Medicare for All

We hear it over and over again – the private sector just does it better. Whether we’re talking education or healthcare or our criminal justice system, the default Republican (and sometimes Democratic) talking point is that competition in the marketplace allows the best ideas and best people (Elon Musk, lookin at you) to rise to the top and lead us to a utopian future (sponsored by Meta).

But then something wild happens like the cyberattack on UnitedHealthcare, which is causing massive fallout throughout our healthcare system over the past two weeks – so much so, that the company appears to have paid a 22 million dollar ransom to the hackers who breached their system and now the federal department of Health and Human Services has had to bail them out. That kind of thing really makes you question how anyone is still making the argument that the private sector has this shit handled. This episode, we’re bringing in special guest and political messaging expert Jordan Berg Powers to talk about how we talk about all of this stuff: public healthcare, private corporations, and how to message our way out of the corporate hellscape in which we currently find ourselves!

Jordan Berg Powers is a consultant and the former director of Mass Alliance. Most importantly, he is coming up on 30 YEARS of experience in campaigning and organizing for progressive causes and candidates. Jordan is a return guest to the podcast, first appearing in our My Big Fat American Healthcare episode.

Show Notes

UnitedHealthcare debacle is a little bit fun for us because we get to talk about the failures of a really shitty company, but like any healthcare debacle, there are some serious consequences. What happened here, and what does the UnitedHealth scandal look like for folks on the ground?

Starting on February 21, a group of hackers breached “Change Healthcare,” which is the largest electronic medical records and medical claims processing platform in the country. About half of all Americans’ health insurance claims pass through Change Healthcare, which was bought two years ago by UnitedHealthcare, the largest health insurer in the country.

Following the hack, Change Healthcare shut down its entire network, leading to complete mayhem in the healthcare system, which is still ongoing:

• “Hospitals have been unable to check insurance benefits of in-patient stays, handle the prior authorizations needed for patient procedures and surgeries or process billing that pays for medical services. Pharmacies have struggled to determine how much to charge patients for prescriptions without access to their health insurance records, forcing some to pay for costly medications out of pocket with cash, with others unable to afford the costs.” (source)


• This has led to a financial crisis for many hospitals, health clinics, physicians, and pharmacies, none of whom can be reimbursed for the care they’re providing, since they can’t submit medical claims. Provider associations are losing their shit, and the federal government has had to intervene to try to bail providers out in the meantime. 


• The story keeps getting crazier and juicier: apparently UnitedHealthcare made a ransom payment of $22 million to the hackers who breached their system using BitCoin (source) – p.s. those are our healthcare premium dollars hard at work


• Russian hackers may now have access to almost half the country’s medical records. I’m sure that won’t come back to haunt anyone in the years to come!

As much as we’d love to dwell on the UnitedHealthcare scandal that is unfolding, this incident really got us thinking about the broader debate over distrust of government, hatred of taxes, and bipartisan worship of market-based solutions.

Jordan explains the false dichotomy of government vs marketplace, public vs private; there is no marketplace without government. The question is, which way does the government tilt the marketplace playing field? The debate about government vs private market run healthcare isn’t productive. We should be concerned about the fact that we’re all being robbed to make rich people richer. UnitedHealthcare is owning so much of the healthcare marketplace is the result of 40 years of Wall Street profiteering at the expense of American patients and the security of our data.

Over the last 40 years the Right has been very successful at convincing Americans that the government is bad at everything. One slogan or one campaign can’t undo that. The message that does cross party lines is that we’re being ripped off.

The reason we need public programs like public education and healthcare is because they give the people oversight. Not only do they provide opportunities to the marginalized in our society, they are the only thing we can control.

It often feels like those of us who are fighting for the expansion of the public sector through programs like Medicare for All are constantly fighting the notion that government is dangerous, in part because the private insurance industry has controlled the national narrative about healthcare.

A weakness of the Left is letting the opposition frame the debate, and then trying to win the argument on their terrain. Jordan drops the truth bomb we all need to hear: you’ll always lose when you argue in good faith against bad actors. We have to control this impulse, and instead talk about our own good ideas not their dumb ones.

Another mistake we make is to fight an intellectual fight, when the Right is fighting about emotions. We need to work in the emotional state: this system is stupid, they’re stealing from us. We have to tell that story.

Ben reminds us of a report called “Parroting the Right” by Partners for Dignity and Rights, fka NESRI, which found that the health insurance industry got the entire media and polling landscape to use their framing when discussing universal healthcare. You won’t see terms like corporate-run healthcare or public insurance in polls about Medicare for All; you’ll see questions about government-run vs. private healthcare. It’s actually pretty remarkable with this biased polling language how many people still support Medicare for All.

Inside Medicare for All world we spend a lot of time talking about finding just the right words to articulate our cause. We love to talk about talking, but what we love even more is to fight about talking. One really good example is the internal movement debate about whether or not we should talk about healthcare in terms of human rights. A few years ago, Vermont nearly won single payer using rights based language. On the other side of the coin, messaging research in Minnesota found that voters had poor responses to rights-based language.

Rather than fighting about how we describe our solution, Jordan thinks that we need to get away from leading with solutions entirely; we need to take voters on the emotional journey first, before we bring them to the solution. We should start by talking about the broken system and lead people through their emotions of outrage. We need to be outside of for-profit hospital HQs and insurance giants, protesting that they’re stealing from us.

Instead of fighting about messaging and policy, what our movement needs most is people to have conversations with each other about how terrible healthcare corporations are. As fun as it is to fight amongst the choir, we need to talk to people and build the outrage. We don’t need more people who don’t know what they’re doing arguing about messaging and tactics; we need more people to talk to people, or pay someone to talk to people, says Jordan with the next great Healthcare-NOW t-shirt slogan.

Have you donated to Healthcare-NOW recently, by the way?

TL;DR: the #1 organizer question is “tell me how awful your life is.” Works in any setting, with any person: another patient in a clinic waiting room, a harried doctor or nurse, or an unorganized worker. The real “messaging” we need to worry about is the conversations we have with individuals. Instead of arguing about a hypothetical ad buy we can’t afford and won’t move the scales, work on the conversations!

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