Last Week Tonight with John Oliver (2014–…): Season 7, Episode 1 - Medicare for All - full transcript

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Welcome, welcome, welcome
to "Last Week Tonight."

I'm John Oliver.
Thank you so much for joining us.

We are back,
and there is simply no time to recap

everything that has happened
since we've been away.

But in short, we nearly
went to war with Iran,

the UK's election made
BoJo prime minister,

and the coronavirus has started
spreading around the world.

And if you happen to feel like
you're getting sick right now,

you do have it,
and you only have hours to live.

Also, Harry and Meghan
left the royal family,

Baby Yoda showed the world what
it was like when Yoda was a baby,



Bong Joon Ho won all the Oscars,
Bernie Sanders won New Hampshire,

and this poodle named Siba
won Best in Show

at the Westminster Dog Show, making
her, I believe, 100% that bitch.

But obviously...
Obviously, we have to get

to the biggest story of the break.

What happens when
an obvious criminal sociopath

is accused of abusing his power,
yet somehow holds on to his office

by sailing through
a sham investigation?

Gritty, the Philadelphia Flyers' mascot,
is now cleared of wrongdoing.

A man claimed that Gritty punched
his 13-year-old son in

the back during a holiday
photo shoot in November.

After an investigation,
Philadelphia police cleared Gritty.

I'm sure that Gritty just
kind of rolled his eyes

because that's what they...
they're googly.



Wait, hold on there.
Hold it. For a start,

I'm not sure
that "googly" is the best way

to describe Gritty's eyes at all.
"Deeply psychotic"? Sure.

"Two swirling vortexes
of horniness and rage"? Better.

"A pair of haunted nipples
"floating on a plate of milk

and surrounded by a nest
of orangutan pubes?"

Now we're getting somewhere. Now
we're describing this monster's eyes.

But clearly, Gritty is not
the only aggro neon weirdo

celebrating his acquittal
these days.

The president beat
his impeachment charges...

Although some Republicans
who voted to acquit him claim

that the whole experience
may well have changed him.

I believe that the president
has learned from this case.

The president has been impeached.
That's a pretty big lesson.

I believe that he will be much
more cautious in the future.

What are you talking about, Susan?

Of course he hasn't learned his lesson.
Trump never learns his lesson.

This is the man
whose firstborn child

was Donald Trump Jr.,
and he kept having children.

There's no lesson-learning
capacity in the man.

And if you need further proof of that,
just look what happened this week

with Trump associate Roger Stone,
convicted last year on seven counts

of lying to congress,
witness tampering,

and obstructing a proceeding.
On Monday, prosecutors recommended

a sentence of seven
to nine years in prison.

-And that is when things got weird.
-Tonight, at least four prosecutors

stepping down from
the Roger Stone case

after a dramatic decision
to overrule their recommendation

that he spend seven
to nine years in prison.

The stunning rebuke from the
Justice Department leadership

came just hours after
President Trump tweeted that

the prosecutors' suggested
sentence for Stone was, quote,

"horrible and very unfair.
A miscarriage of justice."

Yeah, but was it a
miscarriage of justice, though?

'Cause bear in mind, Stone was
found guilty on all counts;

the recommendation was within
established federal guidelines;

and also, just look at him.

I know you shouldn't profile
people based on how they look,

but on the other hand,
look...at...him! Look at him!

His dress code
is "business scoundrel."

He looks like the mannequin
at a department store

for Dick Tracy villains. He looks like
a guy whose day planner just says,

"Frame Roger Rabbit."
Look at him!

And even if you think
the recommended sentence was,

in fact, too long, it's up to
the judge whether to impose it,

and there's an appeal system
after that.

But to have DOJ leadership interfering
in a case involving a Trump ally

hours after the president
directly commented on it

is appalling.
This is America.

Your experience with
the criminal justice system

should not depend on how much
the president likes you.

It should depend on
how much money you have,

what color your skin is,

and whether or not the judge
has already had lunch.

That is how we do things here
in the United States, buddy.

And the excuses offered
by the president's defenders

ranged from the absurd
to the genuinely terrifying.

The executive power is vested
in the president.

The top law enforcement officer is
the attorney general.

If he wants to counteract decisions
of the line prosecutor,

that's his dang job.
I mean, there's nothing wrong with this.

I like the fact that a president
of the United States,

when he sees injustice,
he's pointing it out.

That's exactly what you want
to have a president do.

I don't want to hear any crap
about an independent justice department.

This justice department,
as does everyone,

works for the president.
It is part of the executive branch.

Oh, he's right. Of course.
Everyone at the justice department

works for the president. When he says,
"Jump," they should say, "How high?"

When he says, "Lock her up,"
they should say, "How long?"

When he says, "Get me Flubber,"
they should say, "From the movie?"

When he says, "Yes,"
they should say, "Okay."

When he says,
"Where's that Flubber I asked for?"

They should say, "We're working on it."
When he says, "I need it now,"

they should say, "Okay, here it is."
When he says, "Is this lettuce?"

They should say,
"No. That's Flubber."

When he says, "It's not dancing,"

they should say,
"It's probably just tired."

When he says,
"Go away so my Flubber can sleep,"

they should say,
"It would be an honor."

And then everyone
in the justice department

should line up and kiss the
president's Flubber good night

because, damn it, they're part
of the executive branch.

They work for him!
This whole situation looked so bad

that Barr gave an interview
in which he claimed

he never discussed
Stone's sentence with Trump,

but added that it was time for
the president to stop tweeting

about Department of Justice
criminal cases. You know,

good luck with that.

And while this was
widely portrayed by the media

as a rift between Trump and his AG,
I have a sickening feeling

that Laura Ingraham
was one of the few people

-actually seeing things clearly.
-All right, John,

the media sees this sexy story
of Trump versus Barr,

but they miss the fact
that Barr was basically telling Trump,

"Don't worry, I got this."

To borrow a phrase
used almost exclusively

by white supremacists,
"Laura Ingraham is right."

Barr's comments weren't so much,

"Don't interfere
with the justice department,"

as they were, "Don't publicly interfere
"with the justice department

because I'm already doing
what you want."

In fact, on Friday, news broke

that Barr was reviewing
the DOJ's prosecution

of another Trump ally, Michael Flynn,
all of which suggests

that Susan Collins
may actually have been right

about one thing: Trump did learn
a lesson from his impeachment trial.

Specifically, "I can get away
with anything

because no one
will hold me accountable."

And unlike the child who was
definitely punched in the back

by a googly-eyed fur demon,

we cannot say that
we didn't see this coming.

And now this.

And now, another installment of
"Coming up on 'The Doctors.'"

The seniors that are taking "50
Shades of Gray" to a whole new level.

-Plus...
-You called 911 for that?

-I want my weed back.
-Then...

Is it possible to overdose
on gummy vitamins?

-Then...
-Burglar didn't demand cash.

-Just wanted to suck his toes.
-Plus...

It's time to spin the Wheel of Pee.

-And...
-Spin the Wheel of Poop.

-Then...
-The Wheel of...

And Dr. Abs is on duty,
and he's got the secret

-to banishing your back pain for good.
-Then...

"I've been suffering from
severe butt cheek cramps."

Plus, wanna make some quick cash?

Maybe you should sell your poop.

-This could be a career.
-Then...

-This is crazy.
-Why people are putting

anti-anxiety pills down...there?
And why women are putting

their vacuum down... where?

-No!
-O-M-G.

Plus, it's time
for another installment of...

Don't put that down there.

That's today.

Moving on.
For our main story tonight,

we thought we'd talk about an issue that
has dominated the Democratic primary.

And I'm not talking about why
Tom Steyer doesn't look richer.

But why doesn't he, though?

His skin's sallow,
his clothes don't fit right,

and he seems to only have one tie.

What is this man doing
with all his fucking money?

No, we're not talking about that.

Instead, we're gonna talk about this.

It's the hot buzz phrase
for Democrats running for president:

-"Medicare for All."
-We will have Medicare for All.

We have a chance
for Medicare for All.

-Medicare for All?
-Medicare for All.

Now, there's a lot of talk
about Medicare for All.

-What does that mean?
-Great question

from a great judge
and an even greater human being.

And to answer the question

from Ruth Bader Ginsburg's
inevitable successor,

"What is Medicare for All?"

Well, right now, we have what's
called a multi-payer system.

What that means is maybe your health
care is covered by private insurance

purchased by you or your employer.

Or maybe it's covered
by a government program

like Medicare or Medicaid.

Or maybe you're one
of the 27 million Americans

with no insurance, in which case,
you're fucked.

The basic idea behind Medicare for All
is that all of this will be replaced

by a government-funded,
single-payer program.

And the goal of universal
health care coverage

is extremely appealing.

Both Bernie Sanders
and Elizabeth Warren

have put out versions
of Medicare for All.

But other Democrats
have been much warier of it,

and conservatives
absolutely hate the idea.

We cannot afford Medicare for All.

This is the end of America
as we know it economically.

I think literally 90% of hospitals
would go under tomorrow.

Right. Medicare for All?
I lived in England, Sean.

Nationalized health care is a disaster.
When rich, famous people get sick,

they don't fly to Canada.
They don't fly to Cuba.

The come here because we have
the best medicine in the world.

Look, look. I will give that man this.

America does have one
of the best health care systems

in the world for rich, famous people.

Unfortunately, too many people
are born in this country

with a terrible preexisting condition
called "not being Beyoncé."

Some of us...
many of us, in fact... are Solange.

And for so many Americans,
our system is badly broken.

And I'm not just talking about the
27 million without health insurance,

but the nearly 44 million more
who are underinsured:

people with high deductibles
and co-pays

that can end up bleeding them dry.

The majority of people
who file for bankruptcy

cite medical expenses as a factor.

And you probably
already knew that deep down

from just how often you see
GoFundMe campaigns online

from worried parents
of sick children

or your friend who got
a pineapple stuck up his ass

and needs help paying the doctors
to stop laughing and get it out.

And incidentally, for all
the heartwarming success stories

that you see, a study found 90%
of crowdfunding campaigns

for medical expenses
fail to meet their goal.

And when they fall short,
it can be crushing.

Watch as one family struggles
to raise $10,000 for expenses

arising from their two-year-old
daughter's eye disorder.

Chayla's fundraiser isn't
going as well as they'd hoped.

About a month in,
it's only raised $610.

Early morning on the day
of Chayla's surgery,

her parents are still trying
to get the word out.

Okay, so we're gonna make her sign.
#EyesforChayla.

Very good.

Think about what
you're looking at there.

It's a pretty dystopian society
that we're living in

if your physical
and financial well-being

depend on whether
your crowdfunding campaign

can get a signal boost
from Jiffpom the Pomeranian.

And good luck with that, by the way.
I've been trying to get him to post

our gerrymandering piece for months now,
and he won't do it.

Come on, Jiffpom!
Throw us a fucking bone, you asshole!

The point is, any solution
that might put an end to that

is worth at least
considering, surely.

And to be honest, I personally
think there is a lot to be said

for Medicare for All.
So tonight, let's take a look at it...

not the politics of whether
it can pass, but what it actually is.

And whenever the subject comes up,

we tend
to hear three major criticisms of it

concerning cost, wait times, and choice.
And let's start with cost,

because critics will tell you
that Medicare for All

will simply increase
the federal budget too much.

This sicko socialism
would cost roughly $32.6 trillion

over ten years.

Even if you doubled tax collections
from individuals and corporations...

yes, that means you'd be paying twice
what you already do in taxes...

that still doesn't cover the tab.

My God, free health care
is expensive.

Look, I know that sounds dramatic,

but Sarah Palin's fourth
attempt at cloning herself

actually has a point there.

Medicare for All would,
undeniably, be expensive.

But that fact needs
a lot of context around it.

For starters, well, it would increase
the federal budget, yes,

but it would also eliminate
employer spending on premiums

and your spending
on out-of-pocket costs.

Now would those balance each other out?
That is a good question.

The answer is no one can
possibly know for sure.

There are just too many
variables involved.

"The Times" asked five
prominent experts to estimate

national health care spending
under Bernie's plan,

and they compared that
to what we spend now.

And the results ranged from
"it would actually cost us less"

to "it would cost about the same"

to "it would cost
a fuck of a lot more."

And I know that extra shading
does not look like very much,

but believe me, it's a fuck of a lot.
But look.

Let's say, just for argument's sake,
our overall spending did go up.

We would be getting
a lot for that money.

Remember, 27 million
more people would be covered,

and they'd be covered well.
Bernie's plan is incredibly generous.

It covers vision, dental,
long-term care, and drugs.

In fact, "Medicare for All"
is a misleading title

because Medicare requires some co-pays
and out-of-pocket expenses.

And Bernie will excitedly tell you
his plan eliminates those.

Under the Medicare for All
bill that I wrote,

premiums are gone,
co-payments are gone,

deductibles are gone,
all out-of-pocket expenses are gone.

He's right. Hospital bills are gone.
Co-payments are gone.

Cell phone payments, gone.
Flat tires, gone.

Geico commercials, gone.

All the things you hate
in this world will be gone,

and all that will remain
is universally accessible health care

and Laura Dern.
Finally, life as it should be.

Bernie's plan isn't
just more generous

than most current
private insurance plans.

It's more generous than the policy
of any single-payer country on Earth.

And there is a good case
to be made that

even if national spending
wound up higher,

we might wind up wasting less.

Right now, a lot
of our health care spending

doesn't go to health care.
It goes to administrative costs

that come with having
a vast insurance industry.

That is clearly wildly inefficient.

And consolidating all
health insurance under one roof

would give the government
far more leverage

to negotiate prices down,
because, look, it is no secret

prices for procedures and drugs
are out of control in the United States.

It is so bad,
one insurance provider in Utah

recently started offering
some of its participants cash

if they were willing
to travel a little further

than their local pharmacy
to fill out their prescription.

It's called "pharmaceutical tourism."
Here's how it works.

PEHP puts patients on a plane
and flies them to San Diego.

From there, a private car
takes them across the border

to Tijuana, Mexico,

where their prescription is waiting
for them. The only difference?

The prescription costs
roughly half the price.

PEHP will give people willing to travel
an additional $500 back.

It's cheaper for us to pay
for the drug down there,

send them down there,
and then give them $500.

That's fucking crazy! Giving you $500
to go to Mexico to buy drugs

is not what your insurance
provider should be doing.

It's what your sketchy friend
Meredith should be doing

because she wants to make Brianna's
bachelorette party a total rager.

"I'd go myself,
but I have outstanding warrants."

Under Medicare for All,

the government would be
a much stronger negotiator.

Now, you wouldn't want it
to set prices so low

that it stifles innovation
or bankrupts doctors,

but that is a balance that
you would need to strike.

Overall, you can't definitely say
that it would be more expensive.

But even if it was, I personally would
argue that it's worth it.

And either way, cost is a lot
more complicated an issue

than just going on TV and saying,
"$32.6 ta-rillion"

like Tina Fey doing
her best Dr. Evil impression.

Anyway, the next major
criticism of Medicare for All

concerns wait times, specifically,
that it would result in rationing

-and delays to care.
-If you think it's fun

to wait in line at DMV, you're gonna
love Bernie Sanders' wait times

for Medicare for All.
-It leads to the kind of care

that people now have in England or
Canada, where you have to wait in line.

Just take a look at Canada or the UK.
It means long waiting lines.

it means people not getting
the health treatments they need.

Okay, I get that no one likes
waiting in line for anything. I get it.

Most people see the line at Trader Joe's
and either abandon their cart

or pull the fire alarm
and sneak out with their groceries,

undetected.
I'm not saying I've ever done that.

I'm just saying I had
a show to do tonight

and who wants some
peanut butter pretzels?

But look. As with cost, comparisons
of wait times are very complicated.

For one thing, the international wait
times that you hear about most often

are for non-emergency surgeries,
such as knee replacements.

And while, yes,
people in other countries

do sometimes have to wait
slightly longer for some care,

it's not like Americans aren't
having to do that right now anyway.

Americans are just sometimes forced
to wait due to the expense.

About half of U.S. adults
say they or a family member

put off or skipped care in the past year
because of the cost.

And about one in eight say

their medical condition got
worse because of that delay.

As for the uninsured,

they can wind up having to wait
on a literal line,

seeking care with aid groups
like Remote Area Medical,

an organization that
travels the country,

setting up mobile clinics
to treat people for free

and which draws massive lines
wherever it goes.

Having got their place in line,
many camped out for the night.

Before dawn, this was the moment
they were waiting for.

Number one, come on down.
Number two.

-Two, right here.
-Number three?

One by one, patients
are let in for their chance

of a visit to a doctor,
a dentist, and an optician.

At first, R.A.M. focused on communities

in remote areas
of developing countries.

But Stan says he gradually
came to realize

-the depth of need in the U.S.
-Today,

oh, 80% or more of what we do
is here in the United States.

It's unbelievable to me
that that is the case.

Normally, Americans hate it
when a British person

comes over to diagnose
what's wrong with you.

Believe me,
six seasons of YouTube comments

have made that very fucking clear.
The internet is mean!

And for all critics' talk of wait times
abroad, it is worth knowing,

less than 10%
of Britons or Canadians

say that their health system
need to be "rebuilt completely"

compared to 23% of people
here in the United States.

In fact, when London hosted
the 2012 Olympics,

the opening ceremony featured
a four-and-a-half-minute celebration

of the National Health Service,
featuring swing-dancing doctors

and nurses and children jumping up
and down on hospital beds.

As for Canada, they adore
their health service so much

that when they had a contest
for the greatest Canadian

of all time, this was the result.

The greatest Canadian,
as decided by you, is...

Tommy...

Douglas!

The mother of all national titles
goes to the father of Medicare.

Tommy Douglas! Yeah!

"Yeah! Tommy Douglas!
Yeah! Whoo!"

I mean, his master's thesis,
"The Problems of the Subnormal Family,"

endorsed eugenics,
but we're gonna ignore that

'cause it was the 1930s
and no one's perfect!

Give it up for Tommy! Whoo!

And look... Then, there is the final
big criticism

of Medicare for All,
which involves choice...

specifically, that it would
take away our ability to choose

the sort of health coverage
that we receive.

When I hear that health care is a right,
what I hear is,

"Health care will
no longer have choices."

Under Medicare for All,

your choice
of health coverage disappears.

Americans are still Americans.

We're not socialists.
We're not communists.

We like choice.
And we like to have choice

-in health care especially.
-Right, right.

Americans are Americans. It's true.
And they do like having choices.

It's why the number one
rated series on Netflix

is 40 minutes of looking
through the menu for something good.

It's basically America's
new national pastime.

And the fact you're applauding that
is a full cosign on that concept.

But the fact is, our current system
limits Americans' choices

far more than it expands them.
For starters, as a practical matter,

most of us don't choose
our health insurance.

We get what we get
through our employer.

And because of that,
choices like changing jobs

can become significantly harder.
And not just that.

Oftentimes, your choice of doctors
and hospitals is severely limited

by which ones
your insurance will cover.

Going out of your insurance network
can be prohibitively expensive.

That is why people bend over
backwards to stay in network.

And even when they do that,
it can still all go horribly wrong.

While campaigning in 2018,

Democratic Congresswoman
Katie Porter's appendix burst.

Her first thought?
"How much would it cost?"

I didn't call an ambulance

'cause I knew it can cost a lot
if you call an ambulance.

And I had specifically
had my manager drive me

not to the closest hospital
but to the in-network hospital.

Even though the hospital
was in her network,

the surgeon who helped
save Porter's life was not.

and she got a bill
for nearly $3,000.

Exactly. You can get fucked
by taking an ambulance,

you can get fucked by going
to the wrong hospital,

or you can get fucked by going
to the right hospital

but getting the wrong surgeon.

The American health care system
gives you so many choices

as to how you want to get fucked.

It truly is
the "Kama Sutra" of health care.

And under Medicare for All,
that scenario would not happen.

No doctor would be out of network

because there wouldn't be
a network at all.

And the truth about Americans'
current illusion of choice

is that too often, because of cost,

the choices our current system
forces people to make

are ones like this.

I prioritize the heart
stuff over the insulin

because the heart stuff
is more immediate.

I know over time, you know,
diabetes will kill me.

But it'll take a longer time.

And I know that without
the heart-failure drugs,

I only have 13% function of my heart.
I don't want to play with that.

That's obviously terrible.

A humane health care system
should not require people

to pick their favorite organ.
Although, for the record,

if you're ever asking me
my favorite organ,

I'm going spleen every time.
Now, I know

the brain and the heart get all
the attention, but I'm telling you,

when it comes to filtering blood,
you can't go wrong with the spleen.

#IMASPLEENSTAN.

#YAAASSPLEEN.

So... so those are...

those are the three main
criticisms of Medicare for All.

And I should say it is not
just people on the right

who raise them. Some Democrats
have reservations too.

Pete Buttigieg, for instance,

prefers a different concept
to Medicare for All,

-but with a catchily similar name.
-My health care vision is

"Medicare for All Who Want It."
Let every American have the choice

to walk away from
the corporate, private plans

and toward something better...
but when they're ready,

because I trust Americans
to make that right choice.

Okay, well, hold on there.

You trust Americans
to make the right choice?

You know Americans choose
to drink Bud Light, right?

Which doesn't taste like beer

so much as it tastes like
if beer somehow died

and was discovered in its apartment
three weeks later.

But what Buttigieg is referring to

when he says
"Medicare for All Who Want It"

is basically the public option.
That is where the government

doesn't replace
the private insurance system.

It just introduces its own plan
that would compete with it.

And it would definitely be an
improvement over what we have now.

The problem is, it would leave

so much of our current
insurance infrastructure,

with all of its problems, intact.

So that's kind of like being
offered either a shit sandwich

or a slightly smaller
shit sandwich with guac.

I mean, I guess I'll take the second one
if you're asking, but honestly,

the lack of guac wasn't really
my main fucking concern, there.

And I'm not saying
any of this would be easy.

A lot would have to be figured out,
from how to impose the taxes

to pay for it in an equitable way,
to the consequences of eliminating

the entire private
health insurance industry,

which, by one estimate,
could displace 1.8 million workers.

That is a legitimate thing
to be concerned about.

And any plan would have to be designed
and rolled out very, very carefully.

That is why both Warren
and Sanders talk about

the need for transition plans
for workers in their proposals.

And I get that big change is scary.

It is human nature
to prefer the devil you know

over an uncertain alternative,
but the devil you know is still a devil.

And it is easy to forget that.
I shit on Britain a lot on this show,

and I'm not gonna stop
any time soon,

but one thing Britain does well
is the National Health Service.

It's not perfect, of course.

I'm not gonna swing dance
on a fucking bed about it.

But I will be honest with you:
I've never had a bad experience

and I don't know anyone who has.
But since moving to America,

I don't think I have met
anyone who doesn't have

at least one insurance industry
horror story.

At this point,
the U.S. national anthem

should just be everyone
in a stadium yelling

about their insurance company
for two and a half minutes.

So for what it is worth, personally,
I am in favor of some version

of carefully designed
universal health coverage.

And I will own all the things
about it that are difficult,

including the fact that, politically, it
would be incredibly hard to get passed.

But in return, anyone who's resistant
to significant change

is going to have to own
all the flaws of our current system,

one in which,
when Americans get sick,

they can find themselves
comparison shopping

with a burst appendix,

flipping a coin between
lifesaving medications,

and praying they can come up
with a catchy enough hashtag

to cover their care. Although,
for what it's worth on that one,

until we fix this fucking mess,
if anyone gets a ruptured spleen,

please feel free
to use #YAAASSPLEEN.

That's all yours. Good luck with it.
And now this.

And now, it's someone's job
to send video clips

of the Westminster Dog Show
to local stations.

And this year,
that someone fucked up.

There is a new top dog at
the Westminster Kennel Club.

Siba took home the top prize
at the event last night.

The standard poodle named Siba
won Best in Shown last night.

Siba won Best in Show last night at
the Westminster Kennel Club Dog Show.

-There is a new Best in Show.
-There's a new top dog at Westminster.

A poodle named the top dog
at the Westminster Kennel Club Dog Show.

She was chosen from seven finalists
that included a whippet...

She was chosen from seven finalists...
oh, a little rear shot there.

Well, meet Siba, standard poodle.

-Took home the top...
-Turn around, please.

Dog experts say don't be fooled.
She's more than just good looks.

Why are we showing this shot again?

-Oh, gosh.
-Brittany.

That might have been why she won.
I mean, who knows?

That's our show.
Thanks so much for watching.

See you next week. Good night!