By MICHAEL MILLENSON
It is close to the iron rule: Politics drives privacy. In that context, health policy issues that have largely been overlooked at the Republican and Democratic conventions teach important political lessons.
Start with access. According to KFF (formerly the Kaiser Family Foundation), more than 25 million Americans have been removed from Medicaid as of August 23. Americans don’t need to be insured.
But if you search the convention to find protesters telling heartwarming personal stories to back up those statistics, you’ll be in vain. There is none.
The Poor People’s Army, a group that advocates for economic justice, called on journalists covering the convention to focus on one of the most pressing issues facing the poor and the poor – not access to medical care, but the lack of basic housing.
Homelessness will hit a record high by 2023, according to the National Alliance to End Homelessness, affecting one in 500 Americans, while the number of renters forced to pay more than 50 percent of their income has risen since 2015. big city, while the latter felt millions in every salary.
The political lesson is clear. While support for Medicaid expansion is buried deep in the Democratic platform, at the grassroots level there are no signs of the kind of engagement that could sway votes in a close election. Medicare, of course, is a separate issue, with both parties promising to protect a program dear to the hearts of the country’s parents, who have the highest voting percentage in that age group.
Of course, even those with good health insurance often have to worry about medical expenses, with a KFF poll finding that 41% of US adults have medical debt. However, even the phrase, “That’s the price, idiot!” has become a bipartisan policy refrain, there is no swing state vote to swing by harping on the alleged cupidity of local hospitals. So when it comes to arguing about “medical debt,” no one does.
On the other hand, Democrats repeatedly talk about the depredations of “Big Pharma.” The GOP platform is content with vague promises to “expand access to … new prescription drug options” to address prescription drug costs that are “out of control.” Liability for these prices is not specified.
For health insurance companies, articles about the denial of questionable medical claims by insurance giants like United Healthcare and Humana have garnered headlines and expressions of outrage. But, once again, grassroots reaction is key. There was no public outrage comparable to the HMO backlash in the 1990s. As a result, health insurance has largely vacated the role of politically visible corporate villain.
A political campaign, as former President Bill Clinton pointed out in a speech to the Democratic convention, is a job interview with the American people. Just like a job interview, the total focus is on getting a job offer, knowing that if you do, you can do a lot, but if you don’t, there’s nothing. That means carefully calibrating every utterance during the interview process in order to make a good impression, while avoiding – making invisible – anything that could damage your chances, even if the topic is something you’ve said emphatically. (See: GOP on abortion and same-sex marriage or Democrats on Medicare for All.)
The attraction of potential political power is what produces the second type of invisibility with the greatest influence on policy. That is invisible from big donors and good lobbyists. He wasn’t in the TV picture on the convention floor. They don’t wear colorful costumes or big buttons. Instead, they gather discreetly in hotels where they are delegates and join private parties that make influential policy makers. All the while they practice invisible influence peddling that, behind closed doors, can help make or break policy proposals.
To preserve access to the “room where it happens,” the company carefully donates to both parties and to individual candidates of both parties. A typical example is the list of contributions from UnitedHealth Group, a company that ranks fourth on the Fortune 500 list only behind Walmart, Amazon and Apple.
In the 2024 election cycle UnitedHealth and its affiliates have given $151,343 to Kamala Harris and $57,491 to Donald Trump, according to the latest report from OpenSecrets. There is also approximately $329,000 donated to various Republican campaign committees, and another $200,000 to the Political Action Committee supporting Nikki Haley’s GOP primary run. Various Democratic campaign committees received about $149,000. This is on top of the $10.76 million spent in 2023 on lobbying, OpenSecrets said.
None of this, of course, was mentioned from the speaker’s podium at either convention. Instead, we hear repeated claims to represent the “middle class,” a self-identified group that makes up the majority (54%) of the US population. This group, crucial to electoral success, is considered indifferent to Medicaid and sees MedicareAdvantage as a free health insurance option. They don’t want to talk about the 232,000 Americans who died because they didn’t get the Covid vaccine, and “climate change” is a favorite topic for the Democrats. All they care about is cost, cost, cost.
If you’re among those frustrated by the political invisibility of the host of health issues you’re constantly crying out to be addressed, there’s a solution: Start your own PAC.
As an author, activist, consultant and former Pulitzer-nominated journalist, Michael Millenson is professionally focused on making healthcare safer, better and more patient-centered. This piece first appeared in a column on Forbes
