Photo: Themba Hadebe (AP)

Former President Barack Obama gave what appeared to dually serve as a treatise on the state of U.S. democracy and a quasi-stump speech at the University of Illinois in Champaign, IL, today, delivering a speech that ripped into both his successor in the presidency and the Republicans who enable him. He also endorsed a host of “good, new ideas” that Democrats are running on this year.

Among those good ideas? Medicare for All.

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“I happen to be a Democrat. I believe our policies are better and we have a bigger, bolder vision of equality and justice and inclusive democracy,” Obama said. “We know there are a lot of jobs young people aren’t getting a chance to occupy or aren’t getting paid enough or aren’t getting benefits like insurance. It’s harder for young people to save for a rainy day let alone retirement.

“So, Democrats aren’t just running on good old ideas like a higher minimum wage,” he continued. “They’re running on good new ideas, like Medicare for all, giving workers seats on corporate boards, [and] reversing the most egregious corporate tax cuts to make sure college students graduate debt-free.”

Although this seems to be the first time Obama has given the thumbs up to Medicare for All specifically, he endorsed single payer healthcare while running for U.S. Senate, saying he was a “proponent of a single payer, universal healthcare bill.” Once in the Senate, however, Obama began to waffle, as David Sirota wrote in 2006:

I asked him to give me some specific examples of what he meant. Is a proposal to convert America’s healthcare system to one in which the government is the single payer for all services revolutionary or reformist? “Anything that Canada does can’t be entirely revolutionary-it’s Canada,” Obama joked. “When I drive through Toronto, it doesn’t look like a bunch of Maoists.” Even so, Obama said that although he “would not shy away from a debate about single-payer,” right now he is “not convinced that it is the best way to achieve universal healthcare.”

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After Obama took office as president and his administration began to work on what eventually became the Affordable Care Act, he abandoned the idea almost immediately. In a June 2009 speech to the American Medical Association, Obama said:

I’ll be honest. There are countries where a single-payer system may be working. But I believe—and I’ve even taken some flak from members of my own party for this belief—that it is important for us to build on our traditions here in the United States. So, when you hear the naysayers claim that I’m trying to bring about government-run health care, know this – they are not telling the truth.

And in an interview to NPR given that very same week, then-Health and Human Services Secretary Kathleen Sebelius said:

This is not a trick. This is not single-payer. That’s not what anyone is talking about—mostly because the president feels strongly, as I do, that dismantling private health coverage for the 180 million Americans that have it, discouraging more employers from coming into the marketplace, is really the bad, you know, is a bad direction to go.

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The endorsement of Medicare for All by one of the Democratic Party’s most popular figures is indicative of the seismic shift that’s taken place in the party—just a few short years removed from when the party’s presidential nominee said that single payer would “never, ever come to pass.” With Obama’s support, it’s indisputable that Medicare for All is a firmly mainstream proposal in the Democratic Party.

But Obama’s endorsement should also serve as a warning for healthcare activists. While the House and Senate Medicare for All bills have the support of well over half of the House Democratic caucus and 17 Senators in the Democratic caucus, it’s very easy to support a bill that you know isn’t going to be enacted for at least two and a half more years, as Republicans painfully found out during their attempts to repeal Obamacare. (Still, they were able to gut the individual mandate in last year’s abhorrent tax bill, which Obama also criticized on Friday.)

If we want a truly just healthcare system, it’s going to take more than endorsements to make it happen. It’s going to take relentless pressure on congressional Democrats and party leaders both now and in the future—when what’s merely possible becomes actionable.

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Below, you can watch Obama’s full speech, which begins around the 29:00 mark: