The More Important the Issue, the Less Anyone Discusses It

Bernie Sanders tells Lex Fridman why drug lobbyists, campaign cash, and a healthcare system built for profit keep the biggest American problems off the table.

LFLex FridmanModeration · Lex Fridman Podcast
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Lex Fridman Podcast
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23. Okt. 2024
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1:02:32
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18 Min.
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In a conversation recorded in Burlington, Vermont, Senator Bernie Sanders argues that the United States is sliding toward oligarchy: billionaires buy elections, 1,800 drug-company lobbyists circle 535 members of Congress, and the issues that matter most barely get a hearing. He walks through Medicare for All as a stepwise expansion of an existing program, a RAND finding that some $50 trillion moved from the bottom 90 percent to the top 1 percent over 50 years, and the 2016 campaign that won 23 states with almost no help from Democratic officials. At 83, he says he does not fear death so much as infirmity, and that the crowds he still sees on the trail are why he has not given up.

  1. 1Sanders has a rule he repeats throughout the conversation: the more important the issue, the less discussion there is, and the less important the issue, the more.
  2. 2Washington has 1,800 well-paid drug-company lobbyists for 535 members of Congress, which he says is a large part of why Americans pay the highest prescription prices on earth.
  3. 3He cites an estimate that about 60,000 Americans die every year because they cannot get to a doctor for financial reasons, and that one in four people who get cancer treatment go bankrupt or wipe out the family's savings.
  4. 4According to a RAND Corporation study he cites, roughly $50 trillion shifted from the bottom 90 percent to the top 1 percent over 50 years, even as worker productivity soared.
  5. 5The anger among working people is real, he says; the danger is that demagogues point it at immigrants, minorities, and people even worse off, instead of at concentrated wealth.
  6. 6At town meetings he wants voters to ask two yes-or-no questions: will you vote to overturn Citizens United, and will you move to public funding of elections?
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01

The more important the issue, the less discussion there is

Lex Fridman sits down with Bernie Sanders in Burlington, Vermont, and opens with a question most politicians invite: growing up, did you ever think you would be one? Sanders says no, not in a million years. He also hates talking about himself, which Fridman notes is rare in the business. Politics, Sanders says, should be about the issues facing the country and the world, not whether he is a nice guy. That said, his path runs through 1963: he was arrested protesting segregation in Chicago and rode a bus from the University of Chicago to the March on Washington, where Martin Luther King Jr. gave the "I Have a Dream" speech. What people forget, Sanders says, is that the rally's name was jobs and justice, not racial justice alone.

King's influence on him was organizational as much as moral. Sanders says King built a movement from the bottom up, with grassroots pressure that forced communities and officials to end segregation and open the vote. The part he wants remembered is what happened after the Nobel Peace Prize. When King took on Lyndon Johnson over Vietnam, establishment editorial pages turned on him, with a message Sanders paraphrases as: you are Black, deal with civil rights, leave foreign policy to us. King answered that if he talked about peace and nonviolence, he could not stay silent about Vietnam. He was assassinated in Memphis while backing AFSCME sanitation workers fighting for a union.

Fridman connects that courage to Sanders's 2002 vote against the Iraq resolution and the Patriot Act, a speech that, in hindsight, predicted the war's costs. Sanders says the lesson came from Vietnam: the country went in on a lie, lost close to 60,000 Americans, and saw millions die in Vietnam and Cambodia. He did not believe Dick Cheney and others on Iraqi nuclear weapons. Asked how to fight the military-industrial complex King named, Sanders widens the frame. The United States, he argues, is moving toward an oligarchic society, with more concentrated corporate ownership than ever and billionaires spending huge sums to buy elections. On Trump's campaign, he says three multi-billionaires had spent over $200 million.

Companies and lobbyists complete the picture. Americans pay the highest prescription-drug prices in the world, Sanders says, and there are 1,800 well-paid drug-company lobbyists in Washington, including former Republican and Democratic Party leaders, circling 100 senators and 435 House members. The Pentagon, in his telling, spends a trillion dollars a year and is the only federal agency unable to submit to an independent audit. Real corruption, he insists, is rarely an envelope of cash for a vote. It is dependence: a Senate race in Ohio can cost $50 or $60 million, raised at $5,000-a-plate dinners, until wealthy donors become a politician's world and political base. His 2016 campaign's average contribution, he says, was about $27. The fix he wants is to overturn Citizens United and move to public funding of elections, with small-dollar thresholds to prove support and a spending cap so no one outspends an opponent ten to one. The catch, which Fridman names, is that politicians funded by billionaires will not volunteer to kick them out. Sanders's answer is a grassroots test at every town meeting: are you prepared to overturn that decision and fund elections publicly? "The more important the issue," he says, "the less discussion there is."

02

Sixty thousand people a year die because they cannot afford to see a doctor

Fridman calls many of Sanders's proposals radical. Sanders objects. Walk down the street, he says, and ask whether billionaires should spend whatever they want to buy politicians; nine out of ten people will call that crazy. Healthcare is the same test. He has polled it: should every American be able to see a doctor regardless of income? He puts the yes vote at about 85 or 90 percent. From Burlington, he notes, you can drive 50 miles north into Canada and ask what a hospital visit costs. People will look at you strangely. It does not cost a nickel there, or in virtually every country in Europe. The American system, he argues, is designed not to provide care to all but to make huge profits for drug and insurance companies, which is why he has led the fight for Medicare for All.

If he could snap his fingers, he would not invent a new machine. Medicare already exists for the elderly, passed under Johnson in the 1960s, though he says private insurers are chopping it up through Medicare Advantage. Strengthen it: wipe out the deductibles seniors now pay, let them go to any doctor, have Medicare cover the hospital bill, and add dental, hearing, and vision. Then lower the eligibility age from 65 to 55, then 45, then 35, then everyone, over four or five years. Studies, he says, show that taking the profit motive out of insurance and drugs can deliver quality care to all for no more than the country spends now, because the United States already spends twice as much per person as any other nation.

The attack ads write themselves: Bernie Sanders wants to raise your taxes. He does not deny it. He says the money is already coming out of wages. Employers tell workers they cannot offer more than a 3 percent raise because healthcare costs went up 10 percent; unions hear the same tradeoff at every negotiating table. A self-employed family with kids, he estimates, might pay $15,000 to $20,000 a year in premiums. Under his plan those premiums vanish. Taxes might rise by something like $12,000, depending on income, but not by $20,000 in premiums, copays, and deductibles. The money does not disappear. It moves from the insurance company to the tax system, and the slice in between is what the current setup wastes.

Fridman argues that the worst part of the status quo is not only bankruptcy but the standing fear of getting sick. Sanders, who chairs the Senate committee that handles this, says doctors tell him patients walk in much sicker than they should be. Why didn't you come six months ago? A $10,000 deductible, or no insurance. Some of those people do not make it. Others land in the emergency room at huge cost to the system. One in four Americans, he says, cannot afford the drugs their doctors prescribe. The estimate he cites is that some 60,000 people die every year unnecessarily because they cannot get to a doctor for financial reasons. Crazier still, in his words: one in four people who get cancer treatment either go bankrupt or deplete the family's resources. Fridman recounts his friend Peter Attia taking a dehydrated son to the ER for a basic test and an IV; the bill was $6,000, insurance covered $4,000, and Attia paid $2,000. Sanders's reply is that people know that number, and when they feel off they stay home rather than risk it.

03

He had one Democratic senator with him and still won 23 states

Fridman turns to 2016. WikiLeaks emails showed the Democratic National Committee tilting toward Hillary Clinton, and many listeners still want to know whether Sanders is angry. Of course he is angry, he says, and of course he is upset. He had taken on the Democratic establishment, moneyed interests in the party, corporate America, and the corporate media, while calling for a political revolution. The opposition was always going to be extraordinary. What he is proud of, in 2016 and 2020, is that he challenged the anointed candidate anyway. In the Senate he had one supporter among 50 Democrats, no governors, and maybe a few people in the House. They still took on the whole political establishment, won millions of votes, and forced the party to deal with the ideas. He later helped write the American Rescue Plan during COVID, and he wants those policies made permanent. He also thinks he would have beaten Donald Trump.

Trump, he says, is a little bit crazy and a smart politician who appeals to anger working-class people should feel. The task is to point that anger in the right direction, not at people even worse off, which is what demagogues always do. Then he quizzes Fridman. Over 50 years, technology has massively raised worker productivity. Is the worker today making more in real dollars? Fridman allows that the number is roughly flat, depending on the series, while inequality has exploded. That, Sanders says, is the point. RAND, he cites, found a $50 trillion redistribution from the bottom 90 percent to the top 1 percent. CEOs now make 300 times what their workers make. Three people at the top own more wealth than the bottom half of American society. People are angry that their kids may have a lower standard of living, in the wealthiest country in the history of the world, and his 2016 campaign tried to tap that anger by arguing for a fairer distribution.

Fans wanted him to keep fighting for a progressive takeover of the Democratic Party instead of backing Clinton. He notes that they did try: they ran then-Congressman Keith Ellison, now Minnesota's attorney general, for DNC chair, and the establishment from the president on down beat him by a few votes. Why support Clinton? "What's the alternative? Donald Trump?" He calls Trump an extremely dangerous person trying to undermine American democracy. Clinton's views were very different from his, but politics, he says, sometimes requires doing things you are not excited about. He made the same calculation with Biden in 2020, with more success. Asked in 2024 whether he considered running again, he says he gave it about five minutes. The progressive slogan is that it is not about me, it is about us, and taking on Biden, whose domestic record Sanders considers quite strong, would have split the party and laid the groundwork for an easy Trump victory.

Fridman recounts a 2018 meeting described in Ari Rabin-Havt's book *The Fighting Soul*. Obama told Sanders he was an Old Testament prophet, a moral voice, but prophets do not get to be king, because kings have to make choices. Was Obama right that he had to moderate to win? Sanders does not answer on Obama's terms. Sometimes you run and lose and really win, he says, if the goal is transforming society rather than holding office. One of his heroes is Eugene V. Debs, the early-1900s railway union organizer who ran for president five times, the last from a jail cell for opposing World War I, and still got a million votes. Debs lost badly every time. In 1932, Franklin Delano Roosevelt enacted some of what Debs had talked about. Where Sanders disagrees with Obama is the sequence: raise consciousness among ordinary people first, then organize them to fight. Women in the Senate, gay rights, civil rights, all of it, he says, came because people at the grassroots demanded it. He knows Obama, chats with him, and will not underestimate what it meant in 2008 to be the first Black president. He calls Obama extraordinarily intelligent and one of America's best speakers, and says the family held the office with respect even from political opponents. They still disagree on healthcare: Sanders believes Obama's public line is that he would do Medicare for All if he started over, but that the Affordable Care Act was the best he could get. Sanders does not accept that as the last word.

04

You can reward innovators without handing three people more wealth than half the country

Fridman asks about capitalism. Sanders's book *It's OK to Be Angry About Capitalism* is, they agree, a critique of hyper-capitalism, not of every market. European friends tell him that in France or Denmark he would be a mainstream left politician, not a radical. The best the country can do now, he says, is encourage innovation while guaranteeing everyone in a wealthy nation a decent standard of living. Scandinavia, which American debate barely mentions, has had healthcare as a given for years: you end up in the hospital and you do not pay a bill. Germany, he says, has six weeks of paid vacation plus holidays. The United States is the only major country without paid family and medical leave. College in Germany, as he recalls, is tuition-free because they want the best-educated workforce they can get. That is the social safety net he wants: healthcare, affordable housing, childcare through university, retirement benefits, publicly funded the way police, libraries, and schools already are.

That does not mean the government runs every mom-and-pop store. Go start a business, he says, produce a product, make money. He does not think you should end up with $100 billion. He once turned the tables on Bill Gates, then in his telling the third-wealthiest American behind Musk and Bezos, and asked whether the dream of becoming a multi-billionaire is what motivated Microsoft. Gates said no; he loved programming. Sanders believes scientists hunting Alzheimer's and cancer drugs are not doing it to become billionaires either. Reward success, he says, but you do not need a billion dollars. People should get satisfaction from the work, whether they clean a street or develop a drug. The global picture, as he draws it, is a few thousand extraordinarily wealthy families with unbelievable economic power over more than seven billion people, which is why Musk talking to trillionaire families in the Middle East is not, to him, an accident.

Fridman grants that Musk pours money back into businesses and that the country can celebrate builders while still asking why the working class often lacks a living wage. Sanders is no great fan of Musk, especially in Trump's campaign, but he calls him brilliant, hardworking, and genuinely innovative. He would rather see that talent pointed at affordable housing, medicines, and cutting carbon emissions. The line he will not cross is three people owning more wealth than the bottom half of the country. On the minimum wage, he treats Trump's McDonald's apron as a standard photo opportunity, the kind politicians of every stripe do. A reporter asked whether Trump supported raising the federal minimum wage, then $7.25, with many McDonald's workers on $12 or $13 an hour. Trump, Sanders says, praised the workers and did not answer. In the richest country in history, a 40-hour week should not mean poverty. His number is $17 an hour. It will not solve every working-class economic problem. It will help.

05

Three houses did not erase the memory of watching the grocery price tags

Since the presidential runs, the right has attacked Sanders for a net worth of about $2 million and three houses. Fridman notes that most of the money came from books, and that the fortune is modest next to other people of that fame. Sanders does not dodge the inventory. He lives in a middle-class Burlington neighborhood. He owns a home in Washington, D.C., as most senators do; he rented through 16 years in the House and bought after winning a six-year Senate term. Like many Vermonters, he has a summer camp on Lake Champlain. The money, he says, came from two bestsellers, including the capitalism book and a youth book, plus a salary of about $175,000. That is how he became "the zillionaire that I am." The Burlington house, he adds, is a nice middle-class house, not a mansion.

He entered politics worth $1,100. Has money changed his ability to relate to the working class? Growing up without money in a rent-controlled Brooklyn apartment, he says, is still the most significant fact of his politics. He drives an 11-year-old car. His jewelry is a solar watch and a wedding ring; he has no interest in a Rolex. What did change is worry. He and his wife, who also grew up working class, no longer stay up nights about the doctor or the electric bill. That lift, he says, is enormous. As chair of the labor committee he has been involved in dozens of strikes and stood on picket lines, trying not to fall into the easy trap of separating from ordinary people's struggles.

Fridman, who was poor for most of his life, describes the same lift: filling the tank, buying dinner, and going to the ER without doing math in the dark. Sanders says he has watched the change in himself at the supermarket. He used to look at the price of everything. He does it less now. Fifty cents more for a can of something? So what. That indifference, he says, is a luxury you have when you no longer have to worry, and he knows it. He does not care about fancy cars or houses, and he and his wife have not taken a real vacation in longer than he can remember because he works. The major thing money has done is remove the fear that someone in the family will get sick, or that he cannot put food on the table or pay the mortgage.

06

The fight inside the Democratic Party is corporate money versus the working class

Fridman asks whether progressives, even democratic socialists, will take over the Democratic Party. Sanders calls that the most important question in American politics. One success he is proud of is that the House now has almost 100 members of the Progressive Caucus, led by Pramila Jayapal of Washington, including Alexandria Ocasio-Cortez and Ilhan Omar. Many are young, often women and people of color, many from working-class backgrounds, and he says they represent working families effectively. The struggle, as he frames it, is between a corporate wing and a progressive wing. The corporate wing takes a lot of money from wealthy individuals and large corporations and is, in his view, not vigorous about working-class needs. If it were, the country would already have healthcare for all, a living wage, no housing crisis, and a tax system in which billionaires do not pay a lower effective rate than a truck driver or a nurse.

Trump's political success, Sanders argues, is not mainly his ideas. Most working-class people do not think billionaires need tax breaks. They are angry, and Democrats have not responded effectively to that anger. The fight now is whether the party becomes a working-class party across race, or stays corporately dominated. On Ocasio-Cortez, he is openly fond. She comes from a working-class family, helped her mother clean houses, and bartended in the Bronx. He is proud that his presidential campaign inspired her to run. She took on Joe Crowley, a powerful Democrat, with no money, knocking on doors, and won. When she and her partner Riley visited him in Vermont, people on the street called out "Congresswoman," and the way she smiled, he says, was not phony. You can be a great intellectual and still fail as a politician if you cannot relate to people. She can. She helped create the Green New Deal as a jobs-and-energy frame, and she is a strong advocate for Medicare for All and workers' rights.

Asked for his most enduring impact, he will not pick a single trophy. He is proud of his years as Burlington's mayor and of his Senate record. During COVID, as budget committee chair, he helped write the American Rescue Plan, which put money in pockets, cut childhood poverty by 40 percent through a child tax credit, kept hospitals and colleges going, limited evictions, and pushed vaccines. At the end of the day, though, what he thinks he showed is that the ideas are widely supported. When Trump calls him far left, as if he were an extremist, Sanders lists the agenda: raise the minimum wage, healthcare for all, a tax system that makes billionaires pay their fair share. Those are popular. People did not know that until someone ran for president, drew 20,000 to rallies, and won 23 states. Then the establishment had to entertain them.

The establishment, he says, succeeds by telling you the world is the way it is and always will be. They have the wealth and the power. You have no power. Give up. They do not say it quite that way, but that is the intent. What the outsider campaign showed is that you can take on the Democratic establishment, come close, win 23 states, and talk about ideas working-class people and young people already believe. Out of that came dozens of House members, city councilors, and state legislators who did win. Fridman says he showed that winning is possible, and that the idea will resonate for decades.

07

At 83 he does not fear death. He fears infirmity

Fridman asks whether Sanders ponders his own mortality, and whether he is afraid of it. At 83, he says, the question does come across. He is not afraid of death. What he fears is infirmity. Knocking on wood, he has been reasonably healthy except for a heart attack five years earlier, and what blew him away was that his body had failed him for the first time. Suddenly he was in a hospital bed. He has a great deal of compassion for people in nursing homes who have a hard time walking, or whose mental agility is slipping. That is the hard part. Everyone is going to die, and that he can live with. Getting older in that way concerns him. Fridman tells him his mind is as sharp as any politician he has heard, and that the warmth off-mic is still there after all the speeches and all the houses.

What gives him hope about the country and the world? He admits it is easy to become cynical: terrible wars, divisiveness, ugliness, poverty, climate change. He considers himself lucky because he has been able to go out. The image that crystallized it was a rally in an agricultural part of California, at sunset, with thousands of people. He looked around and saw young and old, Black, white, Latino, Asian American, a huge cross-section, all there to make the country better. He sees the same thing on the trail: people not interested in becoming billionaires, who want to improve life for others. It sounds like a platitude, he knows, the thing every politician says. But when you go to Native American reservations and factories, and you have been to every state, you see things many others have not, and that inspires him.

Fridman thanks him. Sanders turns the compliment around. He thinks there is growing dissatisfaction with corporate media, and not because reporters lie all the time; that, he says, is nonsense. People want to hear folks talk in a calm manner about important issues corporate media does not discuss. That is what Fridman and some others are doing, and Sanders calls it an important service to the country. Fridman thanks him as a former mayor for a wonderful town and says he looks forward to walking among the fall leaves. Sanders, dry as ever, notes that he did not quite create the leaves.

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