Will ‘Medicare for All’ Doom Bernie Sanders and Elizabeth Warren in Nevada?

Scott Bixby
Aaron Bernstein/Reuters

LAS VEGAS—On the eve of the Nevada caucuses, presidential hopefuls hoping to thwart Sen. Bernie Sanders’ hopes of clinching his second primary contest victory in a row have honed in on what they hope is a winning message to voters: “Medicare for All” will steal your gold-plated union health care.

But even though former Vice President Joe Biden, former Mayor Pete Buttigieg and Sen. Amy Klobuchar of Minnesota remain convinced that they can use Sanders’ signature issue to drive a wedge between the Vermont senator and the all-powerful union vote—and stymie a resurgent Sen. Elizabeth Warren, who has also built her campaign around the policy—whether the argument will actually peel labor voters away remains an unanswered question.

“I mean, it’s still unclear,” said Bethany Khan, director of communications and digital strategy for the Culinary Workers Union Local 226, which represents workers in the hotel and restaurant industry and describes itself, accurately, as “one of the strongest political forces in the state.”

“I think that's why we’ve been insistent on the conversation, including our right to have choice on our health and keeping our health care benefits that we fought for 85 years to have,” Khan added.

There is no better evidence of the fruits of that decades-long fight than the union’s glistening Culinary Health Center—and the Culinary Workers Union clearly knows it, considering the number of candidates who have been invited on well-publicized tours therein. Members access care at the center with no premiums and almost no copays, as well as medical staff exclusive to the union’s members and their families.

The center, an ultramodern facility northeast of the Las Vegas Strip that provides primary, preventative, dental, pediatric, pharmaceutical and vision care to members of the Las Vegas Culinary Health Fund, is the crown jewel of the union’s health care coverage—and, some members fear, at risk of vanishing if the union’s plans were to be replaced by a single Medicare for All-type system.

“This is the strongest union in town—they’re doing a great job for their workers,” said Tom Steyer after the conclusion of a tour of the center on Friday morning, gesturing around the brightly lit entrance area of the center as evidence of just how good a job the union had done. “I think that we need to push the rights of working people, the rights of organization in the United States again, because working people have been screwed for 40 years.”

Steyer, who admired the building’s floral decor and marveled at the “light show” demonstration at the center’s pharmacy—wherein a plastic bag clip lights up when a person’s prescription has been filled, allowing quick retrieval of medications without risk of accidentally swapping them—said that his ideal health care system was a version of the center that would be available to all, rather than taking it away from union members.

Staff at the center highlighted the importance of a facility that understands the particular medical needs of people in the service industry, where stress-related hypertension and diabetes is a major risk and where long hours can be a particular health hazard.

“One of the things I think that’s important about us being here 24/7 is we understand the schedule—the three shifts, some are working two shifts at a time,” one physician told Steyer. “Another thing that sounds kind of crazy… when they take a once-a-day pill, sometimes it'll say ‘at bedtime.’ Well, bedtime for them changes depending on what they're working that week.”

Steyer brought the conversation to cost, which he pinned on the pharmaceutical industry and “total monopolization” of drug prices, relaying a story from the night before when a group of pharmaceutical representatives in town for a convention approached him at dinner to take a photograph.

“I said, you guys are screwing everybody,” Steyer said. “And they’re like, ‘we know that!’”

Steyer’s experience didn’t shift his view of Medicare for All, he said later.

“I’m not for Medicare for All—I’m for choice,” Steyer said. “I’m for a public option on the Affordable Care Act, and if we can make it good enough, then everybody’s going to choose it. But it’s on us to make it good enough so that people are willing to give up their employer-based health care.”

But no demographic is a monolith, and every voter is a thread in a rich tapestry of vastly different life experiences, values and needs—which means that when The Daily Beast canvassed Culinary Union workers in five different casinos and hotels on the Las Vegas Strip, many of them said that Sanders’ and Warren’s commitment to Medicare for All had little bearing on their support for the two senators. In fact, some said that the instability of many service industry careers made them more likely to support such a proposal.

“The health care we get is really, really good,” said Donna, a housekeeper at the Aria Resort & Casino who, like the rest of the Culinary Union members The Daily Beast spoke with, preferred to use her first name since she was on-shift. “But if you lose your job, that’s it—you’re stuck with nothing.”

“I have friends who aren’t in Culinary who get mad jealous” of its health care coverage, said Marc, an elevator attendant at another casino resort, “but if you’re in a restaurant and it closes down you’re basically, like, screwed.”

Comments like those illustrate a break of sorts with the union’s leadership, which faced the brunt of an ugly harassment campaign after it circulated a flyer saying that Sanders’ signature policy proposal would “end Culinary Healthcare” by forcing members to lose negotiated benefits and go on a government health plan.

Warren’s plan, the flyer said, would “replace Culinary Healthcare after 3-year transition or at end of collective bargaining agreements.”

Consequences of the resulting online firestorm were felt in the real world: Sanders was the only Democratic presidential hopeful campaigning in the state who did not join picketing union members outside of the Palms Casino Resort. Hours later, on the debate stage, Buttigieg promised to “deliver health care without taking it away from anyone,” and to “build a movement without having legions of our supporters online and in person attacking Democratic figures and union leaders alike.”

Sanders publicly disavowed the attacks, which culminated in the spokeswoman for the Culinary Union receiving calls from people telling her that she was “a fucking whore,” a “bitch,” and “an ignorant dumb fuck.”

“If there are a few people who make ugly remarks, who attack trade union leaders, I disown those people,” Sanders said on Wednesday. “They are not part of our movement.”

Sanders also pledged to never sign legislation “that will reduce the health care benefits they have—we will only expand it for them, for every union in America.”

The Sanders campaign has pledged to create a system whereby the Culinary Union and others like it would be able to maintain their clinics, even under a government-run system.

“Bernie has been clear that under Medicare for All, we will guarantee that coverage is as comprehensive or more so than the health care benefits union workers currently receive, and union health clinics, including the Culinary’s health clinic, will remain open to serve their members,” Nevada state director Sarah Michelsen said in a statement.

But those assurances haven’t necessarily convinced top union brass. The Culinary Union’s decision to not endorse any presidential candidate was seen by many as a way to dodge further online opprobrium, as well as to avoid alienating members for whom Medicare for All isn’t so bad. Khan said that simply wasn’t the case, however.

“The no-endorsement reflects the overwhelming view of the members: that we prioritize our organizing goals,” Khan said, listing the union’s fight with union-busting Station Casinos, its work on immigration, and living wages.

“There are plenty of good candidates in the field—members can choose who they like,” Khan added.

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