House Budget Committee chair Paul Ryan, R-Wisconsin, proposes to undermine the integrity of the Medicare and Medicaid programs, with an eye toward enriching the insurance companies that so generously fund his campaigns.

The American people are not amused. They have sent a clear signal that they want to maintain Medicare and Medicaid.

And rightly so. despite the battering they have taken from misguided and malignant policy makers, the Medicare and Medicaid programs still provide the rough outlines for a single-payer health care program that keep costs down while expanding access to prevention and treatment for millions of Americans. 

So, instead of gutting Medicare, as Ryan proposes, why not expand on what works.

That’s what Vermont Senator Bernie Sanders is proposing. 

"The United States is the only major nation in the industrialized world that does not guarantee health care as right to its people. Meanwhile, we spend about twice as much per capita on health care with worse results than others that spend far less," Sanders explained Tuesday, as he announced plans to introduce the American Health Security Act of 2011, would provide federal guidelines and strong minimum standards for states to administer single-payer health care programs. "It is time that we bring about a fundamental transformation of the American health care system. It is time for us to end private, for-profit participation in delivering basic coverage. It is time for the United States to provide a Medicare-for-all single-payer health coverage program." 

Sanders’ plan is the right response to America’s health-care crisis — and any country where tens of millions of citizens lack health-care coverage, where tends of millions more lack adequate coverage and where costs are skyrocketing because of insurance-company profiteering has a crisis.

Don’t get the independent senator wrong. He voted for the health-care reform legislation that passed Congress last year and that was signed by President Obama. He even improved that legislation by fighting to include funding for public-health programs and community clinics.

But Sanders also recognizes flaws in the 2009 reform — which, reformers note, keeps the for-profit private health insurance industry at the center of the U.S. health system. And the senator argues that the ultimate cure for what ails American health care is a "Medicare for All" approach that ends the profiteering and focuses on prevention and treatment of disease.

And he is not alone.

Congressman Jim McDermott, the Washington Democrat who has for two decades been one of the House’s steadiest backers of real health-care reform, will introduce a parallel bill in that chamber. Says McDermott:  "The (2010)  health care law made big progress towards covering many more people and finding ways to lower cost. However, I think the best way to reduce costs and guarantee coverage for all is through a Single-payer system like Medicare. This bill does just that – it builds on the new health care law by giving states the flexibility they need to go to a single-payer system of their own. It will also reduce costs, and Americans will be healthier.

The Sanders-McDermott initiative in Washington, DC, comes as the Vermont Legislature has taken steps to make the senator’s homestate the first in the nation to develop what advocates desctibe as a state-based variation on the single-payer approach. Vermont. Sanders applauds the move, and thinks it could serve as a national model. Others agree, while noting that Medicare provides another model.

Sanders and McDermott were joined at the announcement of their new "Medicare for All" push by Arlene Holt Baker, executive vice president of the AFL-CIO; Jean Ross, co-president of the National Nurses United; and Greg Junemann, president of the International Federation of Professional and Technical Engineers. All three groups are encouraging this fight for real reform.

“Providing a single standard of high quality care for all is a priority for registered nurses who have seen their abilities to act as patient advocates made more difficult as for-profit interests control more patient care decisions," says Ross,whose union has been in the forefront of the fight for single-payer. "We commend Senator Sanders and Representative McDermott for their vision and passion to help registered nurses create a more just healthcare system through the American Health Security Act and applaud our brother and sisters in labor for their support,"

Physicians for a National Health Program, the movement of doctors and medical students for real reform, welcomed the national legislation.

“At a time when the airwaves are filled with talk about cutting or even ending Medicare,” said Dr. Garrett Adams, PNHP president, “Senator Sanders has boldly stepped forward with the seemingly paradoxical proposition that the best way to financially strengthen the Medicare program is to upgrade it and expand it to cover everyone.”