In 1966, every American citizen over the age of sixty-five received a card in the mail emblazoned with the words “HEALTH INSURANCE” and an official seal from the federal Department of Health, Education, and Welfare.

The card certified the right of its recipient to health care coverage, funded by progressive taxes. The elderly could no longer work? No problem. They would receive insurance untethered to employment. Many had little savings, and families with few resources. Again, no problem. The coverage would be paid for by all of society, on the basis that every person deserved to lead a dignified and secure existence in their final decades. The program was called Medicare.

On the anniversary of Medicare’s creation, Bernie Sanders is calling for its expansion into a universal and comprehensive public health insurance policy. For over half a century, Medicare has guaranteed millions of people medicine, treatment, and relative peace of mind. Everyone deserves these things, says Sanders, not just older people.

“I want to say a word about this transition,” Sanders said Wednesday, at a speech at George Washington University,

because I hear over and over again from political opponents, from the industry, “It can’t be done.” Stop and think about the year 1965, when Medicare was first introduced. They did not have then the kind of technology that we have right now. They were developing a brand new program, with all of the difficulty that entails. So please do not tell me that… with all of the technology that we have, that we cannot simply over a four year period expand a successful program that is fifty-five years old.

Medicare for All is not just an expansion of existing Medicare benefits. As the slogan coined by National Nurses United in reference to Medicare for All goes, “Love it! Improve it!” The program would eliminate co-pays, premiums, and deductibles for everyone, including Medicare recipients who currently shoulder those costs. In its first year, Sanders’s proposed program gives current Medicare recipients coverage for eyeglasses, hearing aids, and dental care.

“The ability to hear, the ability to see, the desire to have teeth in your mouth is a healthcare issue,” Sanders said.

Over a four-year period, the eligibility age will gradually lower until everyone is covered. Recipients will then be able to go to the doctor, hospital, or clinic of their choosing, instead of having to worry about whether it’s in network. They will no longer receive medical bills. People will pay slightly more in taxes, but way less overall in healthcare costs, and would be able to get the care they need, whenever they need it.

On this latter point, Sanders tackled the right-wing spin with sarcasm. Opponents of Medicare for All, he said, “seem to think that the American people hate paying taxes, but they just love paying insurance premiums. ‘Oh my god dear, the insurance premium is here, what a wonderful day! Oh wow, let’s celebrate, hey!’”

People don’t care who they write their checks out to: they just want to pay less, get the care they need, and never again have to make difficult decisions between their health and their finances.

Everyone, Sanders insisted, will get a better deal under this system. Well, almost everyone. Medicare for All will put private insurance companies out of business, and allow the federal government to negotiate with pharmaceutical companies to bring down prescription drug costs.

As Medicare for All has risen from obscurity to broad popularity in the last few years — thanks in large part to Sanders himself, who has supported single-payer healthcare since the eighties and made it the central demand of his 2016 presidential campaign — insurance and pharma executives rightly view it as an existential threat to their bottom line.

Sanders is not shying away from that conflict. In fact, he wants the American people to know that the main thing standing in the way of them and tax-funded, comprehensive, permanent health care is corporations’ compulsion to maximize profits.

“The current debate over Medicare for All has nothing to do with healthcare,” Sanders said.

We are not in a debate about which healthcare system is working well or which is better. Nobody thinks that a system in which 80 million or more have no health insurance or are underinsured is a good system. Nobody I know thinks that when Americans are paying the highest prices in world for prescription drugs, that that is a good system.

“The debate that we are currently having,” he continued,

has nothing to do with healthcare but it has everything to do with the greed and profits of the healthcare industry. What we are talking about is a healthcare industry of the insurance companies, the drug companies, the medical equipment suppliers, Wall Street, entities that make tens and tens of billions of dollars every single year while ignoring and turning their backs on the needs of the American people. That is what this debate is about.

This debate is about whether we maintain a dysfunctional system which allows the drug and healthcare companies to make over one hundred billion dollars in profit last year, while the top CEOs in the industry made 2.6 billion in total compensation — all the while, when one out of five Americans cannot afford to fill the prescription drugs that their doctors prescribe.

By contrast, Sanders said, Medicare for All is “a rational healthcare system” whose purpose “is to provide healthcare to all in a cost-effective way, not to make billions in profits for the drug companies and the insurance companies.”

Sanders also delivered a sober assessment of the battles to come. These companies, he said, have unimaginable resources, power, and influence, and they will lobby hard to defeat Medicare for All — not because it’s an ineffective system, but because it undercuts and in some cases eliminates their ability to profit off ordinary people in their time of need.

“The struggle we are now undertaking,” Sanders said, “will be opposed by some of the most powerful special interests in our country, entities that have unlimited amounts of money. … They will use those resources in opposition to the Medicare for All campaign.” He continued,

You will be seeing these entities spending endless amounts of money on thirty-second television ads telling you how terrible Medicare for All is. You’re going to see full-page magazine and newspaper advertisements, you’re going to see radio ads, and you’re going to see a number of corporate entities come up with studies that will tell you why Medicare for All is not the way to go.

But let me just tell you that over fifty years ago, when Medicare in this country was passed, the special interests did exactly the same thing. … They failed. And my friends, they are going to fail again.

In preparation for the coming showdown, pharmaceutical and insurance industry lobbyists have not restricted their backroom dealmaking to reliable friends in the GOP. They have also poured money into the Democratic Party, attempting to buy allies who can propagate misinformation about and deflate enthusiasm for Medicare for All. And they’ve found more than a few takers.

His hand forced by Sanders, who has made the practice a near-taboo in Democratic Party politics, Joe Biden has promised not to directly accept special-interest money for his campaign. But his PAC continues to absorb corporate donations, including from donors with ties to the pharmaceutical and insurance industries.

Donations aside, Biden is also a political moderate who was selected as vice president by Barack Obama in order to balance the scales and appeal to more conservative voters. He personally cautioned Obama against the Affordable Care Act, considering it too radical. Even though our healthcare system is failing millions of people, Biden has no real personal interest in fundamentally changing it. He will only go as far left as he thinks is necessary to stay afloat in the party primary.

It comes as no surprise, then, that Biden is swinging hard against Medicare for All. He has counterposed it to his own plan, which introduces a public option to be sold on the Affordable Care Act marketplace.

Biden admits that his plan does not guarantee universal coverage. By one estimate, 125,000 people will die from lack of insurance in the first ten years under Bidencare.

Biden is not a deep thinker on matters of healthcare policy. Luckily for him, he has industry talking points to guide him. Sanders has taken him to task on his cookie-cutter misinformation campaign.

On Tuesday, Sanders published a quiz on his website, challenging readers to guess who said what about Medicare for All — Joe Biden, Donald Trump, Mitch McConnell, or United Healthcare CEO David Wichmann. Their smears are indistinguishable.

It was Joe Biden who said, “Medicare goes away as you know it. All the Medicare you have is gone.” It was Donald Trump who said, “Medicare for All would really be Medicare for None… today’s Medicare would be forced to die.”

Sanders devoted a great deal of his speech on Wednesday to dispelling myths about Medicare for All. He then issued a challenge, one that seemed tailormade for Biden.

“Today I am calling on every Democratic candidate in this election to join me in rejecting money from the insurance and drug companies. Reject that money.” He continued, “Candidates who are not willing to take that pledge should explain to the American people why those… donations are a good investment for the healthcare industry.”

In recent weeks, the Sanders campaign has been leaning even harder than usual on issues of healthcare inequality. On Monday, Sanders spoke in Philadelphia outside of Hahnemann University Hospital, which is slated to close because its owner, an investment banker from Los Angeles, no longer sees it as a good investment. The hospital serves a mostly low-income, non-white population, which will be left without ready access to medical treatment after it’s gone.

Later this month, Sanders also plans to accompany a group of diabetes patients on a trip from Detroit to Canada, where they will acquire the insulin they need to live at a fraction of the price. The trip aims to draw attention to astronomical drug prices in the US, a problem that Medicare for All will allow the federal government to tackle head-on.

Sanders’s speech on Wednesday showed that despite the forces arrayed against him — and with full knowledge of the extent of their power — he’s steadfast in his support for Medicare for All. And he’s ready to rumble with the healthcare executives and their elected friends.

If Sanders and the movement he’s trying to build win, maybe we will all eventually get a card in the mail similar to the one millions of people received in 1966. With that card we can go to any doctor or hospital we want, and get any treatment or service we need. It will be the dawning of a new day in America: a day when the health of the many is prioritized over the profits of the few.