eisele/AFP via Getty Images)

Whatever their political inclinations, health care workers are facing atypical times. COVID-19 has clarified how policy, politics and health are inextricably tied together. We need policies that facilitate mask wearing and free mask distribution to vulnerable communities. We need adequate personal protective equipment for all health care workers. We need the Centers for Disease Control and Prevention and the Food and Drug Administration to remain apolitical.And we need a national testing and contact tracing strategy. We’ve achieved none of these things under the current leadership.

Senior FDA career executives:We’re following the science to protect public health in pandemic

The fact that an American dies from COVID-19 every 80 seconds has been written off as “it is what it is.” More than 1 in 7 adults in America now do not have health insurance. In Connecticut, Massachusetts and New Jersey, over 10% of the nursing home population died in the early months of the pandemic due to a series of policy failures. We are watching bad politics destroy health en masse, but we can’t solve these problems in exam rooms. We need to solve them at the ballot box.

That’s why we ask three things from our health care colleagues when it comes to the 2020 election:

More medical workers must vote

►The health care industry needs to vote at rates we’ve never reached before, and we need to tell our friends, neighbors and patients to vote as well. If voting was as common among doctors and nurses as it is among lawyers and teachers, according to our estimates, almost 400,000 more eligible citizens would cast ballots compared with 2016. If voting was as common among medical assistants and home health aides as among child care workers, we estimate thathundreds of thousands of additional people would vote. When friends, neighbors and patients hear from health care professionals about the ways that political choices impact health, they listen. Those millions of additional votes will make a difference.

​​​​​​►We need health care industry leaders to step up and help the entire health care workforce vote. Human resources, department chiefs and practice managers can distribute key information on voter registration and voting by mail to all health systems employees. Hospital executives and practice owners can begin speaking publicly about the importance of voter turnout.

For those who need to vote in person, every hospital, ambulatory care center and private practice in America can ensure that all paid employees have a window in their schedule to vote on Election Day and the masks they need to vote safely. Outpatient practices could even shut down for the first two hours of the day on Election Day to ensure that all staff members are able to vote. 

On nation, one team, one fight: Wearing masks after the 9/11 attacks and during COVID-19

►Health care professionals need to get into the trenches of civic life for the long run, participating in community organizations and professional organizations to move public policy forward. Often, when we see politics going the wrong way, our “involvement” tends to be limited to following the news obsessively from our phones, getting into arguments on social media and cheerleading from the sidelines. We become political hobbyists.We need to resist that trend and do the hard work of organizing our professional community and our neighborhoods, not just this fall but throughout our careers.

We know that health care professionals are under tremendous strain already and are being asked to make mammoth personal sacrifices to save lives. We admit that asking health care professionals to engage in organized advocacy on top of all that they are already doing is likely one ask too many. But we can make a profound statement in the name of health this fall by simply exercising our right to vote. In one form or another, health care professionals all pledged to preserve the welfare of those in our care. Voting in 2020 could be the most powerful way to uphold that pledge.

Eitan Hersh (@eitanhersh) is the author of “Politics is for Power” and an associate professor of political science and civic studies at Tufts University. Dr. Daniel Horn  (@danielmhorn) is a primary care physician and director of population health for the Division of General Internal Medicine at Massachusetts General Hospital, an instructor at Harvard Medical School, and a Public Voices fellow with The OpEd Project.


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