United States of Care Doesn’t Get It: Health Care IS Politics
Photo by John Moore/Getty
United States of Care is a new initiative that aims to “put health care over politics” to “change the conversation.” The group is headed by former acting administrator of the centers for Medicare and Medicaid services under President Obama, Andy Slavitt. The group presents itself as a safe haven to discuss “common sense solutions” to fixing our fundamentally broken health care system. If you feel your eyes rolling back into your head, your instincts are likely correct. Here’s what it’s all about.
A new movement, @USofCare, is being launched to put #healthcareoverpolitics.
Here’s what it’s about. pic.twitter.com/pdHknBNfR7
— Andy Slavitt (@ASlavitt) February 6, 2018
So, first off, health care is politics. Medicare and Medicaid are paid for by the government. Solutions to fixing health care are done through the political system. That phrase is less than meaningless, and it intimates that the policies this group wants solely exist in the private sector. Secondly, what is the difference between number one and number two? How is affordable health care a separate goal from ensuring that people can’t be bankrupted by health care bills? Not to mention, number three undercuts number one and two. In order to make health care affordable, we must spend a lot of money to subsidize it. Slavitt should know, as Medicare doesn’t come cheap. That kind of spending doesn’t appease the deficit hawks that populate most of D.C., and insurance company shills like Bill Frist who happens to be on United States of Care’s board of directors.
Plus, there are plenty of other health care executives on their founder’s council (and zero nurses, a medical constituency famed for its support of universal health care). These executives have spent entire lives ensuring that people don’t have access to affordable health care, and now we’re supposed to believe that they want to right the wrongs they have made millions from? Apologies for my cynicism, but that’s not the America that I grew up in over the last thirty years. United States of Care is two days old, so coming to any unequivocal conclusion of their motives is unfair (especially since they haven’t released any policy positions), but skepticism is far more realistic than optimism—especially since their mission statement is straight out of the Republican playbook. Per United States of Care (emphasis mine):
United States of Care is a new movement to ensure that every single American has access to quality, affordable health care regardless of health status, social need, or income.
This conflicts with Slavitt’s tweet above, who said that every American “should have an affordable regular source of health care for themselves and their families.” That is not the same thing as “access to quality, affordable health care.” This is what the Republican Party has been pushing in their “market-based solutions” my entire life, and if a group filled with a bunch of former health care executives is communicating a different message from the founder of the group, then you can’t help but wonder who’s really driving this car.
so @ASlavitt took a position last year with the Bipartisan Policy Center. one of their goals?
“Policies that promote stable private insurance markets” pic.twitter.com/vrWZLmrBv6— jen (@cruciverberella) February 7, 2018
…the “future of health care initiative” was also introduced by Blue Cross/Blue Shield of Minnesota. pic.twitter.com/xiDAhz6Ero
— jen (@cruciverberella) February 7, 2018
oh, what is this? the “united states of care campaign” is based in Minnesota and DC? huh, wonder why? @ASlavitt it would be really helpful to go ahead and admit where the funding is coming from for @USofCare – otherwise it’s clear it’s just another front for big corporate money. pic.twitter.com/FIcQTGnwdq
— jen (@cruciverberella) February 7, 2018
The endgame for liberals right now is Medicare for all. That became clear when 2020 presidential favorites Kirsten Gillibrand, Kamala Harris and Cory Booker all signed on to Bernie Sanders’ Medicare for all bill. There is robust public support for it, according to Pew.
— 52% of Democrats support single payer.
— 64% of liberals support single payer.
— 33% of Americans support single payer, with another 25% supporting a mix of public and private programs.
— 12% of Republicans support single payer, with 20% of moderate Republicans.
Medicare for all is not the overwhelming political winner it is painted as in the Twitter echo chamber, but it already won the battle on the left, and is making inroads on the right. Take a step back, and it seems inevitable that America will wind up with some form of single payer health care some day. During the entirety of the second Bush administration, Gallup found that over 60% of Americans believed that “it is the responsibility of the federal government to make sure all Americans have health care coverage.” That figure dipped during the Obama years, only to track back up over the past few years—presently sitting at 56%—which suggests that Republicans want government-run health care when Republicans are in government. Ideology gets in the way of a clear majority opinion: private health care systems suck.
Which is why this United States of Care initiative is so weird. It has proponents of Medicare for all on board, like former Obama speechwriter and Pod Save America host Jon Favreau.
I’m a #MedicareForAll advocate. I also want to make sure there’s a path to get there, which involves building a movement and persuading people who don’t currently agree.
— Jon Favreau (@jonfavs) February 6, 2018
Favreau got unfairly raked over the coals on Twitter last night, with people calling him a scab and a traitor. Folks, we are not going to get Medicare for all by rabidly attacking our allies. Nitpick with Favreau’s logic all you want (and you should), but don’t impugn his character. Between the Obama years and his hit podcast with other Obama alums Tommy Vietor and Jon Lovett, he is a very influential voice on the left, and he’s trying to use his influence to accomplish a policy victory that is vital to the far left’s agenda. I’m of the opinion that he’s making the same Sorkinesque mistake that so many Democrats have made before him, but indicting his character over it is a great way to silence key allies.
The mistake that I believe Favreau is making is trying to find compromise with people who have no interest in compromising with him. Republicans have used scorched Earth tactics to jam our ruling class’s agenda down this country’s throat over the last few decades, and the Democrats have allowed it to happen by becoming the Charlie Brown to their Lucy—as the Republicans pull away the football while Democrats try to kick it over and over and over again. Compromise with our oligarchs is not how we get single payer. Building a coalition which outnumbers the establishment is how we get single payer. On this topic, Favreau clearly understands.
No, what’s lacking is 60 votes in the Senate, 218 in the House, and a Democratic President committed to Medicare for All.
— Jon Favreau (@jonfavs) February 7, 2018
But it’s how we go about building that coalition where we disagree. The interests of health care executives are diametrically opposed to single payer. It’s like trying to convince someone who just bought a new house to set it on fire before buying insurance. Polls demonstrate that a majority coalition to get to single payer already exists, and initiatives like United States of Care which aim to work with insurance companies miss the entire point of the present moment. We need a health care revolution in this country, and the ruling class is always the target of any revolution. After all, they’re the ones perpetuating a status quo which necessitates a gigantic sea change—so by definition, their input is not needed on our future. The French didn’t ask the bourgeoisie how to go about building a new government while they were trapped in guillotines, and we didn’t seek input from the King on our American revolution. This is the kind of evil that we’re up against in any market-based health care solution.
I went to the ER on a Sunday night because I felt like my head was exploding and I couldn’t freely move my neck. I was also on antibiotics. My dad is an internist. He told me to go to the ER because he was worried that I had meningitis. 2/
— Sidra Zaidi (@sidra_zaidi) February 6, 2018
When the doctor finally arrives, he asks me about the antibiotics I am taking and my level of pain. He orders blood tests, a “mild inflammatory” drug, and saline. That’s it. No CT scans, no serious pain meds. Just blood draw + saline and ibuprofen. He sends me home. 4/
— Sidra Zaidi (@sidra_zaidi) February 6, 2018
Yes, in hindsight I should have gone to urgent care. But it was a Sunday night. Plus, when doctor dad says go to the ER, you go to the ER. 6/
— Sidra Zaidi (@sidra_zaidi) February 6, 2018
Level 4 emergencies are the second highest emergency levels. Level 5 is the highest. These levels are reserved for severe emergencies that require immediate medical attention, like heart attacks, broken bones, and appendicitis. 8/
— Sidra Zaidi (@sidra_zaidi) February 6, 2018
So @nyulangone calls me today (half a year after I got the bill and 4 months after I disputed it), to explain how they came to their coding decision. Oh boy, here it comes. 10/
— Sidra Zaidi (@sidra_zaidi) February 6, 2018
Coding based on medical history alone discriminates against people with pre-existing conditions. If a cancer survivor goes to the ER for an earache and the doctor notes her past cancer diagnosis, then @nyulangone billing guidelines allow them to bill the highest amount. 12/
— Sidra Zaidi (@sidra_zaidi) February 6, 2018
US #healthcare costs are much higher than in other industrialized countries and do not correlate with superior quality of care. One reason for this is because hospitals and doctors are getting away with price gouging and fraudulent practices. 14/
— Sidra Zaidi (@sidra_zaidi) February 6, 2018
It’s no wonder that Dr. Robert I. Grossman, CEO of @nyulangone, got a 70% pay raise over four years, to the tune of $4 million. https://t.co/JXKnwpwycJ 16/16
— Sidra Zaidi (@sidra_zaidi) February 6, 2018
There is no compromising with that system. The only way to reform it is to smash it, and a bunch of meaningless word barf from a group that won’t disclose its donors and won’t commit to endorsing any policies (as of now), and whose mission statement conflicts with the aims of its founder does not look like part of the solution. It’s a distraction, and one can’t help but wonder if that’s its true reason for existence.
Jacob Weindling is a staff writer for Paste politics. Follow him on Twitter at @Jakeweindling.