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So here's a weird trendlet. The bullshit debate talking points about how much Americans supposedly loooove their private health insurance (and would be very very sad if Medicare for All replaced it) is getting enough traction that it's infecting the way some Democratic candidates frame their healthcare proposals. Elizabeth Warren has lately been playing up her plan to transition to Medicare for All as offering the "choice" to buy in to M4A before full single-payer is rolled out. And in an interview Friday with the Washington Post's Robert Costa, Pete Buttigieg rather awkwardly invoked free-market rhetoric, sounding like a regular Ronnie Reagan, albeit also in the context of a transition to M4A via the option to buy in to Medicare.

Instead of just assuming that sitting here in Washington we're going to know what the right plan is for everybody or even what the right timeline is for everybody to come over, we're going to let people figure it out for themselves. I trust you to figure out your own health care, especially when we create these options.

It didn't help that, on Twitter at least, Buttigieg's remarks got condensed to the snippet "I trust you to figure out your own health care," which launched any number of threads from people pointing out that America's clusterfuck of healthcare "systems" is difficult even for physicians to figure out, let alone the average person. Again, Buttigieg wasn't advocating throwing people to the tender mercies of the free market (his public option would automatically enroll those who are uninsured, with an opt-out). That out of context quote may haunt him forever, like the time Nancy Pelosi never said we'd have to pass Obamacare to find out what's in it.

My point here is that all this talk of "choice" actually buys into a talking point that comes straight from the health insurance industry, and for fucks sake could Democrats please be smarter than to let those vultures frame the debate, please?


The "choice" rhetoric caught the attention of former Cigna vice president Wendell Potter, who has become a huge critic of his former industry and an advocate for Medicare for All. In a must-read thread Monday, Potter warned,

Lately I've noticed some Democratic politicians defending the current healthcare system by saying it preserves "choice" for Americans. As a former health insurance exec who helped draft this talking point, I need to come clean on its back story, and why it's wrong and a trap.

Oh? Do tell!


Potter goes on from there, noting the insurance industry recognized it was losing the argument, as people actually found out just how shitty their coverage was -- remember how in 1997, Helen Hunt briefly made "Fucking HMO bastard pieces of shit!" part of the national discourse on healthcare? And so instead of working to make care better, the industry has launched a PR campaign to gaslight us into thinking that universal coverage would somehow be very very bad for us.

Its name: "My Care, My Choice." Its job: Trick Americans into thinking they currently can choose any plan they want, and that their plan allows them to see any doctor. They've spent big in Iowa.

This isn't the only time the industry made "choice" a big talking point in its scheme to fight health reform. Soon after Obamacare was passed, it created a front group called the Choice and Competition Coalition, to scare states away from creating exchanges with better plans

Potter says he's a bit flabbergasted to see that this time around, it's Democrats talking about the current crappy system providing a "choice," invoking that rhetoric even in calling for a transition to M4A, and

even using it as a weapon against each other. Back in my insurance PR days, this would have stunned me. I bet my old colleagues are thrilled, and celebrating.

If Dems want to talk about "choice" in healthcare, then why not point out that the widest range of choices would actually result from genuinely universal coverage? In European-style systems (some of which are truly single-payer, others not, though still universal), there aren't any worries about which providers are "in network," and hence, no surprise medical bills when you go to an in-network hospital but have an out-of-network anesthesiologist. Prices are kept down through strict regulation of services, medications, and medical devices. Nobody needs to worry about changing jobs or missing open enrollment, because everyone's enrolled.

You want to talk about choice? Talk about how the current system restricts our medical choices, and how a reformed system would expand them. Let's have an honest debate about the best way to move toward M4A, and drop this defense of a system that's far better for CEOs and shareholders than for the people getting healthcare.


[CNN / HuffPo / WaPo / Wendell Potter on Twitter]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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