From Lever Time: Sirota—The Health Care Crisis Is The Democracy Crisis - Master Plan

Summary

Master Plan Podcast Summary: "From Lever Time: Sirota—The Health Care Crisis Is The Democracy Crisis"

Release Date: December 17, 2024

Introduction

In the episode titled "From Lever Time: Sirota—The Health Care Crisis Is The Democracy Crisis," David Sirota, the host of Master Plan and former speechwriter for Bernie Sanders, delves into the intertwined crises of America's healthcare system and its democratic foundations. Awarded the 2024 Signal Awards for News & Politics and Best Writing, this episode sheds light on the systemic corruption that allows the wealthy to manipulate policies for their benefit, leaving the public grappling with inadequate medical care.

Public Anger Over the Broken Healthcare System

Sirota opens the discussion by addressing the surge of public frustration towards America's dysfunctional health insurance system. He draws parallels between the historical unfulfilled promises of various presidencies and the present-day reality where political corruption perpetuates a system designed to deny medical care for profit.

“The fact of the matter is that what we are now talking about doing, most of the countries of Europe did years ago. The British did it 30 years ago. We are behind every country pretty nearly in Europe in this matter of medical care for our citizens.” [03:45]

The episode highlights a recent incident—the murder of UnitedHealth CEO Brian Thompson—as a stark manifestation of this public anger. Sirota emphasizes that while such violence is reprehensible and unacceptable, it underscores the profound disillusionment with a system that forces citizens to resort to extreme measures out of desperation.

Influence of Money in Politics

A central theme of the episode is the pervasive influence of money in politics, particularly from the health insurance industry. Sirota argues that decades of lobbying and campaign contributions have entrenched political corruption, making meaningful healthcare reform nearly impossible. This corruption has led to skyrocketing premiums and widespread denial of claims, exacerbating the crisis.

“Seven health insurance CEOs were paid $335 million in a single year. All of these indignities are the product of a government filled with politicians who are bankrolled by insurers and who use their power to block the most basic reforms.” [18:30]

Sirota underscores how the political establishment prioritizes the interests of the wealthy and powerful over the healthcare needs of ordinary Americans, effectively transforming democracy into a kleptocracy.

History of Health Care Reform Attempts

The episode provides a comprehensive overview of past attempts to reform the U.S. healthcare system:

John F. Kennedy and Medicare: Sirota recalls JFK's pivotal role in the creation of Medicare, highlighting his vision for healthcare reform tied to the survival of democracy.

“Kennedy's speeches on the survival of democracy and the need for health care reform seem more relevant than ever.” [05:20]
Clinton Administration: In the early 1990s, President Bill Clinton pushed for universal healthcare, proposing a healthcare security card guaranteeing comprehensive benefits. However, intense lobbying from the insurance industry derailed these efforts.
Obama Administration and the Affordable Care Act (ACA): Sirota critiques the ACA for including substantial taxpayer subsidies for insurance companies while excluding a public health insurance option, despite initial promises. This compromise maintained the status quo, leaving the fundamental issues unresolved.
Bernie Sanders and Medicare for All: The episode discusses Sanders' 2016 campaign advocating for a single-payer system, which faced significant opposition from within his own party, particularly from Hillary Clinton and later Joe Biden, who pledged to veto such legislation.

“Joe Biden by that point was running for president on a promise to veto Medicare for All legislation if it ever got to his desk.” [24:15]

Current State and the 2024 Election

As the 2024 election approaches, Sirota laments the absence of meaningful healthcare discourse in the campaign. He attributes this silence to the overpowering influence of the healthcare industry, which dictates the agenda to avoid any reforms that might disrupt their profit mechanisms.

“In the 2024 campaign, healthcare debate was essentially this that's right, nothing. There was no health care conversation at all.” [30:10]

This lack of dialogue leaves Americans feeling that their urgent health care needs are being ignored by both major political parties, perpetuating the cycle of inadequacy and public dissatisfaction.

Conclusion: Democracy in Crisis and the Path Forward

Sirota concludes by reiterating John F. Kennedy's warning about the fragility of democracy in the face of sustained inequality and corruption. He emphasizes that the proper response to the healthcare crisis is not violence but a vigorous re-engagement with democratic institutions to demand systemic change.

“The solution is a renewed focus on using our democratic institutions to force lawmakers to change the system. As the old saying goes, power concedes nothing without a demand.” [35:50]

He calls for the public to amplify their demands for a humane healthcare system, warning that without such efforts, the democratic fabric of the nation may further unravel.

Notable Quotes with Timestamps

JFK on Democracy and Healthcare:

“Kennedy's speeches on the survival of democracy and the need for health care reform seem more relevant than ever.” [05:20]
Impact of Insurance Industry Profits:

“Seven health insurance CEOs were paid $335 million in a single year. All of these indignities are the product of a government filled with politicians who are bankrolled by insurers and who use their power to block the most basic reforms.” [18:30]
Critique of Affordable Care Act:

“Affordable Care act included massive taxpayer subsidies for the insurance industry and Obama's promised public health insurance option being excluded from the final bill.” [20:45]
Bernie Sanders on Healthcare:

“I happen to be a proponent of a single payer universal health care. The United States of America... cannot provide basic health insurance to everybody.” [22:10]
Call to Action for Democracy:

“The solution is a renewed focus on using our democratic institutions to force lawmakers to change the system. As the old saying goes, power concedes nothing without a demand.” [35:50]

Final Thoughts

David Sirota's episode "From Lever Time: Sirota—The Health Care Crisis Is The Democracy Crisis" offers a compelling analysis of the systemic issues plaguing America's healthcare system and democracy. By tracing the historical attempts at reform and highlighting the ongoing influence of the insurance industry, Sirota underscores the urgent need for public activism and political will to achieve meaningful change. This episode serves as both a wake-up call and a rallying cry for listeners to engage actively in the democratic process to reclaim the integrity of healthcare for all Americans.

Transcript

David Sirota (0:02)

The Lever hey everyone, it's David Sirota. Today on the Master Plan feed, I'm sharing this special episode from the Levers weekly podcast, Lever Time because it relates to the influence of money in politics, specifically healthcare money. In this episode I discuss the surge of public anger unleashed in recent weeks against America's broken health insurance system. Like Masterplan, this audio essay explores the history of broken promises across multiple presidencies. And it exposes the political corruption that's trapped Americans in a system built to profit off of denying medical care. After you listen, I'd like you to go subscribe to levertime in your podcast app and check out last week's reported episode on the same topic, which was titled why America is Mad as Hell About Healthcare. In that episode, levertime producer Arjun Singh interviews insurance industry whistleblower Wendell Potter, who exposes how these companies harm patients. Just search for LeverTime in your podcast app to find it and go subscribe to LeVertime. Now. Here's my audio essay Murder by Spreadsheet Imagine waking up to find out that your private information has become available online for the world to see. Or talking personal details that you never want exposed. Well, this is the reality for countless people worldwide. For example, just this April, hackers tried to sell 2.9 billion stolen records online. Yes, billion with a B. The numbers are staggering. The major risks here include identity theft, fraud and phishing attacks. One way to fight back is with Incogni. Incogni contacts online data brokers on your behalf to remove your information from servers. Incogni also provides you with an online dashboard showing you how your data is being removed and protected. Go to Levernews.com data right now and get 55% off an annual Incogni plan when you use code lever55 at checkout. That's L E V E R55. There's a 30 day money back guarantee if you change your mind, so there's no danger in trying it out. To claim your massive discount on incogni, go to Levernews.com data from the Lever's reader supported newsroom. This is Lever Time. I'm David Sirota. After the murder of a health insurance CEO and all the anger Americans are suddenly expressing about the healthcare system, I've been thinking a lot about President John F. Kennedy's famous warning in 1962 those who make peaceful revolution impossible will make violent revolution inevitable. Kennedy was recognizing a universal truth in human history. Social stability, the rule of law and civilization itself will eventually break down if a population is immiserated for Too long, while a handful of elites profit. And just two months after that speech, JFK honed in on the health care crisis in America, pressing for the passage of what would become Medicare. The fact of the matter is that what we are now talking about doing, most of the countries of Europe did years ago. The British did it 30 years ago. We are behind every country pretty nearly in Europe in this matter of medical care for our citizens. Kennedy's speeches on the survival of democracy and the need for health care reform seem more relevant than ever. Right now, the connection between the two seems more obvious than ever. Think about what's happened in the last few weeks. All of a sudden, after the murder of UnitedHealth CEO Brian Thompson, everyone seems to be talking about healthcare. And yet a discussion of healthcare was almost completely absent from the presidential campaign. This is the democracy crisis staring at us in the face. A public is rightly angry at a massive policy failure, and yet politicians and the media making sure that that failure is not even being discussed in the election. That's supposed to be where we the people, make our voices heard. It all feels like what JFK was warning about, as evidenced by all the anger expressed at health insurers after the shooting. Many Americans clearly believe that elections and the political process have become so corrupt, so overrun with healthcare industry campaign cash, and so broken, that democratic institutions like Congress and the White House have become obstacles to fixing something like the health care system. And that has prompted some to cheer on vigilante violence. The shooter got out from behind a parked car, pointed a gun at Thompson's back, and then shot twice. Let me be absolutely clear. Extrajudicial murder is not good. It's not laudable, it's not justified. Violence is not justifiable. The shooting is not something to be cheered on. There is no rationalizing, excusing or honoring murder. And there is no virtue in getting yourself social media clicks by cheering that kind of thing on. Nobody should be valorizing anyone who engages in vigilante murder. Democracy and civilization itself is based on the idea that we do not settle our differences through violence against people we disagree with. Violence is not only vile and immoral, it makes it more difficult to achieve progress. But I also fear that JFK's warning is relevant here. While the shooting is deplorable and heinous and unacceptable and counterproductive, I fear it's also an example of the kind of chaos that may become inevitable in a country whose political establishment has spent decades tearing up the social contract, legalizing and normalizing another kind of Violence. Murder by insurance industry spreadsheet. Murder by spreadsheet may sound like an exaggeration, but it is our reality. Right now. Studies suggest around 60,000Americans die every year because they lack access to decent medical care. We have insurance companies using artificial intelligence to systematically deny their customers medical claims, even as the average family premium in an employer based health care plan now costs more than $25,000 a year. Fourteen years after the passage of the Affordable Care Act, 100 million Americans face a combined total of $220 billion of medical debt. As just one of many horror stories, a recent study found that 42% of cancer patients see all of their life savings depleted within two years. This is horrendous for most Americans, but a jackpot for the health insurance industry. As the Lever reported this week, the largest insurers raked in $371 billion in profits since the passage of the Affordable Care Act. And they also spent $120 billion on stock buybacks, enriching their shareholders and their executives. Amid increases in premiums and increases in claim denial rates, seven health insurance CEOs were paid $335 million in a single year. All of these indignities are the product of a government filled with politicians who are bankrolled by insurers and who use their power to block the most basic reforms. Stuff like a public health insurance option or an option to buy into Medicare, or simply expanding Medicare to cover everyone. What's so frustrating is that politicians have spent decades, decades, saying they recognize the problem and they make promises to do something about it, and then almost nothing happens. Think about the last 50 or 60 years of history. After JFK and LBJ's pressure resulted in Congress creating Medicare. The push for universal healthcare popped up in the early 1990s with the Clinton administration. Under our plan, every American would receive a healthcare security card that will guarantee a comprehensive package of benefits over the course of an entire lifetime, roughly comparable to the benefit package offered by most Fortune 500 companies. The healthcare industry famously killed that initiative with a ton of lobbying and campaign cash. And the health care industry profiteering continues continued, sparking outrage and new promises of reform from Democratic Party rising stars like this guy from Chicago. I happen to be a proponent of a single payer universal health care. The United States of America, the wealthiest country in the history of the world, spending 14%, 14% of its gross national product on health care, cannot provide basic health insurance to everybody. And that's what Jim's talking about when he says everybody in, nobody out. A single payer healthcare claim, universal health care plan. That's what I'd like to see. But as all of you know, we may not get there immediately because first we've got to take back the White House and we gotta take back the Senate. So there it is. There's Barack Obama saying he supports single payer. But when Obama himself took back the White House with huge Democratic majorities in the House and Senate, his administration deployed its Secretary of Health and Human Services, Kathleen Sebelius, to promise that single payer wouldn't even be considered in any healthcare reform. This is not single payer. As you know, there have been a lot of congressional advocates who say why not? Why can't we have a single payer? That's not what anyone is talking about. Mostly because the President feels strongly, as I do, that dismantling private health coverage for the 180 million Americans that have it, discouraging more employers from coming into the marketplace is really the bad direction. Eventually, what became the Affordable Care act included massive taxpayer subsidies for the insurance industry and Obama's promised public health insurance option being excluded from the final bill. And though the Affordable Care act did include some very important reforms, the health care crisis continued, as did Americans anger. Much of which was channeled into Bernie Sanders 2016 presidential campaign for Medicare for All. But that campaign ran straight into a wall known as Hillary Clinton. And the bulk of what he is advocating for is a single payer healthcare system which would probably cost about $15 trillion. It's a bit concerning to me because it would basically end all the kinds of health care we know. Medicare, Medicaid, the CHIP program, Children's health insurance, Tricare for the National Guard, military Affordable Care act, exchange policies, employer based policies. When Sanders campaign nonetheless surged towards a win in the Iowa caucus, Clinton doubled down insisting that Medicare for All was impossible and that voters basically shouldn't ever expect anything better than the current healthcare system. Health emergencies can't wait for us to have some theoretical debate about some better idea that will never ever come to pass. By the time the 2020 election rolled around, even as researchers estimated that a Medicare for all system could have saved 200,000 lives during the pandemic. Joe Biden by that point was running for president on a promise to veto Medicare for All legislation if it ever got to his desk. I would veto anything that delays providing the security and the certainty of health care being available. Now my opposition relates to whether or not a it's doable to what the cost is and what the consequences for the rest of the budget. Are how are you going to find $35 trillion? Side note, the Republican led Congressional Budget Office found that Medicare for all would actually save Americans $650 billion by 2030. Biden did promise that one of his first initiatives would be a public health insurance option, but once in office he never mentioned the idea again. And then, of course, came the 2024 campaign in which the healthcare debate was essentially this that's right, nothing. There was no health care conversation at all. A reality, summarized by a New York Times headline which read the campaign issue that isn't Healthcare Reform. Basically, in deference to their healthcare industry donors, both political parties, message on healthcare seems to be that line from the doctor's office scene in the old Jack Nicholson movie what if this is as good as it gets? Not surprisingly, lots of Americans being bankrupted by health care simply don't accept that this is the best we can do. Which raises the question, why can't we do better? Out of all the challenges facing our country, why does this one issue, decent medical care for everyone, seem to be such an impossible problem? Why haven't we solved this problem once and for all? How is it, as JFK once said, that we are behind every country in this matter of medical care for our citizens? He said that more than 50 years ago, and we're still at this impasse. How could that be? What will it take to finally get the humane health care system that we deserve? Vigilante violence is not the solution. The solution is a renewed focus on using our democratic institutions to force lawmakers to change the system. As the old saying goes, power concedes nothing without a demand. This past week's primal screams of outrage at the health insurance industry are the demands for change. The health insurance industry is undoubtedly hoping that that noise quickly dissipates like everything else on social media. But the rest of us need those demands to get louder right now. I hope you enjoyed this episode from our weekly podcast LeVertime. Please go subscribe to LeVertime in your podcast app right now. Just search LeVertime in your podcast app and be sure to hit follow so you never miss an episode. Thanks for listening. This episode of Lever Time was written by me, David Sirota, and produced by Ronnie Ricobenny and Jared Jakang Mayer, with help from Arjun Singh. You can read the print version of this essay at levernews. Com. Thanks for listening.