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.
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.
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.
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.
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.
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.