El Sayed, who has also embraced the radical ‘Abolish ICE’ slogan, wants the public to trust Washington with sweeping power over medical care. It goes to the heart of whether El Sayed lives according to the principles he promotes when seeking votes, influence, and public power. Psychiatry practices operate in a difficult corner of the health care system, where reimbursement, administrative burdens, and patient access all carry serious consequences. El Sayed may argue that Medicare for All would differ from the current Medicare system. On this issue, El Sayed faces a simple credibility problem that no amount of progressive branding can erase.