The murder of the CEO of UnitedHealthcare, America’s largest health insurer, has generated a lot of discourse over the past week and renewed conversation about the state of the U.S. health care system — something that was almost entirely missing from the 2024 campaign.
Social media users have actively celebrated the shooting and thirsted over the suspect. In the other direction, New York Times columnist Bret Stephens argued the insurance exec was a “working-class hero,” while blogger Noah Smith asserted that health insurers are simply “middlemen” and not “the main villain of the U.S. health system.” The CEO of UnitedHealth Group (UHC’s parent company) wrote in the Times that the health conglomerate’s purpose is “to build a health care system that works better for everyone.” Sure, man.
Yet, CNN offered perhaps the strangest take in one segment this week: Americans are responsible for our health care system staying the way it’s designed today — i.e. based around private health insurance — because they like their insurance plans.
On Wednesday, CNN anchor John Berman and Harry Enten, a senior political data reporter, reviewed poll results from Gallup which showed that Americans broadly have negative views about health care coverage in the U.S., believe health care costs are too high, and say the health care system has major problems. Americans, for the most part, have more favorable views of their own health care coverage — which Berman and Enten repeatedly emphasized — though those numbers were not resounding.
“We can’t just say Americans hate health care. No, they like their health care,” said Berman. “They just have this notion they don’t like the health care system. I suppose you can hold those two views at once, but it is complicated.”
The argument that Americans like their own health insurance plans is a favorite industry talking point. Indeed, as the internet was heralding the UnitedHealthcare CEO’s murder, the health care industry’s primary anti-reform front group was posting on X: “A majority of voters nationwide are satisfied with their current health plans.” (The corollary to this industry talking point is: And that’s why nothing should ever change.) The thing is, people are typically OK with their health insurance plans until they really need to use it — and see their claims denied, get told they can’t receive a necessary treatment, or find themselves paying major out-of-pocket costs.
Considering the rest of Berman’s comment, the idea that Americans could like their health care and hate the system is still not necessarily a complicated view, because the U.S. health care system is uniquely expensive and wasteful. America spends far more on health care than other wealthy countries — for exceedingly poor outcomes. Being dissatisfied with the total cost of the health care system — as 79 percent of Americans are, per the Gallup poll — is simply correct.
Enten took things a step further: “You wonder why the health care system in this country stays the same,” he said. “It’s because people don’t like health care, in sort of the abstract — but when it comes to their own health care, a lot of Americans actually are pretty gosh darn satisfied with it.”
The idea that Americans are responsible for the health care system remaining the way it’s designed is ludicrous. The two have nothing to do with each other. The public doesn’t set policy — and even when Americans believe they are voting for change or for a specific policy platform they were promised, they rarely get it, thanks to entrenched corporate power and rampant corruption.
Donald Trump won in 2016 railing against health insurers that “are making a fortune because they have control of the politicians.” His first administration did nothing to address this in office, and instead encouraged more seniors to sign up for privatized Medicare Advantage plans. Joe Biden, meanwhile, campaigned in 2020 on a promise to enact a public health insurance option — and has not even once mentioned that policy idea as president. Instead, Democrats gave more subsidies, i.e. extra money, to health insurers to help more Americans sign up for individual health insurance plans.
Blaming Americans for the current system remaining in place obscures those who are actually responsible: a collection of massively lucrative businesses that profit from the current arrangement and the many politicians on both sides of the aisle who either dutifully represent their interests or are afraid to take on an industry with deep pockets — or both.
Our health care system works phenomenally well for health insurance companies, of course, and for other powerful industries: for instance, pharmaceutical companies that want to be able to keep drug prices far higher in the U.S. than in the rest of the world, or hospital chains that charge private plans much higher prices than Medicare would pay.
That’s why lobbies for health insurers, drug companies, and chain hospitals created a front group to oppose reform ideas like Medicare for All, the public option, and efforts to lower the Medicare eligibility age. (That front group is the one trying to tell people on X that Americans actually really like their health coverage and don’t want any meaningful changes.)
These lobbying groups each collect tens or hundreds of millions of dollars in revenue each year, from industries that collectively generate tens or hundreds of billions in annual revenue. (To be clear, there are many other lines of business that profit off our health care system’s bloat and administrative waste.)
All of the money sloshing around the health care system makes it incredibly difficult to change much, if anything, about it — because it limits any political incentive to try. Powerful health care interests shower politicians with donations, fund front groups that support them, and can spend these politicians into the ground any time, at will, if it becomes necessary.
As Democrats negotiated the Affordable Care Act between 2009 and 2010, health insurance lobbyists quietly funneled more than $100 million to the U.S. Chamber of Commerce to run a sprawling campaign slamming the legislation and its supporters. The ACA became law, but Democrats ultimately nixed the public option — before promising that idea again in 2020 and immediately dropping it once they won.
This year’s election featured little conversation about potential health care reforms. When Trump was asked during a debate to describe his plans for health care, the president-elect only said he had “concepts of a plan” to improve the ACA.
It was an embarrassing moment — yet, a Fox News Voter Analysis found the majority of respondents who said they were very concerned about their health care costs were supporting Trump.
Now, Team Trump is considering making it even harder for low-income households to access Medicaid coverage — and using the savings to help pay for more tax cuts for the wealthy and corporations. Republicans may also allow the expanded subsidies to expire, which would make it more expensive for many Americans to buy individual coverage.
Americans didn’t make our health care system the way it is today — and they certainly didn’t vote for Republicans to make it even worse, if that’s what they end up doing. An immensely powerful health care industry and corrupt political class give Americans no choices in these matters at all.
Daniel D`Amico for SANREMO.FM
