President Donald Trump on July 4 signed into law an omnibus reconciliation bill, branded in MAGA propaganda (and much of corporate media) as the “Big Beautiful Bill.” The legislation scraped up just enough votes to narrowly pass in both chambers of the Republican-controlled Congress, with 51 to 50 votes in the Senate and 218 to 214 in the House.

The focal point of the bill is a $4.5 trillion tax cut, partly paid for by unprecedented slashes in funding for healthcare and food assistance. The wealthiest 10% will gain $12,000 a year from the legislation, while it will cost the lowest-earning 10% of families $1,600 annually. Media addressed the fiscal aspects of the bill, though more often through a fixation on the federal debt rather than looking at the effect of the budget on inequality (FAIR.org, 7/17/25).

But it’s not just a question of money. Many of the bill’s key provisions—including Medicaid, SNAP and clean energy cuts, as well as handouts to the fossil fuel, military and detention industries—will be literally deadly for people in the US and abroad, in both the near and long term.

FAIR’s Belén Fernandez (7/9/25) closely examined the dramatic lack of coverage of the vast expansion of the government’s anti-immigrant capacities. But the deadly consequences of the other aspects of the bill were also remarkably underexplained to the public.

To see how major media explained the contents and consequences of the reconciliation bill to the public before its enactment, FAIR surveyed New York Times, Washington Post, CNN and NPR news coverage from the Senate’s passage of the final version of the bill on July 1 through July 4, the day Trump signed the bill into law. This time frame, when the actual contents of the bill were known and the House was deliberating on giving it an up or down vote, was arguably the moment when media attention was most critical to the democratic process.

‘We all are going to die’

This USA Today article (7/1/25) was one of the more informative in detailing the impact of the bill, but it still fell short of detailing the projected cost in human lives.

While corporate media reported that the finalized bill with the Senate’s revisions would significantly cut healthcare funding to subsidize the tax breaks, they rarely explained the social consequences of such cuts. The Congressional Budget Office (CBO) estimates that the bill will reduce $1.04 trillion in funding for Medicaid, the Affordable Care Act and the Children’s Health Insurance Program over the next decade. This will strip health insurance from 11.8 million people.

The New York Times (7/1/25), acknowledging these statistics, quoted Democrats who opposed the bill due to “the harmful impact it will have on Medicaid,” and who noted that people will soon “see the damage that is done as hospitals close, as people are laid off, as costs go up, as the debt increases.”

But the outlets in our sample, at this crucial time of heightened attention, failed to mention the most significant consequence of cutting Medicaid: death.

These outlets (New York Times, 5/30/25; NPR, 5/31/25; CNN, 5/31/25;  Washington Post, 6/1/25) had all earlier acknowledged what the Times called Sen. Joni Ernst’s (R-IA) “morbid” response to her constituents’ concerns about deaths from Medicaid cuts: “Well, we all are going to die.”

But as the House deliberated on whether these cuts would become law, these outlets failed to reference credible research that projected that the large-scale loss of health insurance envisioned by the bill would have an annual death toll in the tens of thousands. One USA Today piece (7/1/25) did headline that “Trump’s Tax Bill Could Cut Medicaid for Millions of Americans,” but didn’t spell out the potential cost in human lives.

Before the Senate’s revisions, researchers from Yale’s School of Public Health and UPenn’s Leonard Davis Institute of Health Economics (Penn LDI, 6/3/25) projected that such massive cuts to healthcare would result in 51,000 deaths annually. That number is expected to be even higher now, as the calculation was based on an earlier CBO estimate of 7.7 million people losing coverage over the next decade (CBO, 5/11/25).

‘Harms to healthcare’—not to people

CNN (7/4/25) euphemized life-threatening withdrawal of care as “harm to the healthcare system.”

CNN (7/4/25), in a piece on “Who Stands to Gain From the ‘Big, Beautiful Bill.’ And Who May Struggle,” similarly failed to spell out the dire consequences of the Medicaid cuts. It wrote that low-income Americans would be “worse off” thanks to those cuts, yet it extensively described only the fiscal impacts, as opposed to the costs in life and health, on lower- and middle-class families.

Hospitals would also be “worse off” due to the bill, as it would “leave them with more uncompensated care costs for treating uninsured patients.” This rhetorically rendered the patient, made uninsured by legislation, a burden.

The article quoted American Hospital Association CEO Rick Pollack, who said that

the real-life consequences…will result in irreparable harm to our healthcare system, reducing access to care for all Americans and severely undermining the ability of hospitals and health systems to care for our most vulnerable patients.

But CNN refused to spell out to readers what that “harm to the healthcare system” would mean: beyond “reducing access,” it would cause people to die preventable deaths.

Outlets often seemed more concerned with the impact of the bill on lawmakers’ political survival than its impact on their low-income constituents’ actual survival. The Washington Post (7/4/25), though acknowledging that their poll revealed that “two-thirds [of Americans] said they had heard either little or nothing about [the bill],” made little or no effort to contribute to an informed public. Instead, it focused on analyzing the “Six Ways Trump’s Tax Bill Could Shape the Battle for Control of Congress.”

The New York Times (7/1/25) similarly observed that the Senate Republicans’ “hard-fought legislative win came at considerable risk to their party’s political futures and fiscal legacy.” In another article (7/1/25), they noticed that it was the “more moderate and politically vulnerable Republicans” who “repeated their opposition to [the bill’s] cuts to Medicaid.”

‘Winners and losers’

“Opponents of the bill say the proposed cuts will leave millions of adults and children hungry”; the New York Times (7/1/25) apparently doesn’t know whether that’s true or not.

The Medicaid cuts aren’t the only part of the bill that will result in unnecessary deaths. The bill will cut $186 billion from the Supplemental Nutrition Assistance Program (SNAP), a program that helps low-income individuals and families buy food. CBO (5/22/25) estimated that 3.2 million people under the age of 65 will lose food assistance. This contraction is expected to be even more deadly than the healthcare cutbacks: The same researchers from UPenn (7/2/25), along with NYU Langone Health, projected that losing SNAP benefits will result in 93,000 premature deaths between now and 2039.

SNAP cuts were mostly only mentioned alongside Medicaid, if at all (Washington Post, 7/3/25; New York Times, 7/3/25; CNN, 7/4/25). And when they did decide to dedicate a whole article to the singular provision, they rarely ventured beyond the fiscal impacts of such cuts into real, tangible consequences, such as food insecurity, hunger and death. The New York Times (7/1/25) asked “how many people will be affected,” but didn’t bother to ask “how will people be affected?”

What’s more, according to the Center for American Progress (7/7/25), the bill’s repeal of incentives for energy efficiency and improved air quality “will likely lead to 430 avoidable deaths every year by 2030 and 930 by 2035.”

The New York Times (7/3/25), however, analyzed this outcome as a changing landscape with “energy winners and losers.” It described how the bill will eliminate tax credits that have encouraged the electrification of homes and alleviated energy costs for millions of families. Somehow, the “loser” here (and all throughout the article) is the abstract concept of “energy efficiency” and private companies, not actual US families.

Another little-discussed provision in the bill is the funding for the Golden Dome, an anti-missile system named for and modeled on Israel’s Iron Dome. The bill set aside $25 billion for its development, along with another $128 billion for military initiatives like expanding the naval fleet and nuclear arsenal.

Media, though, did little more than report these numbers, when they weren’t ignored entirely (CBS, 7/4/25; CNN, 7/4/25). The New York Times (7/1/25) characterized these measures to strengthen the military/industrial complex as “the least controversial in the legislative package”; they were “meant to entice Republicans to vote for it.” In utterly failing to challenge $153 billion in spending on a military that is currently being deployed to bomb other countries in wars of aggression and to suppress protests against authoritarianism at home, the media manufacture consent for militarism as a necessity and an inevitability.

Ignorance a journalistic fail

The Washington Post’s headline and article (7/3/25) perfectly exemplified the paradox with today’s media—calling out how “The Big Problem With Trump’s Bill [Is That] Many Voters Don’t Know What’s in It.” Yet it tosses in an unsubstantial explanation about how “it deals with tax policy, border security, restocking the military/industrial complex, slashing spending on health and food programs for the poor—as well as many, many other programs.”

By reducing sweeping legislative consequences to vague generalities and by positioning ignorance as a voter issue rather than journalistic failure, media outlets maintain a veneer of critique while sidestepping accountability.

Featured image: PBS  depiction (7/30/25) of President Donald Trump signing the reconciliation bill. (photo: Alex Brandon/Pool via Reuters.)

This content originally appeared on FAIR and was authored by Shirlynn Chan.

A new report authored by Public Citizen Health Care Policy Advocate Eagan Kemp highlights the dangers posed by the men and women whom Trump has put in charge of our health care agencies and the threat they pose to patients, providers and the programs on which they rely.

The report includes details on:

• Robert F. Kennedy Jr.’s promotion of conspiracy theory and dangerous anti-science views before his confirmation and during his early months as head of the Department of Health and Human Services (HHS).
• Mehmet Oz’s dangerous views on privatization of Medicare and conflicts of interest, and his early efforts to undermine the programs he is supposed to protect as Administrator of the Centers for Medicare and Medicaid Services.
• Jim O’Neill’s fringe views and significant ties to for-profit biomedical companies and the dangers they could pose as he serves as Deputy Secretary of HHS.
• Casey Means’s lack of qualifications for Surgeon General and misinformed and conspiratorial thinking on public health issues.

“Trump has nominated unqualified and dangerous people to serve in the most important health positions in the country,” said Kemp “From massive cuts to Medicaid and the ACA, layoffs of key staff, and failures to adequately engage with real emergencies, like the ongoing measles outbreak, America is reaping the bitter fruit of Trump’s terrible cabal. It is clear the Trump Administration will continue to exacerbate existing gaps in our health care system and risk millions more lives. People across the country are already pushing back against their terrible actions, and this must continue if we are to correct course and take back our health care system.”

This content originally appeared on Common Dreams and was authored by Newswire Editor.

The bill will have a remarkably regressive distributional impact. While top incomes will balloon by thousands of dollars, lower-income Americans will actually see their incomes decline. One analysis from before the bill’s final passage found that its major provisions would reduce incomes for the bottom 20% by about 2%.

Tax cuts, after all, are only one part of the bill. More relevant to lower-income Americans is that this bill will deliver the largest cuts to Medicaid and food stamps in US history.

Such a historic weakening of the safety net—the programs that support the finances of lower-income Americans—should warrant not only major attention, but significant scrutiny from national media outlets. And yet, at the New York Times, the approach has been to distract and obscure above all else.

‘Defined by staggering debt’

As Trump slashed $1 trillion from healthcare, the New York Times (6/27/25) stressed the importance of reducing the deficit. 

One manifestation of this approach has been the Times’ insistence on elevating the bill’s effect on the debt as a foremost concern. In the week or so leading up to the bill’s passage, in fact, both an editorial (6/27/25) and an episode of the Times’ flagship podcast the Daily (7/2/25) were dedicated entirely to a discussion of the national debt.

The Daily episode went as far as claiming, “The legislation is defined by the staggering amount of debt that it’s creating.” It then warned of the potential for a debt “doom loop,” whereby rising debt raises borrowing costs and forces the government to issue more debt in order to pay for its existing debt load.

Meanwhile, the Times editorial board opted to focus more heavily on the costs already being imposed by high federal debt. In a piece titled “The National Debt Is Already Causing Bigger Problems Than People Realize,” the board highlighted the “staggering amount of money” the government puts towards interest payments each year. The board’s solution:

The government needs to raise taxes, especially on the wealthy, and it needs to make long-term changes in Social Security and Medicare, the major drivers of spending growth.

In other words, at a time when the Republican Party is gutting the safety net in epic fashion, the New York Times is coyly hinting that Social Security and Medicare will need to be cut.

‘Enough to repair every bridge’

The New York Times‘ own chart (6/27/25) indicates that Trump’s budget bill will have only a modest impact on US interest payments. What did cause interest costs to soar was the political decision to fight inflation through higher interest rates, a decision the Times applauded  (FAIR.org, 1/25/23, 6/27/23).

Across both the editorial and the podcast episode, the primary reason put forward by the Times for concern over the national debt was the borrowing costs associated with it. But is the bill’s effect on borrowing costs—the amount of money the federal government will have to spend to pay off the interest on its debts—genuinely that significant of a concern?

The Times editorial board seems to think so. Warning of the ill effects of increasing borrowing costs, the board observed:

The House version of Mr. Trump’s bill, already approved by that chamber, would increase interest payments on the debt by an average of $55 billion a year over the next decade, according to the Congressional Budget Office. The increase alone is enough money to fully repair every bridge in the United States.

This comparison is useful to a degree. It exposes the priorities of the Trump administration, which seems to value tax cuts for the wealthy above delivering basic public goods.

But the comparison ultimately obscures more than it illuminates. The reality is that $55 billion is a relatively small sum for the US government. It represents only about 0.8% of the 2024 federal budget, and 0.2% of US GDP.

High cost of high interest rates

The interest rate on 10-year US Treasury bills has risen from 0.6% in 2020 to 4.5% today (chart: CNBC).

The total amount the federal government pays in interest—the amount it pays in excess of what it borrowed when it pays back loans—is of course much larger: The Times relays that interest payments are on pace to surpass $1 trillion this year, representing around 15% of last year’s federal budget. As the editorial board notes, this level of spending on interest payments crowds out other, more useful spending by the government. In other words, it does impose a not-insignificant cost.

What the board de-emphasizes or ignores, however, is that high interest payments are really just a symptom of other more fundamental policy choices.

On the one hand, they reflect the political decision to rely on the blunt instrument of interest rates to combat the pandemic-era spike in inflation. The result has been a rise in interest rates on ten-year government bonds, from under 1% in 2020 to above 4% today.

This was not an inevitable development. Other methods exist for combating inflation. But these methods were sidelined in favor of a regressive, debt-inflating approach. Would you know this by reading the Times editorial? Absolutely not.

The incredibly low tax rate

The United States has one of the lowest effective tax rates among wealthy countries (chart: Tax Policy Center).

On the other hand, high interest payments also reflect the political decision to run up the US debt load through tax cuts for the wealthy. This history of tax cuts is discussed by the editorial board, but it is framed as more of a secondary issue. Little would readers know that the crowding-out effect imposed by high interest payments, which the Times depicts climbing above the cost of Social Security in coming years, is dwarfed by the crowding-out effect of low tax revenue.

For such a rich country, the US collects incredibly little in taxes. Its tax revenue registers a meager 29% of GDP, compared to 42% in Canada, 52% in France and 62% in Norway.

Meanwhile, interest payments as a percentage of GDP are set to double over the next 30 years, reaching about 6% of GDP in the 2050s. That’s not even half the revenue deficit the US faces versus Canada—and Canada’s a low-tax country compared to France and Norway!

The Times nonetheless has run no editorial in recent months decrying the US for being such a low-tax country. Even in its editorial about interest payments, a breakdown of the pitiful state of US tax collection by international standards is nowhere to be found. Instead, we get a muddled denunciation of the bill’s irresponsible contribution to burdensome borrowing costs.

But, again, the bill’s contribution is tiny. Yes, interest payments are projected to reach 6% of GDP by the 2050s, but they will hit 5% even in the absence of this bill. With this single percentage of GDP boost in borrowing costs, the bill imposes a cost in 30 years that is a fraction of the cost of our tax deficit versus Canada today.

‘People benefit from working’

In its one editorial (5/23/25) on the reconciliation bill’s cuts to the safety net, the New York Times endorsed the idea “that some government benefits should be tied to employment.”

This is not to say that the Big Beautiful Bill will not impose Major Gratuitous Pain. But it is to say that such pain will not be found in an analysis of its impact on borrowing costs.

Rather, where we should look to see clear evidence of negative effects is the savings side of the bill, where Republicans have enacted brutal cuts to the social safety net, cuts that the economist James Galbraith calls “the direct result of bipartisan scaremongering over deficits and debt.”

The Times editorial board has run one editorial (5/23/25) on the bill’s cuts to the safety net. Published over a month before the bill’s passage, the piece was headlined “Republicans Can’t Hide Medicaid Cuts in a ‘Big, Beautiful’ Bill.” As it pointed out, the Republican bill would reverse the progress that has been made over the past decade or so in expanding health insurance access to more Americans.

Oddly, however, the editorial extended an olive branch to the GOP, conceding:

We are sympathetic to the idea that some government benefits should be tied to employment. People benefit from working, and society benefits when more people are working.

Explaining the decision to insert this concession into the piece, editorial director David Leonhardt (New York Times, 7/1/25) has since elaborated:

I actually understand why, at a top-line way, people would want to put work requirements on a federal program, and actually I do think there are federal programs that should have work requirements. I’m a pretty big skeptic of universal basic income, of the idea that we’re just going to have the federal government give people lots of money outright. I don’t think it’s worked very well. I think it’s hugely expensive.

This is a baffling explanation. As worded in the editorial, it appears that the board is expressing sympathy for work requirements for some existing government benefits, and justifying them with reference to the value of work, despite work requirements’ long history of doing nothing to increase employment. Yet Leonhardt gives no example of a current government program that should be saddled with a work requirement. Instead, he merely expresses his opposition to universal basic income, using conservative arguments against the policy in doing so. This level of clarity, however, may be all we can expect from the Times.

Unnoted cutbacks

At least as notable as the contents of the editorials published by the Times on the Big Beautiful Bill is what the Times has failed to highlight about the legislation. After all, the paper has run just two editorials on what is probably the most regressive major piece of legislation in at least a generation. What have these missed? A lot.

For one, the largest cuts to food stamps in history are entirely absent from the Times editorial board’s critiques of the bill. That millions would lose access to food stamps and tens of millions would see their benefits cut is apparently an afterthought for the board. It evidently does not warrant the denunciation that somewhat higher borrowing costs require.

Decimation of clean energy provisions and heavy new restrictions on student loans likewise appear a grand total of zero times in the Times’ editorials on the bill. This is the sort of resistance that the most prominent establishment newspaper in the country has to offer.

‘Big ugly battle’

The situation at the Daily has been better, though it had only a rather low bar to clear. Through the day the bill was signed into law, the show published three episodes on the legislation. The first (6/5/25), titled “The Big Ugly Battle Over the Big Beautiful Bill,” touched on the bill’s attacks on climate provisions in its first half, and devoted its second half to a conversation about cuts to Medicaid.

Food stamps, by contrast, were mentioned in just two sentences. And student loans didn’t make a single appearance.

The following episode (7/2/25), discussed above, centered on the debt, but the third episode (7/4/25) dedicated additional airtime to cuts to the safety net, again including a discussion of Medicaid cuts in the second half of the episode. Its first half also centered the serious negative impacts of the legislation, mostly focusing on the array of tax cuts in the bill, but framing the overall impact as wildly regressive:

The most important thing to know about this package is that it delivers its greatest benefits to the wealthy, and it extracts its greatest cuts on the poor.

The largest cuts to food stamps in American history, however, garnered no airtime. Same goes for the massive pullback in student loans.

A ripple in a tsunami

We found only two New York Times headlines like this one (6/5/25)—out of nearly 800 in its US politics section—that straightforwardly conveyed the impact of the budget bill’s cuts.

Unfortunately, this poor coverage is not limited to Times editorials and the Daily. As it turns out, the news section of the Times has been similarly lacking in serious coverage.

The paper’s US Politics section is case in point. From the start of June through July 4, when Trump signed his bill into law, this section of the Times featured a total of seven articles that mentioned “food stamp(s),” “SNAP” or “food aid” in either their headline or subhead. For “Medicaid,” “health cuts” and “Obamacare,” the number was ten.

But few of these articles bore headlines straightforwardly reporting the facts of what’s projected to happen to millions of Americans as a result of cuts to food stamps and healthcare spending. In total, only two headlines, both about healthcare, really fit this description:

• “GOP Bill Has $1.1 Trillion in Health Cuts and 11.8 Million Losing Care, CBO Says” (6/29/25)
• “Millions Would Lose Their Obamacare Coverage Under Trump’s Bill” (6/5/25)

Other headlines mentioned cuts, but some didn’t even reference that information. For instance, one headline (6/3/25) read, “Trump Administration Backs Off Effort to Collect Data on Food Stamp Recipients.”

Amazingly, at least in the US Politics section of the paper, zero headlines included the phrase “student loans,” despite substantial retrenchment in student loan policy. The term “safety net” appeared in the headline or subhead of only six articles.

With around 800 articles appearing in the Times’ US Politics section during this timeframe, coverage of historic cuts to crucial safety net programs resembled a ripple in a tsunami.

‘Fair to criticize Democrats’

The type sizes conveys the relative importance the New York Times (7/1/25) places on prices paid by politicians vs. those paid by the public.

Nonetheless, when Times editorial director David Leonhardt was asked whether he thinks “Americans who will be impacted by these cuts understand what’s happening,” given the lack of public outcry so far, he gave credit to Republicans for succeeding in minimizing public opposition, and blamed Democrats for failing to make a bigger deal out of the bill:

I also think it’s fair to criticize the Democratic Party and activists who are aligned with the Democratic Party for not figuring out ways to make a bigger deal out of these cuts. To some extent, they’ve allowed the Republican cynical strategy of staying away from town halls to work better than it might have.

The role of corporate media, and more particularly of the New York Times, may never have even crossed Leonhardt’s mind. But, of course, the Times is a critical player in US politics. With around 12 million subscribers and millions of daily listeners to the Daily, the outlet has incredible reach. If it wanted to, the Times could play a significant role in raising public awareness of this bill. The problem is that it seems completely uninterested in adopting this role.

I would argue, therefore, that the paltry public outcry is fundamentally a result of editorial decisions, not least those made at the Times. By refusing to cover cuts to the social safety net with more than minimal urgency, the Times has done a good deal to deprive the Democratic Party and other opponents of the legislation of the sort of informational environment in which public opposition to harmful policies can be effectively mobilized.

Through inaction, through poor coverage, the Times is making a political choice to undermine opposition to some of the Trump administration’s most damaging policies.

This content originally appeared on FAIR and was authored by Conor Smyth.

BEARING WITNESS: By Cole Martin

As a Kiwi journalist living in the occupied West Bank, I can list endless reasons why there is no peace in the “Holy Land”.

I live in a refugee camp, alongside families who were expelled from their homes by Israel’s violent establishment in 1948 — never allowed to return and repeatedly targeted by Israeli military incursions.

Daily I witness suffocating checkpoints, settler attacks against rural towns, arbitrary imprisonment with no charge or trial, a crippled economy, expansion of illegal settlements, demolition of entire communities, genocidal rhetoric, and continued expulsion.

• READ MORE:  Israel bombs Gaza, Syria as alarm grows over rise in starving children
• Other West Bank reports

No form of peace can exist within an active system of domination. To talk about peace without liberation and dignity is to suggest submission to a system of displacement, imprisonment, violence and erasure.

I often find myself alongside a variety of peacemakers, putting themselves on the line to end these horrific systems — let me outline the key groups:

Palestinian civil society and individuals have spent decades committed to creative non-violence in the face of these atrocities — from court battles to academia, education, art, co-ordinating demonstrations, general strikes, hīkoi (marches), sit-ins, civil disobedience. Google “Iqrit village”, “The Great March of Return”, “Tent of Nations farm”. These are the overlooked stories that don’t make catchy headlines.

Protective Presence activists are a mix of about 150 Israeli and international civilians who volunteer their days and nights physically accompanying Palestinian communities. They aim to prevent Israeli settler violence, state-sanctioned home demolitions, and military/police incursions. They document the injustice and often face violence and arrest themselves. Foreigners face deportation and blacklisting — as a journalist I was arrested and barred from the West Bank short-term and my passport was withheld for more than a month.

Reconciliation organisations have been working for decades to bridge the disconnect between political narratives and human realities. The effective groups don’t seek “co-existence” but “co-resistance” because they recognise there can be no peace within an active system of apartheid. They reiterate that dialogue alone achieves nothing while the Israeli regime continues to murder, displace and steal. Yes there are “opposing narratives”, but they do not have equal legitimacy when tested against the reality on the ground.

Journalists continue to document and report key developments, chilling statistics and the human cost. They ensure people are seen. Over 200 journalists have been killed in Gaza. High-profile Palestinian Christian journalist Shireen Abu-Akleh was killed by Israeli forces in 2022. They continue reporting despite the risk, and without their courage world leaders wouldn’t know which undeniable facts to brazenly ignore.

Humanitarians serve and protect the most vulnerable, treating and rescuing people selflessly. More than 400 aid workers and 1000 healthcare workers have been killed in Gaza. All 38 hospitals have been destroyed or damaged, with just a small number left partially functioning. NGOs have been crippled by USAID cuts and targeted Israeli policies, marked by a mass exodus of expats who have spent years committed to this region — severing a critical lifeline for Palestinian communities.

All these groups emphasise change will not come from within. Protective Presence barely stems the flow.

Reconciliation means nothing while the system continues to displace, imprison and slaughter Palestinians en masse. Journalism, non-violence and humanitarian efforts are only as effective as the willingness of states to uphold international law.

Those on the frontlines of peacebuilding express the urgent need for global accountability across all sectors; economic, cultural and political sanctions. Systems of apartheid do not stem from corrupt leadership or several extremists, but from widespread attitudes of supremacy and nationalism across civil society.

Boycotts increase the economic cost of maintaining such systems. Divestment sends a strong financial message that business as usual is unacceptable.

Many other groups across the world are picketing weapons manufacturers, writing to elected leaders, educating friends and family, challenging harmful narratives, fundraising aid to keep people alive.

Where are the peacemakers? They’re out on the streets. They’re people just like you and me.

Cole Martin is an independent New Zealand photojournalist based in the occupied West Bank and a contributor to Asia Pacific Report. This article was first published by the Otago Daily Times and is republished with permission.

This content originally appeared on Asia Pacific Report and was authored by Pacific Media Watch.

Senate lawmakers are debating President Trump’s 940-page so-called big, beautiful bill as Republicans race to meet a Trump-imposed July 4 deadline and are set to vote on key amendments. Senate Republicans have deepened the cuts to Medicaid while cutting taxes for the wealthy and increasing the national deficit. “Basically, you have Republicans taking food and medicine and other things away from vulnerable people in order to finance tax cuts for the rich,” says David Dayen, executive editor of The American Prospect.

Dr. Adam Gaffney, a critical care physician and professor at Harvard Medical School, co-authored a report that found the bill could lead to 1.3 million Americans going without medications, 1.2 million Americans being saddled with medical debt, 380,000 women going without mammograms, and over 16,500 deaths annually. “I work in the ICU. I see patients with life-threatening complications of untreated illness because they didn’t get care because they couldn’t afford it. What happens when we add to that number massively?” says Gaffney.

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

On June 6, thousands of veterans, union members, VA hospital nurses, elected officials, and more gathered on the National Mall in Washington D.C. at the “Unite for Veterans, Unite for America rally” to protest the Trump administration’s attacks on veteran jobs, benefits, and healthcare. In this on-the-ground edition of Working People, we report from Friday’s rally and speak with veterans and VA nurses about how Trump’s policies are affecting them now and how to fix the longstanding issues with the VA.

Speakers:

• Peter Pocock, Vietnam War veteran (Navy) and retired union organizer
• Everett Kelley, national president of the American Federation of Government Employees
• Terri Henry, Air Force veteran
• Ellen Barfield, Army veteran and national vice president of Veterans for Peace
• Lindsay Church, executive director and co-founder of Minority Veterans of America
• Lelaina Brandt, veteran (National Guard), 2SLGBTQIA+ advocate, and part-time illustrator and graphic designer.
• Eric Farmer, Navy submarine veteran
• Irma Westmoreland,  registered VA nurse in Augusta, GA, secretary-treasurer of National Nurses United, chair of National Nurses United Organizing Committee/NNU-VA
• Andrea Johnson, registered VA nurse in San Diego, CA, medical surgical unit and the NNOC/NNU director of VA Medical Center- San Diego
• Justin Wooden, registered VA nurse in the intensive care unit (ICU) at James A. Haley Veterans’ Hospital in Tampa, FL
• Cecil E. Roberts, Vietnam War veteran (Army) and president of the United Mine Workers of America

Additional links/info:

• Tim Balk & Helene Cooper, The New York Times, “Military parade in Capital on Trump’s birthday could cost $45 million, officials say”
• Lolita C. Baldor, Associated Press, “Transgender troops face a deadline and a difficult decision: Stay or go?”
• Eric Umansky & Vernal Coleman, ProPublica, “Internal VA emails reveal how Trump cuts jeopardize veterans’ care, including to ‘life-saving cancer trials’”
• Maximillian Alvarez, Working People / The Real News Network, “Trump cuts leave VA hospital nurses and veteran patients in a crisis”

Featured Music:

• Jules Taylor, “Working People” Theme Song

Credits:

• Audio Post-Production: Jules Taylor

Transcript

The following is a rushed transcript and may contain errors. A proofread version will be made available as soon as possible.

Maximillian Alvarez:

Alright. Welcome everyone to another on-the-ground edition of Working People, a podcast about the lives, jobs, dreams, and struggles of the working class Today. Working People is a proud member of the Labor Radio Podcast Network and is brought to you in partnership within these Times Magazine and the Real News Network. The show is produced by Jules Taylor and made possible by the support of listeners like you. My name is Maximillian Alvarez and I am here on the National Mall in Washington, DC at the Unite for Veterans Unite for America rally, where thousands of veterans from all military branches and age groups, union members, VA hospital nurses, elected officials, and more have gathered to send a message to the Trump administration. This is a critical follow-up episode to our recent interview with VA nurses and national nurses, United Union reps, where we talked about the devastating impact that President Trump’s cuts to federal agencies and attacks on federal workers are causing for VA healthcare workers and the veteran patients that they serve as national nurses.

United describes in their press release about today’s rally on Friday, June 6th, the anniversary of D-Day, dozens of registered nurses from National Nurses Organizing Committee slash National Nurses United will join Senator Tammy Duckworth, veterans federal workers, military families and allies in Washington DC for the Unite for Veterans, unite for America rally organized by the Unite for Veterans Coalition. This rally is modeled after the 1932 Bonus Armies march on Washington DC and will spotlight attacks on veteran benefits, call out attempts to privatize the VA and rally the veteran community to defend the institutions that serve them. So I am here on the ground talking to folks about why they’re here, why it’s important, and what message they want to send to the administration and to their fellow workers around the country.

Peter Pocock:

I’m Peter Pocock. I’m out on the mall here in DC with a whole bunch of other veterans. I’m an old timer. I’m pushing 80. I’ll be 80 this year. I was in the Vietnam era and happily for me and intentionally for me, I was in the Navy because you were more likely to avoid bullets in the Navy. Yeah, we’re out here on the mall today because the Veterans Administration, which takes care of a lot of us, myself included, I’m 90% disabled and we can go into that later, but we’re here because certain parties who are in the government are really trying to cut the hell out of what we have supposedly earned by our service over the years. Yeah, Gary from the podium, we’re here to fight back. First of all, there’s a whole lot of vets that actually are losing their jobs, particularly government jobs.

We got a preference. That was one of our benefits of being in the service. We got a little bit of a preference for jobs coming out and especi people who have been working for the government for 10, 20, 30 years who are being basically told, we don’t need you anymore. Thank you very much. Actually, no, thank you very much. Let’s just go away. Not happy about that. I tend to do only family friendly language and interviews, but there’s a whole lot of words I could use to describe what the Trump administration is trying to do to labor. That’s something that the right wing has been after for what decades, maybe more, and I’ve been fighting. I was in the labor movement my whole working life after the Navy and been fighting it that whole time. Even in retirement. Keep on showing up is the way that you win every time.

We’re not going to storm the capitol. We’re not going to surround the White House and take prisoners and things like that. What we’re going to do is keep on showing up everywhere in the country, every opportunity we have, every chance to have a conversation with somebody about it, talk to ’em about what’s going on, talk to ’em about the fact that people’s livelihoods are being taken away. Things that people have worked for their whole lives are being taken away. That’s not just veterans, that people with jobs. You got a job, you want somebody to take it away from you for no good reason except to send a little more money to some folks that have no need of more money. Thank you very much. I came back in 1970 to an environment that was not particularly friendly to veterans

And I kept showing up. I kept telling people I never held it against somebody that they thought that I was at fault for this war. I was against the war myself. Well, another thing that has got me out here is I’m 90% disabled according to the Veteran’s Administration, and it’s because I’ve got Parkinson’s disease. See, there’s what I got is Parkinson’s Disease, and it’s generally attributed to the fact that I was exposed through Agent Orange during my service. My bet is that basically any of the folks that were in Southeast Asia in the late sixties and the early seventies all have been exposed to Agent Orange and many of them will if they haven’t already be displaying all kinds of symptoms because of it. In my case, Parkinson’s.

I’m lucky that it didn’t show up until late so that I’m still, I’m going to make it to 80. Anyhow, a lot of my people have, the VA takes care of people like me. The VA takes care of people who are in wheelchairs because of their service for laying flat on their backs in a hospital bed because of their service, and that’s where they’re going to be. The VA’s taking care of them. That’s not waste, that’s not fraud, that’s not abuse. That’s what they have earned is that care and that’s what everybody in this whole country earns just by being citizens is care. How come we are not taking care of our people? We had all kinds of very interesting things going on in the Navy, in the army. I got friends that were doing some really good anti-war stuff that endangered them. So when I came back, that’s what I started doing and I mean doing it ever since. I wasn’t in a labor movement at the beginning. I was in left wing politics, anti-war politics, and from there being in the labor movement was just a natural. As soon as I got the kind of a job that actually had that kind of stuff going on in it, we don’t need to go into it too much, but I was a real hippie organizer in Politico. I was not in a position to be in anything but the IWW. So yeah, but I spent 30 years in the labor movement and I’m still with it.

Everett Kelley:

My name is Everett Kelley. I’m a proud Army veteran and I have the pleasure as the National President of the American Federation of Government Employees A FGE. First and foremost, I want to thank the Union Veteran Council for inviting me to speak and for putting on this necessary undue event. Now I want to welcome all of you who came here today from out of town. Your commitment is aspiring and I want to thank you for being here today. We’re here to unite on behalf of all veterans and to bring awareness and attention to this unprecedented and un-American attack on veterans jobs, benefits, healthcare and union rights. What do you say? Well, it doesn’t matter what branch you serve in, right? We’ve all made a huge sacrifice for our country and all of you are my family. Now though we all come from different backgrounds and different races have different religious beliefs and political views.

We all have similar stories as veterans. My story starts in good water, Alabama, where at 18 years old I joined the United States Army and went on to serve in the Army Reserve for another eight years. After my three year tour, like many of you, after I my military services, I wanted to continue to serve my country. So I became a federal employee working at Anderson Army Depot with my fellow veterans while we continued supporting the mission. You see, just because the job change doesn’t mean your service is complete. Our mission has not changed. Our mission is protect and to serve, to support and defend, and that has not changed. But now what has changed, however, is the government’s promise to be there for us when we get home that changed the promise to care for our families, our caregivers, and our survivors. For years, politicians on both sides of the aisle have campaigned on their support of veterans, but once they get in the office, they cut our benefits on the fund, our services and take every opportunity to privatize our healthcare.

What do you say about that? No, and guess what? Brothers and sisters, we are tired of it. Veterans are tired of being celebrated on Veterans Day remembered on Memorial Day and forgotten about after election day. What do you say about that? Are you tired? We’re tired of being thankful. Our service in the public and stabbed in our back in the private. We are tired now. This S ring no true than today. In January, the VA presented employees, what a fuck in the road. Wow. They encouraged members to end federal services in February, VA recklessly terminated more than 1500 probationary employees resulted in chaos and confusion within the department. In March, the VA announced plan to cut 83,000 jobs for no rhyme or reason whatsoever under disguise of efficiency. I say it’s not efficiency, it’s fraud and a FG been fighting sensely because we know what the big ass will do, don’t we?

Right? And if you don’t know what the big enough plan for Americans veterans is, let me share it with you. The big enough plans for Americans, veterans, it’s a privatized veteran healthcare. In order to make themselves wealthier, they want to make a quick buck offer the sacrifices of the pain and the scars of all those of us who have served this country. They want to take away our VA medical centers claiming that private healthcare is better. However, study after study showed that vegetable prayer to get their care to be VA because it was created for us. Now, the VA is a place my brothers and sisters to go too far camaraderie and for exchanging stories where we are treated with respect and honor because nearly 30% of the employees are veterans too, and they understand who we are. They understand the sacrifices that we’ve made.

They understand the specialties that’s needed. They understand a person that has PTSD. They know it’s not a sham. They know it’s for real. The VA plays for veterans by veterans and for veterans. However, these master reorganization plans that stand before us today is the targeted attack on veterans job, on healthcare, on benefits and union rights. The layoff plans aren’t just figments of our imagination. They are here. We’ve already seen thousands of employees being fired, but brothers and sisters, lemme tell you this, I got to leave you, but before I go, I want you to know that you have doctors, nurses, housekeepers, es, chiropractors, pharmacists, social worker, benefit specialists, police officers, janitors, engineers, painters, electricians, psychiatrists, cooks, greeters at the front door at the va.

Terri Henry:

I’m Terri Henry. I live in Alexandria, Virginia. I’m here in Washington DC today to protest the Trump administration’s treatment of veterans. I am a veteran. I’m married to a Vietnam veteran. My father is a veteran. My brother is a veteran. I believe in veterans. My husband and I had nowhere to go after high school graduation. We weren’t born with a silver spoon like Donald Trump. So we joined the military and his two brothers joined as well, and we got our educations through the va. So we are all college educated people who were able to improve our lives by virtue of our military service. That would not have been a path open to me. Only marriage and children would’ve been open to me. I had no education and no way to earn a living. The military taught me skills and I used those skills and I believe in America.

The other thing that happened is my husband got agent orange cancer for his Vietnam service. So we rely on the VA for his cancer treatment. If it had not been for the va, I tell you, I would’ve had just a complete breakdown. But they were wonderful. They took him in, they gave him chemo. We never had to worry about a bill. Every American that gets cancer in America has to worry about how they’re going to pay for their treatments in the military. We never worried about that. We went to the doctor when we needed to go to the doctor and they gave us what we needed and they promised us that that care would continue after we left the military. And in my husband’s case it has. But now in the Trump administration that care is threatened, these veterans are threatened. We’ve got new veterans, young veterans, Afghanistan, veterans, Iraqi veterans, Vietnam veterans still alive.

We need that care. You promised that care. Donald Trump is a draft dodger 1968. He refused to take the cough. In fact, he got his father to pay for a bone spurs excuse. That’s not courage. That’s not courage. And that man is insisting that we the veterans or the active duty military march in front of him like puppets and he is a draft dodger and a felon. The irony, the insult, it is such an insult to the American military to make them parade for him. This is not Hollywood. This is real life. And those federal workers that you’re un employing, they actually take a military member out of a combat seat. Why? Because the federal workers do the things behind the scenes that allow the military to deploy forward. Every federal worker you fire, you’re taking someone out of combat and you should know that you’re harming the mission and they don’t have time to do your petty tasks.

Like this parade on the, what is it, 14th of June, which by the way, that parade is not a birthday parade for Donald Trump. It’s not a birthday parade for the army. What it is is a show of force, a show of force as was conducted in 1939 at another birthday parade in another nation where that dictator showed the world, his military and what they had to be afraid of. That’s what this parade is about. He’s using the US army to threaten the rest of the world with our military might. We’re very proud of our military. We have a great military, but they are already overt, tasked and now he’s cutting them as is Pete Heg said. Now Trump’s priority is real estate. What he wants to do is put Gaza puts the French Riviera in Gaza. He wants to own Greenland. All he sees when he sees other nations is real estate opportunities, opportunities to make money.

That is not what the government does. The government is here for. We the people, they only exist to serve. We the people just as a church passes a collection plate. The government passes the tax plate, we put the money in with the intent that’ll be spent on our needs, not on his. And there’s quite the difference between the two. So I say to you, don’t believe Donald Trump, he is lying every day. He has a network that does that Cox News. He’s cutting down on journalism like N-P-R-P-B-S so that you will never hear the truth. And now voice of America as well. So this is a very dangerous time in our nation and it is time for us to stand up and say, no, no, Donald Trump, we see you. We’ve seen this before, but it’s not going to happen here in America.

Ellen Barfield:

My name’s Ellen Barfield. I’m a nearly 30-year-old Baltimore aunt originally from, did a lot of my life in Texas and I did four years in the Army, 77, 81. I’m the co-founder of the Baltimore Chapter of Veterans for Peace, and I’m back on the national board.

Maximillian Alvarez:

Well, it’s so great to chat you and yeah, Baltimore out here representing, we are literally sitting on the National Mall right now at the Unite for Veterans Unite for America rally. I wanted to just ask if you could say a little more about yourself, about why you’re out here and what the message today really is.

Ellen Barfield:

Well, the main messages stop trashing veterans and stop taking away our benefits and firing. So many of us disproportionately veterans are employed in the federal government. They do get a little bit of a point for being veterans and they come from that kind of mindset. So they want to keep serving, if you will. So the threats to our VA healthcare and the firings of so many veterans, those have got to be stopped and reversed. And that’s why we’re here now. A lot of the folks here are a good bit more politically conservative than veterans for peaces, but that’s okay. We have to get together to defend the promises this country made to its veterans to take care of us in exchange for our possibly being sacrificed. I personally think war is the enemy and humanity better unlearn war. It’s going to finish us. So I don’t glorify wars, but it is something nations have done for a long time. It’s had militaries. And part of the deal is you potentially risk your life in exchange for benefits afterward. That’s the promise. And they’re taking that away and we got to hang together here. Even if we don’t politically agree to say hell no, we’re not going to let you do that.

Maximillian Alvarez:

And can I just ask, as a veteran yourself as an organizer with Veterans for Peace, have we been fulfilling that promise to our veterans? And I guess that’s a two part question. How have we been treating our veterans in the aggregate before 2025 and what are these new attacks from the Trump administration doing to our veterans on top of that?

Ellen Barfield:

Yeah, thank you. Because that’s exactly right. The VA has essentially never been fully funded. It was already down about 60 or 70,000 staff around the country before Trump even got back into office. And now there’s threats of about 85 or 90,000 more cuts and they’re talking about, oh, we’ll keep the essentials doctors and nurses, excuse me, if the floor is a wash and trash and the toilet won’t flush and all of the staff is important, it’s not just the professionals. So give me a damn break.

Maximillian Alvarez:

Brian and I literally just interviewed multiple VA nurses to say like, look, when you cut our support staff, who do you think has to pick up the work us? Which we can’t tend to

Ellen Barfield:

Our patients take care of the patients, exactly. We got to have medical tests and we got to have clean bathrooms and all of that. I wear this shirt the same, our VA shirt when I go to the VA and talk to some of the staff. And some of them are very grateful to see it and some of them are kind of puzzled amazingly, this one guy who’s been doing the check-in for me, the blood pressure and whatnot before I see my endocrinologist have a thyroid condition. And this was before Trump got back in, but that’s exactly what I was talking to him about. The staff is way, way down across the nation. I’m sure y’all are tight here. And he said, yeah, as a matter of fact, you’re right, we are. So it was interesting that I was helping him understand, and you’re absolutely right, it was far from perfect for a long, long time, but it was a lot better than we’re looking at and being fearing right now. So yeah, it’s chipping away at something that was already far from the strength that needed to be.

Maximillian Alvarez:

And I guess, I know there’s a broad question, but we got a lot of folks who listen to the show who are not veterans, right? They’re workers union and non-union. I’m sure they’re curious if you had to give a general sort of overview, how is this country treating its veterans?

Ellen Barfield:

Well, how is this country treating anybody who isn’t a massively wealthy person? And I have said for a long time that VA healthcare, if fully funded and staffed is the way everybody’s healthcare should be. Single payer, everybody in, nobody out. And sadly, the VA has never been everybody in. They don’t cover everybody and they really should. It depends on timing, depends on a lot of things as to whether they will take you or not. But a large chunk at least of veterans, but it is a single system where your records are all together, your care is all in one place. They understand the specifics of you being a veteran. And there are lots of other categories of people that need particular attention paid. Everybody should have single payer get rid of the 30% insurance premium that the civilian world pays for their healthcare.

Then we could afford to make sure everybody had primary care, everybody had preventive care. It wouldn’t be showing up at the emergency room at the last minute when you’re catastrophically sick and if they’re going to save you, they’re going to have to spend a lot of time and money, preventive, preliminary, that’s what everybody needs. The VA at least theoretically and to a large extent in fact is damn good. It’s a unified system where it’s all together and they take care of it all. It’s so much easier than having to ferry records across town because you have to go to a specialist who’s never seen you before. Everybody should have it. So yeah, the nation’s not being kind to veterans, but it’s not being kind to anybody that isn’t filthy rich.

Maximillian Alvarez:

Listen, truer words never spoken. And you mentioned something at the beginning of our interview here where you said there are a lot of conservative folks out here. There are folks more on the left, but this moment of crisis is bringing those folks together here as one crowd on the National Mall. Things are getting so bad that it is forcing a lot of folks to come together in common struggle. And I wanted to kind of end on that note from the veteran side of things. What possibilities, possi, do you think this moment presents and what do people need to do to seize on that moment and fight for our rights, fight for our future before they’re all gone?

Ellen Barfield:

Well, I have really avoided the thought that things have to bottom out to energize people, but it’s obviously happening sadly. People are terrified as they have reason to be here. And are we going to lose our Medicaid? Are we going to lose our healthcare? Are we going to lose our social security? And then what the hell are we going to do? Yeah, there is reason to be terrified and we have to unify across our differences and across our skin color and our religion and all those things that they are using. It is what imperialists fascists always do is to divide and conquer, to teach you that somebody who’s on the same level as you is threatening you. When that’s bullshit. Immigrants don’t threaten us. Black folks or white folks or brown folks don’t threaten each other. Pretty much all of us in the same boat now, there was a middle class, it’s pretty much gone.

So we don’t have any damn choice and it is pulling people together. I’m glad of that, but I’m horrified that it had to get so bad. But here we are, veterans for Peace is 40 years old this year. We’re fixing to have our first face-to-face conference in a while because of COVID and other things. We are small. We’re only about 3000. We got up about 10,000 in the earlier Iraq years, but we’re small, but we speak out about challenging all war and there’s got to be a better way that the imperialists of Europe and the US have got to figure out they need to be just part of the world like the rest of it. We got to, there’s struggle in the United Nations and other international forum to recognize that the climate is going to kill us if we don’t stop pumping crap into it. And we have to work together to solve that. And the ridge world owes the global south a huge amount of funds to help them take care of it. And we got to do it here too. And that’s totally the direction we’re not going right now. We can’t possibly, as human beings expect it continue if we don’t come together. And sadly, when it gets this bad, it kind of knocks people upside the head and they understand it a little better.

Lindsay Church:

Good afternoon. My name is Lindsay Church. I’m a Navy veteran, the executive director of Minority Veterans of America, and someone who still holds tightly to a belief that this nation is worth fighting for, not with weapons or wars, but with truth, with compassion, and with conviction that we all deserve to belong. We stand here today not just in protests but in protection one another of our shared future of the Soul of public service itself. Because what we are witnessing is not theoretical, it is not slow moving. It is here, it is deliberate, and it is already doing harm. Today marks the beginning of what history will remember as a purge of transgender service members, an unconscionable order from Secretary of Defense, Pete Hexes that puts thousands of service members across the country and around the world in the crosshairs of their own government. Troops who serve with integrity and distinction are being told that their presence is a problem, that their identities are incompatible with patriotism, that they must choose, walk away from the careers that they’ve built or stand and stay to be persecuted. This week I walked to the halls of Congress beside some of them. Brave, steady, remarkable people who are carrying the weight of betrayal was grace that shouldn’t be required of them. I watched as they told their stories calmly, powerfully, beautifully. And I watched members of Congress and their staff move from polite interest to a deeper knowing. Those weren’t statistics in front of them, they were patriots. And no matter what, some want to believe they belong.

But Secretary Hex says is not the only one making these decisions. At the Department of Veterans Affairs secretary Doug Collins has announced his goal to eliminate 83,000 jobs. Jobs failed by the very people who care for us. When the wars are over, people who process disability claims answer crisis lines, help veterans find housing and walk alongside us through recovery. Many of them veterans themselves, many of them survivors of the very systems now being dismantled. This isn’t reform, it’s abandonment, and it’s not isolated to VA today. The cuts, the job cuts are there, but they’re already spreading the workforces. Its social security, FEMA education, those pillars of community stability are already being slashed. Public servants across the country are being demoralized, discarded, and erased. Not because they failed in their duties, but because they dared to serve the people that those in power find inconvenient. This is not about cost saving, this is about consolidation of power, of control, of the very definition of who gets to be counted as an American. This week, the Navy quietly announced that it will rename the USS Harvey Milk.

A name meant to honor courage, authenticity, and sacrifice stripped from our national memory. Without ceremony, without justification and without shame, the Harvey Milk story is not one they can erase. And neither are the stories of Harriet Tubman or Medgar Evers or Ruth Bader Ginsburg or John Lewis. All namesakes of navy ships, these aren’t just names, they’re the scaffolding of American progress. They remind us who we’ve been and they point to us towards who we could become. When we erase them, we do not become stronger, we become smaller. And while these symbolic erasers continue, the real world harm accelerates. Just weeks ago, the VA rescinded protections that in turn, the transgender non-binary veterans like me could access medically necessary care. Care that is affirming care, that is evidence-based and care that saves lives. This isn’t about budget, it’s not about medicine, it’s about cruelty, cloaked in bureaucracy.

And while the spotlight is aimed at transgender people benefits for others, women, people of color, disabled veterans are being quietly dismantled in the shadows. Let me be clear, we are the canary in the coal mine. What they do to us in the headlines they will do to you in silence. I’ve stood besides veterans as we slept on the steps of the capitol to pass the Pact Act because our sick and dying friends deserved better. I’ve traveled to Ukraine with fellow veterans to stand with our allies in their fight for freedom. I’ve stood my life in the military and far beyond it answering the call to serve. Because to me, service isn’t defined by the uniform. It is defined by what we choose to protect, by who we choose to stand up for. Whether we leave behind a world that is more just more compassionate and more free. So I say this to secretaries, he Collins, and to every person who believes that they can quietly erase us from this country’s fabric. We are not going anywhere. We are your neighbors, your coworkers, your classmates, your family. We’re veterans, we’re public servants, we’re Americans, and we’re still here. We will not be erased. We’ll not be silenced, and we’ll not stop fighting, not just for ourselves, but for the America we know is still possible. Thank you.

Leilana Brandt:

So my name is Leilana Brandt. I am a veteran of the Army, national Guard, served from 1996 to 2002 in the 36 50th maintenance company in Colorado.

Eric Farmer:

My name is Eric Farmer. I served from 1999 to 2020 in the Navy. Did most of my time on submarines, also did a tour to Iraq and I come from Texas.

Maximillian Alvarez:

Well, thank you both so much for chatting with me. We are standing here on the National Mall to unite for veterans, unite for America rally. I was wondering if we could just hear a bit more about you all your time in the service and what the hell’s going on right now that is bringing so many folks out here to the mall?

Leilana Brandt:

Well, I am a transgender person and I also was in the military during Don’t ask, don’t tell last time. So I was completely closeted for my own safety, not just in the military, but in my life in general. And it took me a very long time to have the courage to do what some of the service members now are doing, which is being themselves while being in the military. And each and every one of us have taken an oath to the constitution just like every other service member and veteran. And I feel that them being stripped away from the military right now, not only losing their livelihoods but also their homes, their friends, they’re just being stripped from their lives completely just because of how they were born. And I think it is appalling and insulting to all of us.

Maximillian Alvarez:

And can I just ask on that note, could you remind folks who maybe forgotten what the hell it was like in the Don’t ask Don’t Tell era? It felt like we made quite a bit of progress in a short amount of time and now we’re just yanking it right back.

Leilana Brandt:

While for anyone in the two s LGBTQI plus community, they were expected to not speak of it, to not have any hints of who they were. And so they basically had to hide themselves in order to serve. And there were many that were separated through no fault of their own, but because they were outed by other people. And then there were just folks that used that as an opportunity to shirk deployments and stuff like that by falsely claiming it. So it’s not anything that makes sense as far as readiness goes. And also Hertz enlistment because there are many folks in the queer community that want to serve or that need to serve because that is the best way for them to make a livelihood for themselves in a country that discriminates against them already. And the military has long been a place that started to be more diverse before the public sector was. And so I believe that that’s something, or sorry, before the private sector was. So I believe that that’s something that should continue, that it should be at the front of the pack as far as allowing everyone who wants to serve to do so.

Eric Farmer:

My time in the Navy, like I said, was mostly on submarines. When I first started out, it was strictly men, it was strictly men. When I first started out in the submarine community, it wasn’t until about 2006 that they started allowing females to serve on submarines and that was started out as officers. My last submarine that I was on that I did a deployment on was integrated with enlisted females as well. And they stepped up. They stepped up and did the job that all the other men said that they wouldn’t be able to do. And so I have a feeling that what’s about to happen is that they’re going to try to do away with females in the submarine community and it’s not going to make us ready. The jobs are being filled by females right now, and if you take all those females out, we’re not going to be capable of deploying our submarines.

Now what’s bringing out the veterans here is the fact that they are trying to take away the jobs of the veterans. They’re saying that that’s going to help the veteran community with the va. And I’m telling you that we’re about to find out that you can’t do more with less. I have had three to four phone calls where I’m trying to get community care on the phone so that way they can send something to the VA so I can get my work done. And they’re, they’re not picking up the phone. I’ve been on three or four phone calls where it’s been 30 plus minutes and no one’s picking up and it just cuts off and I have to call back. And so I’m waiting. I’m already waiting. And the cuts have just begun.

Maximillian Alvarez:

One, it really gives a grim meaning to that phrase, right? We are doing more with less, but it’s not what people think. You have more plane crashes around the country when you have fewer air traffic controllers. You have more wait times for veterans like yourselves when you have less healthcare staff at the va, right? That’s the kind of more we’re getting for less, which is nuts. But I wanted to ask you if you could both touch on that a bit more. Since your time in the service, what has your experience been like as veterans? How have we been doing as a country in caring for our veterans before the new Trump administration? And then we’ll talk about what the hell’s going on right now.

Leilana Brandt:

Well, I think that what I have seen, I never used the VA because I was never overseas, but my father was Lifetime and had multiple deployments and he has been someone who used the VA and he has always had complaints. He has always had complaints, and it is mostly about the understaffing. It’s not that there is waste happening as far as personnel goes, and that’s the place where they’re trying to make cuts is personnel. That’s the thing they need more of, not less. So if they need to find ways to make it more efficient, that’s great, but personnel is not the place to start with that.

Eric Farmer:

So when I first got out in 2020, I was scared about to go into the VA because I’ve heard all the horror stories. And for me, when I first got out, it was actually pretty good. Not very long wait time to get ahold of somebody. No wait time to get in. It wasn’t until recently that the wait times have become longer and longer and I’m not getting the care that I feel like I need. In fact, I go Wednesday to have a surgery on my shoulder from an injury from the Navy that I re-injured, but I’m not going through the va. I’m having to use my personal insurance. I’m going through TRICARE because the VA wants you to go through physical therapies before they do anything, and I have a tear in my labrum that needs to be fixed.

Maximillian Alvarez:

There’s been so much going on in the past three months alone, it’s hard to even know where to start. But like you said, the cuts to federal agencies across the board, including Veterans Affairs, and I just interviewed some of the nurses at VA hospitals, so they’re feeling it. Folks here in DC are feeling it on the administrative side. It’s going to take a while for us to really wrap our hands around the impact of all this. But I think one silver lining of the terrible moment we’re in is that it’s bringing so many folks out of complacency to gatherings like this. Even people who don’t normally agree on stuff, people who maybe aren’t down with L-G-B-T-Q rights, but who are saying, fuck it, we’re all getting destroyed right now. If we don’t start learning how to work together, we’re all going to fall like dominoes. So I wanted to kind of end on that note because things are obviously pretty grim right now, but what do you think it signifies that so many folks have come out to the mall, that there’s so many diverse groups of veterans, there’s union folks, non-union folks, older folks, younger folks. What message does that send and what do you think it’s going to take for us to really stand together as working people to fight this?

Leilana Brandt:

Well, I think that the military needs to continue to lead that way in diversity as it always has. Every person I ever served with, regardless of what their personal political views, religious views, anything like that, they didn’t give a shit what their buddy in the foxhole believed or where they came from or anything like that, as long as they had their six. And that’s something that we need to remember is that we need to have each other six. We need to be there for each other knowing that we all have a common goal and we have a common enemy, and that is anyone who is an enemy to the constitution that we took an oath to support and defend, and if any of us are under attack, then we all come together to fight that.

Eric Farmer:

I think the silver lining of having the diverse group to show up today is sending a message. It’s going to send a message that the oath that we took does not end, that it’s going to continue until we eradicate the fascism that is trying to implement our country. My grandfather fought in World War II against this, and never in my mind did I think that we would have to fight this, but taking it to the front lines today, to the front steps, to the front door of the capitol, as long as someone, even if they support a certain person, just listens to some facts from today, that might change their mind and go, you know what? I have that oath. I need to defend the constitution because I’ve asked people, well, what are you going to do whenever the constitution starts getting taken away? And they told me that they would fight, but they’re not here. They’re not protesting

Leilana Brandt:

Because they’d be here today if they

Eric Farmer:

Actually recognized it was already happening. They don’t go to any protests. They sit idly by and we can’t do that as veterans with the support of non-veterans. This is what it’s going to take. Non-veterans supporting the veterans, the veterans coming up and being the bonus army that this is about bonus Army of 2025.

Irma Westmoreland:

Well, good afternoon you guys. My name is Irma Westmoreland and I’m a registered nurse in Augusta, Georgia for the va. I’m also secretary treasurer for National Nurses United and chair of our VA division. While I’ve worked for the VA for 34 years as a nurse, some of my earliest memories are going to the VA in Augusta, Georgia to work with the veterans on bingo nights or dance parties. When I got older with my mother who spent 50 years as a VA volunteer, I know. Pretty cool, huh? Also, my husband is a retired SFC Army veteran of 21 years of service who has disabilities from its service. So the VA is deeply personal to me. Our servicemen and women were told, if you need us, we’ll be there for you. It’s a promise. Now, secretary Collins and the administration want to take that promise away and we’re not going to allow it. That’s why it deeply pains me to see these attacks on the va. When we have a contract for the VA care, the nurses and the doctors are going to be caring for these patients. When the administration says they won’t cuts, we say, no, we need to live up to what we told and promised our veterans. We told them that we would be there for them and we need to do that. They stood for you and me and I ask you now to stand for them. No cuts to the va.

Maybe some of you know someone or love someone ill from burn pit smoke or from Agent Orange or lost a limb from an IED exposure or died or suffered from PTSD, military sexual trauma or other chronic illnesses. We know the VA is the best place to get care for these ailments and more. The VA is the only healthcare system centered around the special needs of service members. 30% of our employees are veterans themselves, but it’s more than that. It’s also the only healthcare system in the country that’s fully integrated will help with veterans in poverty, with homelessness, offers, clothing, allowances, and much, much more. I’ve seen magic happen at the VA friendships form fast and it’s not unusual to see veterans helping veterans, whether it’s pushing a wheelchair or walking them down the hall to an office. These veterans share a deep sense of camaraderie and a sense of belonging. That goes a long way in making a person feel better and stronger. Now, if you ask, is the VA perfect? No, it’s not. I can’t tell you that it is, but let me tell you, we’re light years better than the private sector.

That’s why I will not stop fighting to see the VA improved and not destroyed. As you all know, secretary Collins is now looking to cut tens of thousands up to 80,000 jobs from the va eight. Yeah. These decisions are being made at the atmospheric level. The staff that do the work know best where things can be improved and streamlined. And I say ask them. He says, no mission critical positions will be cut. But let me tell you that all positions in the VA are mission critical. It’s important for every person to keep their job from the engineering staff to the housekeeper, to the dietary staff, secretarial staff, and many, many more. When cuts are made, who will be there to have to pick up the work that needs to be done? The nursing staff and the medical staff that are left when supply folks are cut. I heard that operations were being postponed so nurses could run, get clinical surprise. Let me explain that for you. In one place, a nurse had to go and to the warehouse in the VA to get supplies for surgery needed in the OR for a patient who was waiting. That’s not right. That’s right. But that veteran finally got their surgery. It was delayed, but it was done. But it was because the nurses stood for that veteran.

When housekeeping was cut, I heard delays in veterans getting into beds because there was no one to clean the rooms. This causes delays for our patients getting needed treatments started, and in some cases it may need to lead for a more elevated critical need of treatment. It’s common sense cutting 80,000 jobs will cause delays in veteran care. So we say absolutely no cuts. That’s right. We know. We know we are. What we’re witnessing is an effort to push the VA past its breaking point. The ultimate goal is to privatize the VA and pour billions of taxpayer dollars into giant healthcare corporations and the pockets of billionaires instead of the veterans who served our country.

Don’t sell us out because what they do, they know the VA and the federal government. It’s going to pay them on time every time. That’s why they want our care, but they don’t know our care. They don’t know how to provide our care. They don’t know that the VA does it better than anybody. The nurses and the doctors are specifically trained to do it. We’ve been training for years since the VA was incepted and while right now we are not going to go away for sale, we are not for sale. That’s exactly right. It is the nurses and the government workers who are standing up to block this privatization effort. It is because of our unwillingness to back down that nurses and other unions are filling the retribution that came down on March 27th with an executive order designed to strip us of our union rights. It is union busting and intimidation, plain and simple, but we’re fighting back national nurses united along with other federal workers, labor unions, and other veterans groups. We sued the administration over this outreach of executive power. This is not about us, it’s about our patients. We must have collective bargaining protections that allow us to advocate for our veterans and to speak up about issues in our facilities that cause us concerns for our patient safety. One example is we’ve had shortages of IV normal saline to mix medications. How stupid is that?

With that being said, you all understand the VA is not a contract. The union’s not a contract. The unions are nurses. We represent, the union says, and I say no cuts. Keep the VA strong so that we can care for every veteran. NNU knows that an injury to one is an injury to all. So we say when we fight, we win. When we fight, we win and we will prevail. The VA will stand strong for our veterans. Thank you.

Andrea Johnson:

My name is Andrea Johnson and I’m a registered nurse. I work with veterans in San Diego.

Justin Wooden:

And I’m Justin Wooden. I am a registered nurse in the ICU and I work in Tampa, Florida.

Maximillian Alvarez:

Well, Andrea, Justin, thank you both so much for chatting with me today. We are of course standing out here on the National Mall at the Unite for Veterans, unite for America rally. You all with National Nurses United have shown up in full force because of course, these cuts that the administration is doing to the federal agencies across the board are impacting workers, including workers at the VA and across the board across the country. So I wanted to ask if you could just say a little more about who you guys are, the work that you do, and what it’s like to work where you work under the conditions we’re under right now.

Andrea Johnson:

So we’re a special breed, and I say that because we care for patients that are not typical patients. Veterans went overseas, they fought wars. They’ve done many things that affect them morally and mentally. And because of those actions and the things that they had to choose to do in wars, they come back broken. And that’s what is unique about the VA system and VA nurses and healthcare providers in general, is that we have that knowledge and experience to care for the veteran in their entirety, right? Outside public hospital systems don’t have that knowledge or experience working with veterans and the special, unique needs that they come back after serving their country with. So as BA nurses we’re there, we’re taking care of that whole veteran. We’re taking care of their medications, we’re taking care of their home life. We’re coordinating with social workers to make sure that they have all the resources that they need. It’s not just passing medications. We’re caring for that whole veteran. And I think that’s what’s special about being nurses

Justin Wooden:

And our veteran population that we care for is also different than the fact that I’ve worked private sector before and I’ve worked the va, the veterans, they’re not like the average person when it comes to their care. They want it straight, don’t beat around the bush. They want to know what’s going on, cut to the chase, just tell me what is going on. They don’t want sugarcoated. They want direct answers and we offer that.

Andrea Johnson:

That’s right. And I think the other thing that makes veterans unique is that they come from a system where they’ve been told what they can wear, how they can act, what they can say, what they can do. And soner, VA nurses and healthcare providers in general struggle sort of with this authority in a way where we educate and try to teach our veterans better ways to care for themselves.

But we have that sort of roadblock because they put up a wall, it feels like we’re telling them what to do, and that’s never what we are trying to do. So we always have to find unique ways with each veteran. Each veteran is unique in how they receive and retain information. So I think that’s what makes us unique too than outside hospitals, is that veterans are a very special population and taking away the care that the VA provides them is despicable. And like I said, no outside hospital system could take on the number of patients that the VA system cares for or the special needs that the veterans have.

Justin Wooden:

And veterans, they have a little camaraderie. If you’re in the army, you’re army strong. If you’re in the Marines, you’re strong. So every branch kind of has a little internal battle with each other, but when it comes to it, they’re all a brotherhood. They will stand behind each other. A lot of our veterans in Tampa where I go, they come to the VA hospital just to be around veterans. So it’s a community to them. It’s not just a place to get healthcare, but they go there because they feel the camaraderie, they feel the brotherhood. So while they have appointments, they come early just to talk with other veterans that they know from places or they just feel more secure. And a lot of military veterans don’t like to talk about their time and their service, but at the va, we encourage it, it therapeutic, it’s cathartic, and they feel free to tell stories there that they haven’t told their families.

I mean, we have patients who are towards the end of their life and they have all these things that they haven’t said that they finally want to say, and they feel comfortable with the nursing staff, with the doctors at the VA to have those conversations and tell the things that they were so afraid to talk about before. So I love working for the va. I think it’s a phenomenal thing and a wonderful place to work. But the current administration is causing a lot of rifts and making it a lot more difficult in a lot of ways.

Andrea Johnson:

These actions by the government are creating anxiety and fear for healthcare workers coming to the va. That’s not stopping us from coming to the va. We’re dedicated to our mission and we show up day in and day out to deliver that care despite what’s happening. But that’s why we’re here today, right? We’re fighting for what we know the vets earned and what they deserve.

Maximillian Alvarez:

Could you guys say a little more about what has been going on inside the VA over the past three months? I mean, how have these policies from the Trump administration affected you all in your day-to-day work? Right. I mean, there’s the current attack on the collective bargaining rights of federal employees, over a million federal employees, including nurses at National Nurses United work for the va, right? There’s like the voluntary resignations, staff cuts that are impacting agencies across the board in different ways. Could you just give listeners a little on the ground view of how has this been affecting you all and the work you do over the past few months?

Andrea Johnson:

Well, like I mentioned earlier, nurses, at least the nurses I’ve been speaking to in San Diego, and I’m hearing from my colleagues across other VA facilities as well, is that there’s a decrease in morale. People are feeling fearful and anxious coming to work because we don’t know what’s next. We don’t know if tomorrow when I go into work, I’m going to lose my job. So we’re dealing with those fears, but we’re still coming in, right? It’s not stopping us from coming in. It’s not making me want to quit my job and go find a job somewhere else. I know what I do at the VA is important, and I know that the veterans appreciate the care that they receive there. And I think the government and the people making these decisions need to actually come and spend some time with these people to better understand where they’re coming from, making these decisions without any of their, in my opinion, without any of the veterans in mind, any of the federal workers really, or the American people for that matter. But specifically for today, they’re making these decisions, not considering what the veterans want.

Justin Wooden:

So I work in the ICU at the bedside, and it affects me in ways because sometimes they send us to areas because they’re short staffed, that we are going to areas and covering areas that we’re not familiar with or used to working in these areas. And a lot of people are like, oh, well, you’re a nurse, you can work anywhere. Well, and I like to is like, would you go to a podiatrist to get your teeth done? They’re both doctors, but it’s similar. We have different specialties. And also as a leader in the union at my facility, I round the hospital and talk with all the nurses and all the units to see what their concerns are. And a lot of ’em come to me. They’re like, well, we’re told there’s no union. There is a union,

Andrea Johnson:

Andrea, Andrea. It’s really confusion.

Justin Wooden:

There’s a lot of animosity every day. You don’t know what’s going on. It’s just very tense. I guess that’s a good way to put it. But going around the hospital, a lot of the nurses that I work with are saying they feel that there’s more focus being put on numbers and metrics as opposed to the care of veterans or the staff. They’re putting numbers over the patients. And ever since I’ve been at the va, which is, I’ve always had a wonderful time, but recently it’s becoming very, like you said, very anxious. It becomes very nerve wracking like you’re walking on eggshells just because you don’t know what’s next.

Andrea Johnson:

Yeah. We just don’t have any clue. But I think, and Justin made a good point, that a lot of our nurses are concerned about the union because of these executive orders and attacks on union unions and the federal government in general. But as union leaders, we remind them that the contract our CBA, our contract is not the Union National Nurses United. Yes, we are the union. I’m not the union. It’s every single one of our nurses that are on the floor, right, collectively, so they can try to take us down, but they’re only going to succeed if we let them. And so I’m using that as sort of a motivator to keep my nurses motivated and encouraged to continue to fight the good.

Justin Wooden:

Because right now the current administration is, they’re doing union busting tactics. So being a federal government agency, they took away union dues being done through a direct deposit through your paycheck. So essentially we lost every member we had, and now we have to start from the ground up getting everyone to reset up. So essentially it’s like a grassroots project starting from the ground

Andrea Johnson:

Up. It’s very grassroots right now. Yeah.

Maximillian Alvarez:

Can I just ask a blunt question? What does eliminating collective bargaining rights and changing the structure of how union dues are paid, how does that serve the American people? How is that? Are you creating efficiency or cutting waste?

Andrea Johnson:

It has absolutely nothing to do with government efficiency and cutting waste. If anything, especially federal agency unions provide protections to the employees that they represent to speak out about fraud, waste, and abuse. We provide that layer of protection for VA nurses to speak out about patient safety issues when there’s not enough staff or if we have broken equipment, our collective bargaining agreement provides, in a way, it’s a bubble. It sort of insulates us from retaliation from being targeted by management. So I think that’s the importance of our collective bargaining agreement.

Justin Wooden:

And I worked in private sector, so I can see. So in the private sector, say you’re an employee and you’ve done something. So I call you into the office, say, Hey Max, you did this. Can’t be doing that. Here’s a writeup, right? If you are opposed to that or don’t agree with it, that’s your opinion and you have no say in a union, you have a union backing, you have union rights. You can have a representative there to say, Hey, I don’t think this is right. And we can investigate it and say, Hey, I don’t think this is just what you’re doing. So we stand up for our members.

That’s just one scenario. We also ensure, like Andrea said, safe working additions. We make sure the veterans are safe, making sure that if they change any policies that, or any changes in working conditions that it’s safe for the staff or things like that. So there’s a lot of things the agency does to help protect workers, not just, it’s not saving money. I mean, yes, the union does fight for, we look at locality pay and we look at all the area hospitals, how much are they making? Why is our pay not equal or similar to the surrounding areas? We do those things as well. We also help our employees who have problems with hr. A lot of our time at my facility is spent because HR payroll hasn’t done what they’re supposed to do or bonuses weren’t given or a lot of unjust things are being done by HR because this is the federal government. It’s not just we don’t have our own HR department. We have to go through multiple steps to get things done. So we have a lot of resources that we use to get to the people so we can help our employees.

Andrea Johnson:

Yeah, yeah. Just to kind of last little thoughts on that, like I said, the collective bargaining agreement, and I hate to describe it this way, but it’s sort of an insurance policy for some people because like I said, there’s sometimes fear to speak out about safety issues and when something is being done incorrectly because of that fear of retaliation or being singled out and like I said, that collective bargaining agreement provides that protective layer. It makes people feel safe and comfortable to be able to speak out. And that’s why those are important. It holds management accountable. They can’t just decide to do whatever they want because if it’s written in a contract, they have to follow that

Justin Wooden:

Essentially having union is having a democracy. There’s due process and checks and balances in the private sector, it’s more authoritarian. This is what I say, do it

Maximillian Alvarez:

Well. And that’s always been my retort when I hear folks say they want government to be run a business. And I was like, well, as someone who interviews workers at businesses across the country, I can tell you you’re saying you want our government to be run like a dictatorship. How most businesses are run. I could talk to you guys for hours, but I know I got to let you go here, but I wanted to just pick up on something that you were saying both of y’all. But we’ve interviewed a lot of healthcare workers on this show over the years

And through those interviews from folks who work at private Catholic hospitals to public hospitals, university hospitals, certain common like horrifying trends have become apparent in terms of what’s going on in healthcare. The crisis that we have been facing with more work being piled onto fewer workers, patient care, the quality of patient care going down as patients are increasingly treated like commodities to come in, get their care and get kicked out. This whole sort of McDonald’s model of healthcare is something that I’ve heard described from different healthcare workers around the country. I wanted to ask how much the VA has sort of been going the same way or how things are different within the va. I guess maybe to end on that note, what do you all in the VA deal with on a day-to-day basis that is indicative not only of problems that need to be fixed at the va, but problems that we’re facing in our healthcare industry across the board right now?

Justin Wooden:

I can speak to that first.

Andrea Johnson:

I’m going to let you go ahead

Justin Wooden:

Because working in private sector

Before coming to the va, I’ve seen both sides. So I know everything is about billing. In private sector, it’s about getting money. Because they’re for profit, they need to make money. So every procedure that’s done has to be documented so they can bill for it to get money. At the va, it’s not like that at the va. So you were describing healthcare as like a fast food restaurant. So drive through, get what you need, and then at the VA we care about the veteran whole. So when they come in, we’re worried about discharge planning when they come in. So are there anything you need at home? Do you need shower bars? So we’re working on the discharge to make sure when they do leave, when it’s time for them to go, they have the appropriate things. Do they have problems with any meals? We’re going to get every resource.

Mental health, we schedule their appointments before they leave. Where in private sector, they don’t do that. So before you’re discharged from the va, any follow up appointments, we we make sure they’re scheduled before you walk out the door and we print out a calendar of here’s all your upcoming appointments so you know what you have to have done and all your medications are listed, all these things are there. We don’t want to set up for failure. We want them to know their health course, know what they need to do and follow up with those treatments. We have social workers who call after they leave to make sure, hey, it’s been a week since you’ve been home, is everything okay? So those are the things that I see the biggest difference. I think that’s the biggest strength the VA has. So for them to do cuts and try and eliminate that system, I think is the worst thing we can do.

Andrea Johnson:

And to sort of piggyback off of what Justin was saying is, I mean you made a good point, max. Our people are talking across the country about our healthcare system and how broken it is. And so taking 9 million veterans who receive care in a system, that one has significantly higher standards than any hospital outside of a federal agency. Were held to a higher standard when we screw up. That’s in the news. When local hospitals make a mistake that’s not in the news because they’re smaller, it’s more central. But the VA is a federal agency where across the entire country. So if the VA does make a mistake, it’s known. But what we do very well isn’t necessarily spoken about in the public as much, but the VA does a lot of things very well for our veterans

Justin Wooden:

And veterans choose to come to the VA

Andrea Johnson:

That outside hospital systems cannot, cannot do. And if we eliminate the va, if we try to continue to push veterans into the community with a system who already or that already cannot serve the citizens that they’re set out to serve and we add 9 million more people to that system, what’s going to happen? We’re going to have a very sick America that is unhealthy, that can’t happen

Justin Wooden:

Paying through the nose

Andrea Johnson:

And paying through the nose. And

Justin Wooden:

The PAC Act added 400,000 more veterans that can get care and then they want to cut 80,000 plus jobs. So who’s going to care for those veterans, those newly signed veterans? You’re offering more services for veterans, but now you have less people to provide those services.

Andrea Johnson:

Right. And we know studies show our experience and our knowledge knows that the more staff you have on hand to care for people, the better healthcare outcomes there are. And that’s just, you can’t make that up. It’s documented, very well documented. And we should be looking at not dismantling one healthcare system that serves 9 million people, but looking at the healthcare system as a whole on how we can make it better. Not taking one away and throwing it into this other one that’s already a disaster. We need to be looking at trying to make our outside hospital systems more like the VA as far as standards and things like that go. I think we’d be better off in America if more outside hospital systems followed in the va, which is why we need to keep the VA in place.

Maximillian Alvarez:

Well, and just a final question on that note to everyone who’s out there listening right now, whether they’re in a union or not, whether they’re veterans or not, why should they care about this and what can they do to help? How can they stand in solidarity with you all at National Nurses United and what can they do to join this fight to save the va?

Andrea Johnson:

Okay. I think this fight, whether you’re Democrat or Republican, you are union or non-union. I think that this is an important issue because we’re dealing with our veterans. These are people who risk their lives, gave up time from their families, were injured, witnessed some atrocious things. And if we’re not supporting them and receiving healthcare, then there’s something wrong. And I think that we need to be focusing on making sure that the veterans continue to receive the care that they have earned and that they receive. And because this is just me, but what they’re doing to the veterans, this is just one step. They could easily turn that to people who are not in the union, to people who are not veterans, to just regular old Americans. And then what are we going to do when our already broken healthcare system is even worse? So I think that healthcare in general should be a human issue no matter what side of the aisle you fall on.

Justin Wooden:

And my point I always like to say is every one of us has family member. If your family member is sick and in the hospital and they hit their call bill because they need help, you want somebody to be there to respond with the way the current healthcare system is going. We’re being put spread more places, so it’s taking us longer to respond to those calls. We as humans, as you said, our job as nurses, we want to care for our patients. We don’t want do any harm to our patients. We want to be there. So we are just fighting and want people to know that we’re here fighting for your family members, for your loved ones and for our veterans because that’s our job. That’s our oath that we’ve taken as nurses. So we just want to be able to have the supplies, the tools and the resources we need to give the best care we can to our veterans and patients.

Cecil E. Roberts:

My name is not just Cecil Roberts, president of United Mine Workers of America. I used to be Sergeant Cecil e Roberts in Vietnam in 1 96, like infantry brigade.

When I first got to Vietnam, I want you to listen to this. Some people tell me I was never scared when I went over there. You’re looking at a guy that was scared to death.

I tell the truth, that’s the truth. I was scared when I first got here. It appeared that nobody liked me. These people with 15 months, 10 months, eight months counting the days, they looked at us new guys as like, that guy’s going to get me killed when they hurt my accent. Oh no. Another hill belly from West Virginia. That’s what they thought. They looked at me, these veterans, they said, how you going to act? I didn’t understand the question. How you going to act? I want you to remember that because I’m going to ask you how are we going to act moving forward from this place? That’s right.

And then bullets go right by your nose. They look at me and say, don’t mean nothing, man. I’m thinking bullshit and say something to me and I want you to think about that. You get immune to this and I saw so many wonderful people with kids at home, mom and dad’s at home, wives at home, and all kinds of friends at home. Not make it. When I first got there, somebody with 30 days got killed, had a daughter he never met. Somewhere in this United States of America, there’s a 57-year-old woman, had never met her father. Now, how many veterans we have here? By show of hands, you’re going to get a test right now. How many of you met a million there in Vietnam or where you are stationed? How many of you met a millionaire? There’s a good reason millionaires don’t defend a country. They take advantage of the country, and if there’s people listening to this live broadcast, you could be mad. Your feelings could be hurt and I don’t care.

The other thing I want to ask you, when you got back home, how many people patted you on the back, particularly if you was a Vietnam veteran? Didn’t happen. Didn’t happen. But I want to thank everybody, every veteran because we’ve been embraced for the last 20 years and that means so much to me. Thank God for you. It isn’t, isn’t enough to come here and rally. This is a great first step. Abraham Lincoln said, this is a country of the people by the people and for the people it has turned in to a country for the rich people who don’t care about the rest of us, I’m going to tell you what we should be planning on doing. We should demand that every person who worked for the federal government and lost their union rights be restored. Right now, I was in the army and I’m glad people recognized the service of people who were in the army, but we shouldn’t be having a parade.

We shouldn’t be having to parade until every veteran has the healthcare they deserve and we shouldn’t be having a tax plan send to the rich who don’t need money. Here’s another tax cut for you. Until every American who has a job, doesn’t have a job, has a job until every homeless person has a home, we should make, I’m going to close with something. First of all, I’m calling on Congress. I’m calling on everybody that’s elected. I’m calling on every American, how are you going to act? Because this is terrible what’s happening to this country, and that’s why we’re here today.

You do know, this is my last quote, okay? On map next to last, Dr. King was assassinated. One month before I left Vietnam and I watched these African-American soldiers so desperate, so frustrated, so hurt, pick up their rifles, pick up their M sixties, and went out into those rice patties and defended the United States. When the United States didn’t defend them, that was wrong. This one will really challenge you. Dr. King in the middle of the civil rights movement said this to those who were being bitten by dogs. He said, listen to this. If you don’t have something, not somebody, not your wife, not your daughter, got your mom, not your dad, something that you would die for, you don’t have a life worth living. Think about that.

This is the last one. It’s strange that I jumped from Dr. King to Mother Jones. My great grandmother and Mother Jones were friends, two great radicals, and I’m so proud of our heritage. You may not know this history, but when you leave here today, read it. How many of you heard La Lulo at Ludlow? The gun thugs came off the hill after taking the machine gun and firing into the tent calling all day long. Sometime in the middle of the day, they cut a 12-year-old boy In two later in the day, they murdered the leader of that tent colony, and then they set those tents on fire and burned 13 women and children alive. That happened. That’s part of our history. Mother Jones did not quit. She called for a rally in Trinidad about 15 miles from the Ludlow site. She looked out on a crowd probably twice this size, and she looked at them, take this W when you go home. She said, sure, you lost. Sure you lost. But they had bayonets and all you had was the Constitution of the United States of America. And then she posed. Lemme assure you, any confrontation between a bayonet and a constitution, the bayonet will win every time. But you must fight. You must Fight and win. You must fight and lose, but you must fight. What must you do? You must fight. You must fight. You must fight.

Maximillian Alvarez:

All right, gang, that’s going to wrap things up for us this week, and I want to thank you for listening and I want to thank you for caring. We’ll see you all back here next week for another episode of Working People. And if you can’t wait that long, then go explore all the great work we’re doing at the Real News Network where we do grassroots journalism that lifts up the voices and stories from the front lines of struggle. And we need to hear those voices now more than ever. Sign up for the Real News Newsletter so you never miss a story. And help us do more work like this by going to the real news.com/donate and becoming a supporter today. I promise you it really makes a difference. I’m Maximilian Alvarez. Take care of yourselves. Take care of each other. Solidarity forever.

This content originally appeared on The Real News Network and was authored by Maximillian Alvarez.

Between discontinuing Affordable Care Act (ACA) coverage for coverage for small businesses owners, family caregivers, and millions of Americans, and kicking 7.8 million Americans off of Medicaid, the Republican tax scam will make basic necessities like food and healthcare more expensive for most Americans in order to pay for tax cuts for themselves, their wealthy donors, and giant corporations.

In April, a dozen congressional Republicans vowed to preserve Medicaid, saying:

“We cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations.”

They voted for the bill and its cuts to Medicaid anyways. Now, millions of Americans are staring down cuts to their healthcare while six of those congressional Republicans stand to personally benefit from passing the tax scam.

This content originally appeared on Common Dreams and was authored by Newswire Editor.

Janine Jackson interviewed independent journalist Bryce Covert about Medicaid work requirements for the May 23, 2025, episode of CounterSpin. This is a lightly edited transcript.

The Nation (2/28/20)

Janine Jackson: Welcome to USA 2025, where the only immigrants deserving welcome are white South Africans, germ theory is just some folks’ opinion, and attaching work requirements to Medicaid and SNAP benefits will make recipients stop being lazy and get a job.

Everything old is not new again, but many things that are old, perverse and discredited are getting dusted off and reintroduced with a vengeance. Our guest has reported the repeatedly offered rationales behind tying work requirements to social benefits, and the real-world impacts of those efforts, for many years now.

Bryce Covert is an independent journalist and a contributing writer at The Nation. She joins us now by phone from Brooklyn. Welcome back to CounterSpin, Bryce Covert.

Bryce Covert: Thank you so much for having me back on.

JJ: Most right-wing, top-down campaigns rely on some element of myth, but this is pretty much all myth: that there’s a problem: Medicaid and also SNAP benefits discourage recipients from seeking work, that this response will increase employment, that it will save the state and federal government money, and that it won’t harm those most in need. It’s layer upon layer of falsehood, that you have spent years breaking down. Where do you even start?

BC: That’s a great place to start, pointing out those claims essentially are all false, and I think it’s important to know, the reason we know that those things are false is because we have years of experience in this country with work requirements in various programs, and they have produced the same results over and over again.

Urban Institute (4/23/25)

So this started, essentially, with welfare, which is now known as Temporary Assistance for Needy Families. In the 1990s, with cash assistance to families, there was a work requirement imposed on recipients in that program that still stands today. And just wave after wave of research has found these requirements did not help increase employment on a long-term basis.

Most people were not actually working after they were subjected to the work requirement, and instead it increased poverty. It reduced the recipients of these benefits. So it essentially didn’t help them get to work, but it did take away the money that they were relying on.

That pattern plays out over and over again, and we have some newer evidence in Medicaid because, up until the first Trump administration, states could not impose a work requirement in Medicaid. The Trump administration allowed waivers to do so. Only one state actually did it. But Arkansas, the state that did impose this work requirement, kicked over 18,000 people off the program with no discernible impact on employment.

JJ: And it has to do with a misunderstanding about who Medicaid recipients are, and their relationship to the workplace, period, right?

BC: Right. Most Medicaid recipients are either working, or have some good reasons for why they’re not working. Either they can’t find full-time work, or they have conflicts, like they’re taking care of family members.

People are disabled, many of them have an official disability and they’re on the actual disability program, but many more are disabled and can’t get on that program. It is a very difficult program to enroll in. The burdens to enrollment are super, super high. And others say it’s because they are in school, or they’re trying to find work, or they’re retired.

So among those who aren’t working, there’s not a lot who are in any good position to go out and start working. And that’s true of a lot of recipients of other public benefits as well. So when you talk about imposing a work requirement on people in Medicaid, what you’re doing is adding administrative burden, which is to say extra steps they have to take to keep getting their benefits, that aren’t going to actually change the situation they’re facing when it comes to their employment.

Think Progress (4/13/17)

JJ: When you wrote about Mississippi, I know, with TANF, you were saying you had to prove you had a job, or were searching for one, before you could get help with childcare. And if people would just take a second and think, how do you search for a job or hold a job without childcare? So it’s not even logical. It’s more a kind of moral, strange misunderstanding of why people are outside of the workforce.

BC: I think this applies to other programs, too. It’s hard to get to work if you don’t have health insurance like Medicaid to get yourself healthy and in a good working position. If you’re not able to get food stamps and buy food for yourself, it’s going to be hard to be out there looking for a job.

These are basic necessities, and I think that’s another really important point to make here, is that Republicans have tried to paint lots of different programs as “welfare,” because that word is very stigmatizing. But what we’re talking about with Medicaid is healthcare. We are talking about feeling as if we need to force people to work—although really what we’re doing is forcing them to document on some pieces of paper that they’re working, which is an important distinction—in order to get healthcare, in order to take care of their bodies and be healthy.

Same with food stamps. We’re saying “you must work in order to eat.” These are basic, basic necessities that people need simply to survive.

JJ: And then we hear about the “dignity” of work. You need to work because there’s dignity there, and yet somehow a person whose grandfather owned the steel mill doesn’t need that dignity. Wealthy people who don’t work somehow are outside of this moral conversation.

BC: Yeah, and we’re talking about imposing work requirements on SNAP and Medicaid, which is what Republicans say they want to do, in the service of tax cuts for the wealthy. Essentially, they are literally paying for tax cuts for the wealthy, to return more money to the rich, by cutting programs for the poor. And those rich people, many of them do not work, or these tax breaks help them to avoid work—the inheritance tax, for example. So that moral obligation to work does not apply.

New York Times (5/14/25)

JJ: The New York Times column recently, from four Trump officials—I don’t remember the headline, but it was something like, “If You Can Work, You Must.” They didn’t marshal any evidence. They didn’t have data, just vibes. Those are some racist, racist vibes, aren’t they?

BC: Yes. That is an important point, that all of this cannot be separated out from racism.

I mean, the conversation over welfare and TANF in the 1990s, that was all race. It was about white Americans feeling like Black Americans were getting the dole, and were too lazy to work and had to be forced to work. The numbers at the time did not bear that out. More white Americans were getting cash assistance than Black ones.

But it’s a really deep-seated belief among Americans, and I think when you see, as in that op-ed, for example, or other places where Republicans are trying to call these other programs “welfare,” it’s barely even just a dog whistle. It is pretty blatant that they are trying to paint other programs as things that help Black people who are too lazy to work.

It’s all caught up in that idea, even though, again, the numbers do not bear this out. White people are more likely to be on these programs. We see equal employment rates among both populations. This is not actually a problem to solve for, but it is one I think a lot of Americans, unfortunately, really believe.

The Nation (6/8/23)

JJ: I’m going to ask you about media in another second. I just wanted to pull up another point about the racism, which is that it’s not just the mythologizing and the “welfare queen,” that those of us who are old enough will remember. But you wrote about how states with larger Black populations have stricter rules, and how when states were asked for exemptions on pushing these work requirements, they exempted majority white counties. So it’s not just the racism in the rationale, the racism in how it plays out is there too?

BC: Absolutely. I mean, these policies hit Black people more heavily. They are more stringently applied in Southern states that have higher Black populations, that are more hostile to their Black populations. And like you said, in the first Trump administration, when states were seeking exemptions, it was more majority white populations who got them. This is just really a fundamental racist myth we have in this country that’s proven very hard to shake, that Black people are lazy and rely on the government to get by and must be forced to work, when just nothing about the actual numbers and data bears that out.

JJ: I sometimes feel like reporters, even if they’re well-intentioned and trying to make it personal, they can kind of make it a thought experiment for folks who are better off. If you were struggling, wouldn’t you take the time to fill out a form? It’s just paperwork. Couldn’t you go across town to the office and fill out that form? And it just represents a total disconnect, experiential disconnect between anyone who has ever had to deal with this and those who have no idea about it at all and just kind of parachute in and say, Oh wow, filling out a form. What’s the big deal?

Bryce Covert: “This is not about, in fact, helping people to work. This is, instead, about kicking people off the program.” 

BC: Yeah, I think most well-off Americans have no idea how hard it is to apply for these programs, to stay on these programs, the paperwork that’s involved, the time that’s involved. And also when we’ve seen work requirements in Medicaid, for example, they are set up in a very complex way. Arkansas’s website was only available during the working day, and then it would shut down, and you couldn’t log your work requirement hours at night. I think that belies the fact that this is not about, in fact, helping people to work. This is, instead, about kicking people off the program.

You can see that in the fact that the reason Republicans are talking about work requirements right now is because they need to find spending savings to pay for the tax cuts. If this were not about kicking people off and spending less on benefits, then this wouldn’t be part of this current conversation about their “One Big, Beautiful Bill.” So these are huge administrative burdens, and it’s also a big burden for something that is a deep necessity. I think the mental impact, the emotional impact of being made to jump through these huge hoops for something as basic as food, it’s really extreme.

For example, I recently had to go to the DMV to get my Real ID. I had to go to the office in person. I had to wait for hours. I had to bring all the right paperwork. It was a huge burden, but this was for something that would just make it a little easier to travel on an airplane.

Think about going through the same process, having to show up somewhere in person, waiting for hours, making sure you have all the right documentation, and if you don’t, then you don’t get the thing that you’re seeking, but what we’re talking about is whether or not you get healthcare. What we’re talking about is whether you get food stamps. I think it’s an experience that’s hard for people who haven’t gone through it to grasp.

New York Times (5/13/25)

JJ: To bring it back to today, May 21, some coverage that I’m reading straight up says some 8.6 million people are going to find themselves uninsured. Other stories matter-of-factly describe work requirements, and some Republicans’ anger that they’re not going to kick in sooner, as about “offsetting” the tax cuts for the wealthy, as though we’re just kind of recalibrating, and this is going to balance things in a natural way.

I guess I would say I’m not getting the energy that there are 14 million children who rely on both Medicaid and SNAP, and there’s children who could lose healthcare and food at the same time, and that includes 20% of all children under the age of five. From news media, I’m getting Republicans versus Democrats; I’m not so much getting children versus hunger.

BC: Yeah, I think, unfortunately, these kinds of political debates tend to be covered like they are just political back and forth. Democrats think this, Republicans think that. It is legitimately harder to explain to people what this will mean in real life. I have reported on the impact of work requirements. For example, I went to Arkansas when they were in effect. It’s hard to report on. The people who are impacted are vulnerable. They have chaotic lives. They may not even know that they are subject to it.

Unfortunately, I think it’s likely that if this passes and these cuts are implemented, we will see more stories about what happens, because it will be a little easier to say concretely, “This kid right here doesn’t get food or healthcare anymore.” But it would be nice to have that conveyed ahead of time, so the public understood what was happening before it went into effect.

JJ: We’ve been speaking with independent reporter Bryce Covert. You can find her work online at BryceCovert.com. Bryce Covert, thank you so much for joining us this week on CounterSpin.

BC: Yeah, thank you for having me.

This content originally appeared on FAIR and was authored by Janine Jackson.

Janine Jackson interviewed independent journalist Bryce Covert about Medicaid work requirements for the May 23, 2025, episode of CounterSpin. This is a lightly edited transcript.

The Nation (2/28/20)

Janine Jackson: Welcome to USA 2025, where the only immigrants deserving welcome are white South Africans, germ theory is just some folks’ opinion, and attaching work requirements to Medicaid and SNAP benefits will make recipients stop being lazy and get a job.

Everything old is not new again, but many things that are old, perverse and discredited are getting dusted off and reintroduced with a vengeance. Our guest has reported the repeatedly offered rationales behind tying work requirements to social benefits, and the real-world impacts of those efforts, for many years now.

Bryce Covert is an independent journalist and a contributing writer at The Nation. She joins us now by phone from Brooklyn. Welcome back to CounterSpin, Bryce Covert.

Bryce Covert: Thank you so much for having me back on.

JJ: Most right-wing, top-down campaigns rely on some element of myth, but this is pretty much all myth: that there’s a problem: Medicaid and also SNAP benefits discourage recipients from seeking work, that this response will increase employment, that it will save the state and federal government money, and that it won’t harm those most in need. It’s layer upon layer of falsehood, that you have spent years breaking down. Where do you even start?

BC: That’s a great place to start, pointing out those claims essentially are all false, and I think it’s important to know, the reason we know that those things are false is because we have years of experience in this country with work requirements in various programs, and they have produced the same results over and over again.

Urban Institute (4/23/25)

So this started, essentially, with welfare, which is now known as Temporary Assistance for Needy Families. In the 1990s, with cash assistance to families, there was a work requirement imposed on recipients in that program that still stands today. And just wave after wave of research has found these requirements did not help increase employment on a long-term basis.

Most people were not actually working after they were subjected to the work requirement, and instead it increased poverty. It reduced the recipients of these benefits. So it essentially didn’t help them get to work, but it did take away the money that they were relying on.

That pattern plays out over and over again, and we have some newer evidence in Medicaid because, up until the first Trump administration, states could not impose a work requirement in Medicaid. The Trump administration allowed waivers to do so. Only one state actually did it. But Arkansas, the state that did impose this work requirement, kicked over 18,000 people off the program with no discernible impact on employment.

JJ: And it has to do with a misunderstanding about who Medicaid recipients are, and their relationship to the workplace, period, right?

BC: Right. Most Medicaid recipients are either working, or have some good reasons for why they’re not working. Either they can’t find full-time work, or they have conflicts, like they’re taking care of family members.

People are disabled, many of them have an official disability and they’re on the actual disability program, but many more are disabled and can’t get on that program. It is a very difficult program to enroll in. The burdens to enrollment are super, super high. And others say it’s because they are in school, or they’re trying to find work, or they’re retired.

So among those who aren’t working, there’s not a lot who are in any good position to go out and start working. And that’s true of a lot of recipients of other public benefits as well. So when you talk about imposing a work requirement on people in Medicaid, what you’re doing is adding administrative burden, which is to say extra steps they have to take to keep getting their benefits, that aren’t going to actually change the situation they’re facing when it comes to their employment.

Think Progress (4/13/17)

JJ: When you wrote about Mississippi, I know, with TANF, you were saying you had to prove you had a job, or were searching for one, before you could get help with childcare. And if people would just take a second and think, how do you search for a job or hold a job without childcare? So it’s not even logical. It’s more a kind of moral, strange misunderstanding of why people are outside of the workforce.

BC: I think this applies to other programs, too. It’s hard to get to work if you don’t have health insurance like Medicaid to get yourself healthy and in a good working position. If you’re not able to get food stamps and buy food for yourself, it’s going to be hard to be out there looking for a job.

These are basic necessities, and I think that’s another really important point to make here, is that Republicans have tried to paint lots of different programs as “welfare,” because that word is very stigmatizing. But what we’re talking about with Medicaid is healthcare. We are talking about feeling as if we need to force people to work—although really what we’re doing is forcing them to document on some pieces of paper that they’re working, which is an important distinction—in order to get healthcare, in order to take care of their bodies and be healthy.

Same with food stamps. We’re saying “you must work in order to eat.” These are basic, basic necessities that people need simply to survive.

JJ: And then we hear about the “dignity” of work. You need to work because there’s dignity there, and yet somehow a person whose grandfather owned the steel mill doesn’t need that dignity. Wealthy people who don’t work somehow are outside of this moral conversation.

BC: Yeah, and we’re talking about imposing work requirements on SNAP and Medicaid, which is what Republicans say they want to do, in the service of tax cuts for the wealthy. Essentially, they are literally paying for tax cuts for the wealthy, to return more money to the rich, by cutting programs for the poor. And those rich people, many of them do not work, or these tax breaks help them to avoid work—the inheritance tax, for example. So that moral obligation to work does not apply.

New York Times (5/14/25)

JJ: The New York Times column recently, from four Trump officials—I don’t remember the headline, but it was something like, “If You Can Work, You Must.” They didn’t marshal any evidence. They didn’t have data, just vibes. Those are some racist, racist vibes, aren’t they?

BC: Yes. That is an important point, that all of this cannot be separated out from racism.

I mean, the conversation over welfare and TANF in the 1990s, that was all race. It was about white Americans feeling like Black Americans were getting the dole, and were too lazy to work and had to be forced to work. The numbers at the time did not bear that out. More white Americans were getting cash assistance than Black ones.

But it’s a really deep-seated belief among Americans, and I think when you see, as in that op-ed, for example, or other places where Republicans are trying to call these other programs “welfare,” it’s barely even just a dog whistle. It is pretty blatant that they are trying to paint other programs as things that help Black people who are too lazy to work.

It’s all caught up in that idea, even though, again, the numbers do not bear this out. White people are more likely to be on these programs. We see equal employment rates among both populations. This is not actually a problem to solve for, but it is one I think a lot of Americans, unfortunately, really believe.

The Nation (6/8/23)

JJ: I’m going to ask you about media in another second. I just wanted to pull up another point about the racism, which is that it’s not just the mythologizing and the “welfare queen,” that those of us who are old enough will remember. But you wrote about how states with larger Black populations have stricter rules, and how when states were asked for exemptions on pushing these work requirements, they exempted majority white counties. So it’s not just the racism in the rationale, the racism in how it plays out is there too?

BC: Absolutely. I mean, these policies hit Black people more heavily. They are more stringently applied in Southern states that have higher Black populations, that are more hostile to their Black populations. And like you said, in the first Trump administration, when states were seeking exemptions, it was more majority white populations who got them. This is just really a fundamental racist myth we have in this country that’s proven very hard to shake, that Black people are lazy and rely on the government to get by and must be forced to work, when just nothing about the actual numbers and data bears that out.

JJ: I sometimes feel like reporters, even if they’re well-intentioned and trying to make it personal, they can kind of make it a thought experiment for folks who are better off. If you were struggling, wouldn’t you take the time to fill out a form? It’s just paperwork. Couldn’t you go across town to the office and fill out that form? And it just represents a total disconnect, experiential disconnect between anyone who has ever had to deal with this and those who have no idea about it at all and just kind of parachute in and say, Oh wow, filling out a form. What’s the big deal?

Bryce Covert: “This is not about, in fact, helping people to work. This is, instead, about kicking people off the program.” 

BC: Yeah, I think most well-off Americans have no idea how hard it is to apply for these programs, to stay on these programs, the paperwork that’s involved, the time that’s involved. And also when we’ve seen work requirements in Medicaid, for example, they are set up in a very complex way. Arkansas’s website was only available during the working day, and then it would shut down, and you couldn’t log your work requirement hours at night. I think that belies the fact that this is not about, in fact, helping people to work. This is, instead, about kicking people off the program.

You can see that in the fact that the reason Republicans are talking about work requirements right now is because they need to find spending savings to pay for the tax cuts. If this were not about kicking people off and spending less on benefits, then this wouldn’t be part of this current conversation about their “One Big, Beautiful Bill.” So these are huge administrative burdens, and it’s also a big burden for something that is a deep necessity. I think the mental impact, the emotional impact of being made to jump through these huge hoops for something as basic as food, it’s really extreme.

For example, I recently had to go to the DMV to get my Real ID. I had to go to the office in person. I had to wait for hours. I had to bring all the right paperwork. It was a huge burden, but this was for something that would just make it a little easier to travel on an airplane.

Think about going through the same process, having to show up somewhere in person, waiting for hours, making sure you have all the right documentation, and if you don’t, then you don’t get the thing that you’re seeking, but what we’re talking about is whether or not you get healthcare. What we’re talking about is whether you get food stamps. I think it’s an experience that’s hard for people who haven’t gone through it to grasp.

New York Times (5/13/25)

JJ: To bring it back to today, May 21, some coverage that I’m reading straight up says some 8.6 million people are going to find themselves uninsured. Other stories matter-of-factly describe work requirements, and some Republicans’ anger that they’re not going to kick in sooner, as about “offsetting” the tax cuts for the wealthy, as though we’re just kind of recalibrating, and this is going to balance things in a natural way.

I guess I would say I’m not getting the energy that there are 14 million children who rely on both Medicaid and SNAP, and there’s children who could lose healthcare and food at the same time, and that includes 20% of all children under the age of five. From news media, I’m getting Republicans versus Democrats; I’m not so much getting children versus hunger.

BC: Yeah, I think, unfortunately, these kinds of political debates tend to be covered like they are just political back and forth. Democrats think this, Republicans think that. It is legitimately harder to explain to people what this will mean in real life. I have reported on the impact of work requirements. For example, I went to Arkansas when they were in effect. It’s hard to report on. The people who are impacted are vulnerable. They have chaotic lives. They may not even know that they are subject to it.

Unfortunately, I think it’s likely that if this passes and these cuts are implemented, we will see more stories about what happens, because it will be a little easier to say concretely, “This kid right here doesn’t get food or healthcare anymore.” But it would be nice to have that conveyed ahead of time, so the public understood what was happening before it went into effect.

JJ: We’ve been speaking with independent reporter Bryce Covert. You can find her work online at BryceCovert.com. Bryce Covert, thank you so much for joining us this week on CounterSpin.

BC: Yeah, thank you for having me.

This content originally appeared on FAIR and was authored by Janine Jackson.

Janine Jackson interviewed Erin in the Morning‘s Erin Reed about transgender care “questions” for the May 23, 2025, episode of CounterSpin. This is a lightly edited transcript.

Washington Post (5/11/25)

Janine Jackson: Washington Post and Amazon owner Jeff Bezos was clear in saying that only certain ideological presuppositions would be acceptable from here on in, when the paper canceled a prepared endorsement of Kamala Harris for president, and canceled a cartoon critical of Donald Trump, and a number of other things. And that sound you heard was many people moving the Washington Post from one place to another in their brains.

But the Post is still the leading daily in the lawmaking place of this country, and what they say has influence on people who have influence. So when the Post editorial board described a report on trans healthcare from the Health and Human Services Department—now headed by Robert F. “I don’t think people should be taking medical advice from me” Kennedy Jr.—as “thorough and careful,” that was going to have an impact.

The piece, headed “Good Questions About Transgender Care,” really raised deeper questions about corporate news media and their role in the world we have, and the world we need today.

Erin Reed is the journalist and activist behind Erin in the Morning. She joins us now by phone from Gaithersburg, Maryland. Welcome to CounterSpin, Erin Reed.

Erin Reed: Thank you so much for having me on.

Scientific American (5/12/22)

JJ: An idea can be utterly discredited—evidentially, scientifically—but can still have resonance for people who just feel like certain things are true. The Post, well, first they point out that this HHS report is “more than 400 pages, including appendixes,” so you’re supposed to sit up straight. But the message is that the HHS report is a review of the existing literature on best practices around healthcare, and that it’s “careful” and “thorough.”

I feel like when anti-trans media is cartoonish, it’s almost easier to bat away. But when something like this comes from a paper of record, it makes it more difficult. So let me just ask you, what are you making of this Post editorial?

ER: Yeah, so a little bit of background. This HHS report was produced specifically because the science on transgender healthcare has been so clear for so long. There’s been repeated study after study, coming out in the most prestigious journals, showing the positive impact of transgender healthcare on those who need it. And so the HHS report was put out in order to give cover to organizations that want to oppose transgender healthcare.

And that’s what we got with the Washington Post editorial page, where the editorial board basically endorses the report. It goes through the report and says that it’s a great report, essentially, and that it raises great questions about transgender healthcare and more.

Washington Post (5/1/25)

Whenever I read something like that from the Washington Post editorial board, though, and then I see how that same board and how that same paper treats everything else that RFK Jr.’s healthcare team puts out—for instance, vaccines, autism, fluoridation in water and more—there’s this double standard whenever it comes to transgender healthcare. The paper is willing to point out the lack of science behind this particular department’s positions under RFK Jr. for all of these other things, but it seemingly ignores that whenever it comes to transgender people.

JJ: And yet they refer to—they’re scientistic. They say that this report “concurs with other systematic reviews.” They give all the gesturing towards the idea that this is science here—and yet it’s not.

ER: And the report itself was anonymously written. They didn’t release any of the names of the people who worked on the report; however, they left the EXIF data in. And so you could actually see the person who compiled the report, and it was Alex Byrne, is the one who’s on the EXIF data in the PDF.

And what that says is that they’re not using experts here. Alex Byrne is a philosophy major. That’s not somebody who’s ever worked with gender-affirming healthcare, and not somebody who’s ever worked with transgender people.

Erin Reed: “What we have is another example of the relentless pseudoscience coming out of this healthcare department under RFK Jr.”

We are seeing these attacks on transgender healthcare using these mechanisms, like the RFK Jr. healthcare department, trying to dictate what science is by fiat, trying to say that it doesn’t matter what the studies say, it doesn’t matter that all the medical organizations and the people that work with transgender people say that this healthcare is saving lives. We are going to dictate what is science and what is not.

I read the whole 400-page report. I read all of anything that comes out about transgender healthcare, because that’s my job; I’m a journalist covering this topic.

And the report, if you read it, it’s not a scientific document. It’s not something that has new information. It’s not something that studies transgender healthcare, it deadnames historical transgender figures, it calls transgender healthcare a “social contagion.” And it advocates for conversion therapy of transgender people, explicitly so, in many instances.

And so I don’t think that what we have is a good scientific document that raises important questions on transgender healthcare, like the Washington Post editorial board claims. Instead, what we have is another example of the relentless pseudoscience coming out of this healthcare department under RFK Jr.

JJ: Part of that involves relabeling, and you just mentioned conversion therapy. And I think a lot of listeners will say, “Oh, I’ve learned about what that means. It involves telling queer people they’re not queer, they’re mentally ill.” But the Post has something to say about how—or maybe it’s the report itself—how, Oh, no, no, no, this isn’t conversion therapy. What’s going on there?

ER: Yeah, so the original report advocates for something known as “gender exploratory therapy.” And I have done a lot of investigations on this particular modality of therapy that’s being promoted by people on the anti-trans right.

Erin in the Morning (12/20/22)

So gender exploratory therapy, it sounds good. It sounds like something that we want. Like of course, if somebody is transitioning, we would love for them to have a good and open environment to explore their gender identity. And that is what we have right now.

But that’s not what gender exploratory therapy is. Gender exploratory therapy is a very kind-sounding name for a repackaged version of conversion therapy.

Essentially, what this modality of therapy does is, let’s say you’re a transgender youth. You’re 14, 15, 16 years old, and you are considering transitioning. What they will do is, they will take you, and they will try to blame your gender identity on anything other than being trans, repeatedly. They’ll go from thing to thing to thing to thing.

And the important point here is that these therapists will never approve your transition. They will never write a gender-affirming care letter for you. They explicitly won’t do that. If you go to the website of the Gender Exploratory Therapy Association, you’ll find that this group has filed amicus briefs against transgender bathroom usage in schools, or that this group has filed amicus briefs against transgender participation in sports like darts. We see that this is not a neutral sort of modality.

The closest comparison that many of your listeners will probably understand is crisis pregnancy centers, where they’ve used this name “crisis pregnancy centers” to try to say that if you’re seeking an abortion, that this is a good clinic to go to. But if you know anything about crisis pregnancy centers, the way that they work is by delaying abortion until it’s no longer feasible. And that’s the exact same way that GETA works, and that’s what we see being promoted by this report.

JJ: Finally, in terms of media, who we know often or virtually always set things up in a “some say, others differ” framework, they’re quoting the Washington Post editorial and other outlets, acknowledging the place where they say ”critics have been scathing.”—this is the Post—”critics have been scathing about what they see as the report’s biases and shortcomings, but it makes a legitimate case for caution that policymakers need to wrestle with.”

And I would just ask you, finally, to talk about this media idea of somehow the truth is in the middle on issues. And then, also, Oh, all we’re asking for is caution. Who’s against caution? And, additionally, anyone who criticizes it is an activist and an interested party, other than these disinterested scientists and ethicists at the Washington Post.

ER: So I’m actually going to push back slightly and make an even broader point here.

JJ:  Please.

ER: “Both sides” coverage and “the truth is in the middle” coverage and “giving both sides a chance to make their point,” that would be an improvement for what we have right now, with transgender reporting and reporting on transgender healthcare.

JJ:  Absolutely.

Them (3/28/24)

ER: Because, let me tell you, whenever you look at the New York Times, whenever you look at the Washington Post, and the way that transgender healthcare is covered right now, the experts, the transgender people, the transgender journalists like myself, are not given the space to make their points. They’re not given the space to make the case for scientific healthcare, and for good treatment of LGBTQ people and transgender people.

But you’ll see the New York Times publish three-, four-page spreads attacking transgender healthcare, from people who have made it their job to attack transgender people. You’ll see the editorial board at the Washington Post explicitly advocate for a healthcare report done by the RFK Jr. healthcare team, targeting transgender people. And whenever it comes to the transgender people, and whenever it comes to the experts and the medical organizations and the Yale physicians, they’re written off as just activists.

And so this is not even “both sides” reporting. It’s not even “the truth is in the middle” reporting. These papers have taken a position on this, and it’s a position that’s not supported by the science. It’s a position that’s not being practiced, importantly, by the people who are giving out that transgender healthcare, who are treating transgender people, day in, day out, who see these patients and understand the impact that gender-affirming care has on their lives.

So I guess what I’m just really trying to say is, I wish they would platform transgender people. I wish they would platform the doctors. I wish they would platform the medical organizations, but they don’t.

JJ: It feels like you’re telling me what better reporting would look like, yeah?

ER: I’m trying.

JJ: Erin Reed is the journalist and activist behind Erin in the Morning. Thank you so much, Erin Reed, for joining us this week on CounterSpin.

ER: Of course. Thank you so much for having me.

This content originally appeared on FAIR and was authored by Janine Jackson.

Right-click here to download this episode (“Save link as…”).

Common Dreams (5/14/25)

This week on CounterSpin: On a Sunday night, not when officials do things they’re most proud of, House Republicans passed a plan to give more money to rich people by taking it from the non-rich. Call it what you will, that’s what’s ultimately happening with the plan to cut more than $700 billion from Medicaid in order to “offset,” as elite media have it, the expense of relieving millionaires from contributing to public coffers. Even the feint they’re using—we’re not cutting aid, just forcing recipients to work, like they should—is obvious, age-old and long-disproven, if evidence is what you care about. Thing is, of the millions of people at the sharp end of the plan, most are children, who have no voice corporate media feel obliged to listen to. We’ll nevertheless talk about them with independent journalist Bryce Covert.

Washington Post (5/11/25)

Also on the show: You may have seen an editorial in the Washington Post indicating that, despite what you have heard for years, from trans people and from doctors and medical associations that work with trans people, maybe it’s OK for you to still entertain the notion that, weirdly, on this occasion, it’s not science but talkshow hosts who have it right, and trans kids are just actually mentally ill. We’ll talk about that with journalist and trans rights activist Erin Reed, of Erin in the Morning.

This content originally appeared on FAIR and was authored by Fairness & Accuracy In Reporting.

House Republicans have successfully pushed forward President Trump’s budget proposals to slash Medicaid and food stamps, putting millions of low-income Americans at risk. Anthony Wright, executive director of Families USA, a healthcare consumer advocacy organization, says the $175 billion reduction is “literally the biggest cut to the Medicaid program in history.”

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

Jewish Voice for Peace held its largest-ever national member meeting in Baltimore from April 31 through May 4, with more than 2,000 attending. We feature the address of Democratic Congressmember Rashida Tlaib of Michigan, the only Palestinian American member of Congress, who addressed the conference as it began. “Why is it that our government always has enough money for bombs, to bomb people, to kill people, but never seems to have money to provide people with healthcare, with housing, enough food for their families?” Tlaib asked in her address.

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

House Republicans appear to be backing off some, but not all, of the steep reductions to the Medicaid program as part of their big tax breaks bill, as they run into resistance from more centrist GOP lawmakers opposed to ending nearly-free health care coverage for their constituents back home.

This is as a new report out Wednesday from the nonpartisan Congressional Budget Office estimated that millions of Americans would lose Medicaid coverage under the various proposals being circulated by Republicans as cost-saving measures. House Republicans are scrounging to come up with as much as $1.5 trillion in cuts across federal government health, food stamp and other programs, to offset the revenue lost for some $4.5 trillion in tax breaks.

“Under each of those options, Medicaid enrollment would decrease and the number of people without health insurance would increase,” the CBO report said.

The Republican President Donald Trump presented to Congress on May 2 his proposed federal budget for 2026.

On May 2nd the U.S. White House — which has made clear that it’s beating the drums for war against China — headlined “Office of Management and Budget Releases the President’s Fiscal Year 2026 Skinny Budget” and reported that “The Budget, which reduces non-defense discretionary by $163 billion or 23 percent from the 2025 enacted level, guts a weaponized deep state while providing historic increases for defense and border security. … Defense spending would increase by 13 percent, and appropriations for the Department of Homeland Security would increase by nearly 65 percent, to ensure that our military and other agencies repelling the invasion of our border have the resources they need to complete the mission.” His budget “guts a weaponized deep state while providing historic increases for defense and border security,” and health care for the poor is part of that “weaponized deep state” he is referring to, which Republicans say must be cut in order to provide these “historic increases for defense and border security.”

All of those increases would go towards paying the suppliers (such as Lockheed Martin, Raytheon, etc.) to the enormously militarized police-state, at the very same time that the health, education, and welfare, of the voters, will be reduced by $165 billion or 23% below the current level.

Here are some more details regarding what that “weaponized deep state” (to use the White House’s phrase for it) consists of:

The White House’s May 2 “Major Discretionary Funding Changes” says that:

For Defense spending [ONLY the Defense Department, NOT including the approximately $700 billion yearly of annual U.S. military spending that is being paid out from OTHER federal Departments], the President proposes an increase of 13 percent to $1.01 trillion for FY 2026; for Homeland Security, the Budget commits a historic $175 billion investment to, at long last, fully secure our border. Under the proposal, a portion of these increases — at least $325 billion assumed in the budget resolution recently agreed to by the Congress — would be provided through reconciliation, to ensure that our military and other agencies repelling the invasion of our border have the resources needed to complete the mission. This mandatory supplement to discretionary spending would enable the Departments of Defense and Homeland Security, among others, to clean up the mess President Trump inherited from the prior administration and harden the border and other defenses to protect America from foreign invasion.

Therefore, approximately $1.7T of total military spending is being sought by Trump (including the 13% increase to the Defense Department), while he is proposing to cut all other discretionary spending (which had previously constituted the other 47% of all U.S. Government annually appropriated federal spending (and which was previously around $800B per year) to be cut down now by $165B to around $635B total, or about 37% of all annually appropriated federal spending. Only the +13% for the Pentagon, and the +65% for the Department of Homeland Security, are increased, while everything else is getting cut drastically in order to make those increases possible.

So, while around $1.7T will be going to the military, only around $635B will be going to pay all of the other discretionary spending (including any non-military portion of the DHS). That will cut the percentage of the Government’s discretionary spending on non-military purposes down from its prior approximately 47% of the federal budget, down to approximately 37% of all of the Government’s discretionary spending.

Medicaid — health care to the poor — is on their chopping block so that the Defense Department portion of that $1.7T military cost that the U.S. Government will be paying in 2026 will be increased by 13% (and so that any non-military portion of the 65% increase to the DHS will also be paid).

Looking further at WHAT is being cut the most, the White House document shows that the only part of the Department of Education that will be increased — by $60 million — is “Charter Schools,” the part that privatizes public-school education, which is the part that billionaires want to increase (since their hedge funds etc. will be owning much of it). Meanwhile, Title 1 and K-12 federal spending will be reduced by $4.535 billion; and the program to incentivize colleges to “to engage with low-income students and increase access” will be cut by $1.579 B.

The Department of Health and Human Services will cut $4.035 from the Low Income Home Energy Assistance Program (LIHEAP), $1.970B from the Refugee and Unaccompanied Alien Children Program, $1.732B from AIDS and financial-assistance health programs, $3.588B from CDC and Prevention programs, $17.965B from NIH, $1.065B from programs working with addicts to help them reduce their addictions.

The Environmental Protection Agency will be cut $2.460B for Clean and Drinking Water State Revolving Loan Funds, and under a billion dollars each for such programs as the Hazardous Substance Superfund.

The Department of Housing and Urban Development will be cut by $26.718B that goes to programs for the poor.

The Treasury Department will be cut by $2.488B for the IRS.

The National Science Foundation will be cut by $3.479B and by an additional $1.130B for “Broadening Participation.”

Most of the other cuts will be below a billion dollars.

Are these massive reallocations away from programs to the needy (and from some other areas such as scientific research), into instead the military and border security, reflections of the public’s will in a democracy?

On February 26, I reported that:

On February 14, the AP headlined “Where US adults think the government is spending too much, according to AP-NORC polling,” and listed in rank-order according to the opposite (“spending too little”) the following 8 Government functions: 1. Social Security; 2. Medicare; 3. Education; 4. Assistance to the poor; 5. Medicaid; 6. Border security; 7. Federal law enforcement; 8. The Military. That’s right: the American public (and by an overwhelming margin) are THE LEAST SUPPORTIVE of spending more money on the military, and the MOST SUPPORTIVE of spending more money on Social Security, Medicare, Education, Assistance to the poor, and Medicaid (the five functions the Republican Party has always been the most vocal to call “waste, fraud, and abuse” and try to cut). Meanwhile, The Military, which actually receives 53% (and in the latest year far more than that) of the money that the Congress allocates each year and gets signed into law by the President, keeps getting, each year, over 50% of the annually appropriated federal funds.

An important point to be made here is that both #s 4&5, Assistance to the poor, and Medicaid, are “discretionary federal spending” (i.e., controlled by the annual appropriations that get voted into law each year), whereas #s 1&2 (Social Security and Medicare) are “mandatory federal spending” (i.e., NOT controlled by Congress and the President). So, Trump and the Republicans are going after the poor because they CAN; they can’t (at least as-of YET) reduce or eliminate Social Security and Medicare. However, by now, it is crystal clear that Trump’s Presidency will be an enormous boon to America’s billionaires, and an enormous bane to the nation’s poor. The aristocratic ideology has always been: to get rid of poverty, we must get rid of the poor — work them so hard they will go away (let them seek ‘refugee’ status SOMEWHERE ELSE).

Trump is increasing the military and border security, and decreasing education, assistance to the poor, Medicaid, federal law enforcement, and even Social Security and Medicare (the latter two by laying off many of the people who staff those bureaucracies).

Therefore, the Republicans’ effort to cut health care to the poor is merely a part of their overall effort to cut Governmental help to the nation’s poor; and all of this is being done in order to increase federal purchases of armaments from corporations such as Lockheed Martin, who make all or most of their profits only by selling to the U.S. Government and to its allied Governments.

However, on many levels, the greatest amount of “waste, fraud, and abuse,” and sheer corruption, is actually in the only federal Department that has never been audited: the Defense Department. This means that Republicans are reallocating from the neediest to the greediest. (NOTE: I have equal contempt for both of America’s political Parties, but this reallocation is specifically a Republican specialty. So, this isn’t merely a matter of opinion. It is a historical fact.)

This content originally appeared on Dissident Voice and was authored by Eric Zuesse.

The Summit (Colo.) Daily (5/2/24) amplified the anxiety health consumers felt in the face of providers’ and insurers’ threats.

This time last year, tens of thousands of people in Colorado anxiously wondered if they’d have to find a new doctor or start using a different hospital. Contracts setting payment levels for Catholic Church–affiliated hospital chain CommonSpirit Health to be a member of preferred provider networks run by insurer Anthem Blue Cross Blue Shield of Colorado were set to expire on May 1, 2024, and negotiations were a train wreck.

CommonSpirit accused Anthem of trying to pay rates so low that its hospitals couldn’t afford to take care of patients, while Anthem shot back that CommonSpirit wanted rate increases at more than twice the rate of inflation (CBS KKTV 11, 4/30/24).

Media coverage reached a fever pitch as the deadline approached. Without a new agreement, Coloradans covered by Anthem insurance plans would have to pay far more out of pocket to use CommonSpirit hospitals and the system’s affiliated doctors (Denver Post, 4/26/24). The potential consequences would be extreme in communities where CommonSpirit is a dominant provider, especially in the state’s rural and resort areas, where the company’s facilities are the only available option for miles around (KOAA, 5/1/24). “What Do We Do?” a plaintive Summit Daily headline (5/2/24) asked.

The high-stakes negotiations dragged on for more than two weeks past the contract’s expiration, with the two corporate giants contending that the other side wanted dangerously low or unaffordably high rates.

The eventual settlement was greeted with a mixture of relief and anger from patients whose care had been disrupted. La Plata County resident Christie Hunter, whose son Ollie suffers from myasthenia gravis, an autoimmune disorder that weakens voluntary muscles, told the Durango Herald (5/17/24, 5/1/24) she was glad the two healthcare titans had settled, but angry that the dispute disrupted her family’s healthcare. The time spent looking for new providers “would have been much better spent trying to help my son, and get him feeling well enough to go to school.” Ollie’s first day at school after months of treatment and preparation was the day the Hunters received initial notice that they could lose access to his specialists.

Although the high-stakes conflict was about money, the terms of the new five-year price deal remain secret.

Performative hostage-taking

This kind of performative patient hostage-taking has become standard practice in hospital rate negotiations across the US. At least four major network contracts in Ohio/Virginia, Connecticut, Texas and Missouri expired at the beginning of April alone.

Media coverage usually captures the anxiety that patients like the Hunters experience at the disruption of critical medical relationships. Otherwise, the quality and depth of coverage varies widely. Some reporting fuels public hysteria to the benefit of the parties, while the best coverage provides critical national context and alerts audiences what to expect.

To help FAIR readers understand what’s happening when these conflicts hit their communities, we’ve assembled a few lessons from the past few years, and principles that should frame local and regional media coverage.

Think mob war

These stories are best understood as economic warfare between gangsters dividing money already looted from the public. Insurers, who offer employers and patients nothing the government can’t do better and cheaper, fight with hospital corporations who wield monopoly power to negotiate the world’s highest prices for inpatient care, leaving millions of Americans saddled with unmanageable medical debt.

Communicating with the public and political leaders through the media is a key negotiating strategy for both hospitals and insurance companies. Each side accuses the other of threatening patients’ access to doctors and hospitals. The corporations issue a deluge of press releases, statements and FAQ webpages to inform patients of pending changes to coverage, and the consequences for their financial, physical and mental health—all seasoned with a heavy dose of spin. The goal is to ratchet up public anxiety as the deadline approaches, and attach blame to the other side to win concessions.

Negotiations receive intense local and regional media coverage, following the same script. Both sides publicize the looming deadline, and warn that patients may lose access to local hospitals and valued doctors. Insurers accuse hospitals of price-gouging, while hospitals insist that insurers want to pay them less than it costs to take care of patients.

You’ll probably keep your doctor

KFF Health News (2/1/19) accurately characterized the antagonists in the rate disputes as “behemoths.”

Outlets frequently catch on to the fact that they’re witnessing “a battle of Goliath and Goliath,” as Dallas-based D Magazine (4/1/25) framed a recent clash in Texas. But reporters and editors should also alert their audiences to the fact that the conflicts usually resolve themselves after a few weeks or months of widespread terror.

Large local and regional insurers can’t run provider networks without major hospital systems, and hospital systems can’t afford to lose access to patients covered by major health insurers. As Georgetown University professor Sabrina Corlette told KFF Health News (2/1/19) during a 2019 dispute in California:

When you have a big behemoth healthcare system and a big behemoth payer with tens of thousands of enrolled lives, the incentives to work something out privately become much stronger.

This is what the market looks like 

The US healthcare financing system relies on the mechanism of having private health insurance companies build networks that use financial and bureaucratic coercion to force patients to use hospitals and doctors within the network, instead of other providers. Insurers offer hospitals privileged access to the thousands of “lives” they cover in exchange for discounted rates. This is supposed to lower costs and improve the quality of healthcare.

You can’t have networks with discounted rates without rate negotiations, which is why these high-stakes gang wars are so common and will continue. The degree to which these rate negotiations are central to the functioning of “market-based” healthcare is a critical piece of context for reporters, too often missing from coverage.

In Colorado, for example, Pueblo Chieftain reporter Tracy Harmon largely followed the companies’ scripts in two stories (5/14/24, 5/20/24) on the Anthem/CommonSpirit fight, focusing on patients’ need for access and sourced almost exclusively to the two combatants.

Summit Daily News reporter Ryan Spencer (4/14/24) offered some additional context, using public data to show that the CommonSpirit hospital in Summit charged rates at twice the statewide average, and “reported profit margins of 35% or more in 2020 and 2021,” according to a report by the state Division of Insurance. Neither Spencer nor Harmon made the critical policy point that the network rate negotiations are supposed to be the country’s primary cost control mechanism.

It doesn’t work

In Colorado, Durango Herald reporter Reuben Schafir (3/23/24) came closest to discussing the core policy problem illustrated by corporate collisions over hospital rates. A spokesperson for a consumer healthcare NGO told Schafir: “These negotiations are often a lose/lose situation for consumers. Even a timely agreement would likely result in higher healthcare costs.”

In other words, the primary US cost control mechanism doesn’t work. Leaving prices to the outcome of mob wars has given the US the highest hospital prices in the world. Since hospital care remains the largest single element of national health spending, the failure of market-based hospital rate negotiations is one of the driving forces making the US an outlier as the costliest system in existence.

MIT economist Jonathan Gruber told the Fort Worth Star-Telegram (4/3/25) that insurer/provider conflicts illustrate why “the government should step in and regulate prices.”

The Fort Worth Star-Telegram got this right. On April 1, contracts between Southwestern Health Resources (SWHR) and Blue Cross Blue Shield of Texas (BCBSTX) expired amidst the usual anxious media coverage (e.g., Dallas Morning News, 4/1/25; WFAA, 4/2/25; KDFW Fox 4, 4/1/25).

A long Q&A-style summary in the Star-Telegram (4/3/25; non-paywall MSN text here) featured MIT economist Jonathan Gruber saying that “really the insurers and the providers are both bad guys when it comes to costs.” According to Gruber, markets have failed, and

situations like these contract negotiations breaking down are good examples of why the government should step in and regulate prices that the private sector has failed to keep within reach of the average consumer.

Gruber’s quote could well have been national news itself. Gruber was the intellectual architect of the Affordable Care Act, and it’s remarkable for an expert of his stature and influence to say categorically that markets have failed, and that government needs to regulate prices. Regardless, Gruber’s observation that market contracts between private insurers and hospitals have failed, and are likely to continue failing, is essential to understanding what’s happening when the healthcare mob wars come to your town.

Washington gangsters agree

As usual in mob wars, politicians bought by the combatants publicly wring their hands, while collecting millions of dollars in campaign assistance from each side and doing nothing to end the carnage. When the allegedly charitable Northeast Georgia Health System and insurer UnitedHealthcare ramped up their fear campaigns in 2023, Sen. Raphael Warnock (D–Ga.) sent strongly worded letters to both parties, typically devoid of anything indicating whether and how Senator Warnock and colleagues intend to prevent this from happening again. The dispute was a rare one that ended without an agreement.

The ultimate missing context for these stories is that for all their public antagonism, the insurance and hospital industries march in lockstep on the most important policy questions in the nation’s capital. The American Hospital Association and health insurers both spend millions of the dollars they get from premiums, and the rates exchanged under the terms of these contracts, to defeat Medicare for All, and make even modest partial reforms, like Gruber’s proposed price regulation, politically impossible.

This content originally appeared on FAIR and was authored by John Canham-Clyne.

Cuts by the Trump administration are putting children at risk, according to a new report by ProPublica. The administration has cut funds and manpower for child abuse investigations, enforcement of child support payments, child care and more. On top of that, Head Start preschools, which offer free child care to low-income parents, are being severely gutted. Democracy Now! speaks with ProPublica reporter Eli Hager on his investigation into Trump’s “War on Children.”

“It wasn’t just cuts to these more liberal-coded programs like support for child care and direct assistance to lower-income families with children, but also these programs that have much more support across the political spectrum, like funds and staffing for investigating child abuse and Child Protective Services,” says Hager.

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

Janine Jackson interviewed the Vaccine Education Center’s Paul Offit about Robert F. Kennedy Jr. and measles for the April 4, 2025, episode of CounterSpin. This is a lightly edited transcript.

AP (2/26/25)

Janine Jackson: Trump-appointed Health and Human Services Secretary Robert F. Kennedy is colorful, which is a problem when someone is a public hazard. Because now that Kennedy is in a position of power, we need journalists to move past anecdote to ideas—ideas that are informing actions that shape not just his reputation, but all of our lives.

Our guest suggests we could begin with a core false notion that lies in back of much of Kennedy’s program.

Paul Offit is director of the Vaccine Education Center, and professor of pediatrics in the Division of Infectious Diseases at Children’s Hospital of Philadelphia. He joins us now by phone from Philly. Welcome to CounterSpin, Paul Offit.

Paul Offit: Thank you.

JJ: The context for our conversation is the first measles death in the US in a decade, in Texas, where we understand they have reported, and this news is fresh, some 400 cases of measles, just between January and March, while the national number for 2024 was 285. This is a tragedy, and a tragically predictable one, due to surges of misinformation around vaccines, around disease and, frankly, around science that have been at work for years, but are turning some kind of corner with the elevation of RFK Jr.

Beyond the Noise (2/11/25)

You identified a keystone belief in Kennedy’s book on Fauci that explains a lot. I would like to ask you to give us some history on that notion, where it falls in terms of the advance of science, and what the implications of such a belief can be.

PO: Sure. So in the mid-1800s, people weren’t really sure about what caused diseases. There were two camps. On the one hand, there were the miasma theory believers. So miasma is just a sort of general notion that there are environmental toxins, initially that were released from garbage rotting on the streets, that caused this bad air, or miasma— kind of a poison, toxin. And so therefore diseases weren’t contagious. You either were exposed to these toxins or you weren’t.

And then, on the other hand, people like Robert Koch and Louis Pasteur were the germ theory believers, that believed that specific germs—as we now know, viruses and bacteria—can cause specific diseases, and that the prevention or treatment of those germs would save your life.

Washington Post (4/7/25)

Robert F. Kennedy Jr. does not believe in the germ theory. I know this sounds fantastic, but if you read his book, The Real Anthony Fauci, on pages 285 to 288, you will see that he does not believe in the germ theory, and everything he says and does now, supports that. His modern-day miasmas are things like vaccines, glyphosate—pesticides—food additives, preservatives: Those are his modern-day miasmas.

So he is a virulent anti-vaccine activist. He thinks that vaccines are poisoning our children. He thinks no vaccine is beneficial. And so everything he says and does comports with that, even with this outbreak now in Texas, it’s spread to 20 states in jurisdictions, he doesn’t really promote the vaccine. Rather, he promotes vitamin A, because he believes that if you’re in a good nutritional state that you will not suffer serious disease. And he still says that, even though that first child death in 20 years, that occurred in West Texas, was in a perfectly healthy child.

JJ: And again, one element of the fallout of this is that he is not just saying, don’t get vaccinated, but saying cod liver oil and vitamin A. And so Texas Public Radio, for one, is reporting kids are now showing up to hospitals with toxic vitamin A levels. So his answer is instead of a vaccine… the response is sending kids to the hospital.

PO: Right. And if you’re a parent, you can see what the seduction is, because here you’re given a choice. He presents it in many ways as a binary choice. You can get a vaccine, which means you’ll be injected, or you’ll inject your child, with three weakened live viruses, or you can take a vitamin. Not surprisingly, people take vitamins, and they take more vitamins and more vitamins, as he sends just shipments of cod liver oil into the area. And so now hospitals are seeing children who have blurred vision, dizziness and liver damage caused by too much vitamin A.

CBS (3/11/25)

JJ: And also, CBS News is having to get hospital officials to contradict just straight-up false comments. The fallout is everywhere. Kennedy is saying, “Oh, the majority of the hospitalized cases in Texas were for quarantine purposes.” And so this person has to say, “Actually, no, no, we’re not hospitalizing people for quarantine. It’s because they need treatment.”

PO: The last place we should quarantine someone, by the way, with measles, is in the hospital. You don’t want measles in the hospital. It’s a highly contagious disease, the most contagious infectious disease.

Also, just one other point is when we say, for example, that the CDC currently states that there are 483 cases in 20 states or jurisdictions, that’s confirmed cases, meaning confirmed by doing antibody testing, or confirmed by PCR analysis, that is the tip of a much bigger iceberg. People who are looking at this, and looking at the doubling time of this particular outbreak throughout the United States, estimate that it’s probably at least 2,000 cases, and maybe more. And the fear is that, given the current doubling times, given that we’re going to be dealing with this virus for at least six more weeks, the fear is that there’ll be another child death or more.

APA (7/1/24)

JJ: You cited a piece in the book where Kennedy says:

Fauci says that vaccines have already saved millions and millions of lives. Most Americans accept the claim as dogma. It will therefore come as a surprise to learn that it is simply untrue.

I think the idea of resisting “dogma” is very appealing to people, because we have seen propaganda efforts, we have seen lies that are en masse, in a way. But I also think that so many folks have, for so long, trafficked in the forms of rational argument without the content, without agreed upon standards of proof, that people are just less able to recognize fallacies, to see when something is anecdotal—not untrue, but anecdotal—and that this impedes our understanding of what public health even is. Misinformation is at the center of this in so many ways.

PO: That’s a really good point. I think we haven’t done a very good job of explaining how science works. I mean, you learn as you go. The Covid pandemic is a perfect example. We were building the plane while it was in the air. There were definitely things that we said and did that were not right over time, but you learn as you go.

And that’s the way science works. I mean, the beauty of science is it’s always self-correcting. It’s introspective, and you’re willing to throw a textbook over your shoulder without a backward glance as you learn new things.

I was a resident training in pediatrics in the late 1970s, the Children’s Hospital in Pittsburgh. I was taught things that were wrong. That’s OK. That didn’t mean the people, the senior pediatricians who taught me, were idiots. It just meant that we got more information over time.

And I think people, at some level, don’t accept that. When you say something that ends up being wrong, “See? You can’t trust them.” And so they throw the whole thing out, to their detriment.

New York Times (3/25/25)

JJ: I mean, yes, it points to a kind of preexisting, if not failure, weakness in media and public conversation about science that makes us poorly set up to engage this kind of thing. But I also think there’s something going on with, you know, Marion Nestle telling the New York Times that she was so excited when Trump used the words “industrial food complex.” She said, “RFK sounds just like me.”

RFK has benefited from a position of a little guy fighting Big Corporate Food, fighting Big Pharma. And I think a lot of folks identify with that. There are things, though, that you’ve talked about that complicate that depiction of him as a little guy going up against well-moneyed interests.

PO: Just the term “Big Pharma” is pejorative. Have pharmaceutical companies acted aggressively or illegally or unethically? Of course they have. I think the opioid epidemic is a perfect example of that. But that doesn’t mean that everything they do is wrong.

For example, I would argue that if pharmaceutical companies were interested in lying about a vaccine, and I’m on the FDA Vaccine Advisory Committee, if they submitted data for licensure or authorization of a vaccine where they lied or misrepresented data or omitted data, they’re going to be found out, because once vaccines are out there, there’s things like the Vaccine Safety Datalink, the Vaccine Adverse Event Reporting System. There is no hiding, because we give vaccines to healthy children, and so we hold them to a high standard of safety. So there is no hiding.

And I want RFK Jr. to point to one example where “Big Pharma” has lied to us about a vaccine that’s caused us to suffer harm. Where is that example? But it’s so easy to make that case.

JJ: When it’s presented in this binary way, as though you can be for corporate medicine or corporate food, or you can be against it, and it sort of absents the idea of, “Well, let’s parse what is being said. Let’s talk about these ideas. Let’s talk about standards of proof,” news media that are more interested to present things as “controversial” shut down that more nuanced conversation.

NBC (3/20/25)

PO: Right. I think probably the most depressing email that I got over the past few weeks was from a nurse in Canada, who said that she was seeing parents of a child who was one month old, and she was giving those parents anticipatory guidance about what vaccines that child would get now a month in, it was a two-month-old. And the father said, and I quote, “I’m not anti-vaccine, but I want to wait to see which vaccines RFK Jr. recommends before I get any of them.”

Which tells you how bad this has gotten. I mean that here they want to trust, basically, a personal injury lawyer to determine which vaccines we should get, as compared to the people who sit around the table at the advisory committees at the FDA or CDC.

JJ: NBC News’ Brandy Zadrozny did have a thoughtful piece about employment by anti-vaccine influencers of that horrific death of the 6-year-old in Texas, and how it’s being used to say, “No, we were actually right, because the other children didn’t die.” But there was an immunologist cited in the story who said, “It’s just harder to tell our story, because the story of ‘child does not get disease’ just doesn’t have the media pickup.”

And so it is difficult for journalists to tell a different story about public health when they are so focused on individual cases and that sort of thing. And so there is a problem there in trying to get reporters to tell public health from a different perspective, and make that as compelling as it should be.

Paul Offit: “We’ve eliminated the memory of measles. I think people don’t remember how sick that virus can make you.”

PO: No, you’re right. I think when vaccines work, what happens? Nothing.

But I’m a child of the 1950s. I had measles, and at the time I had measles, there were roughly 48,000 hospitalizations from measles, from severe pneumonia or dehydration or encephalitis, which is infection of the brain. And of those children who got encephalitis, about a quarter would end up blind or deaf, and there were about 500 deaths a year from measles, mostly in healthy children.

But again, not only have we largely eliminated measles from this country, which we did completely, really, by the year 2000, and it’s come back to some extent, because a critical percentage of parents are choosing not to vaccinate their children. But we’ve eliminated the memory of measles. I think people don’t remember how sick that virus can make you. Unfortunately, I think they’re learning now.

JJ: I’ll just ask you, finally, there’s a reason you call your Substack Beyond the Noise. What’s the noise, and what do you hope is beyond it?

PO: The noise is just this torrent of misinformation and disinformation on the internet. I mean, most people get their information from social media, and it’s just like trying to fight against the fire hose of information. And all you can do is the best you can do.

But I think in the end, I think the great educator, sadly, is going to be these viruses or these bacteria, which, if we continue along the path that we’re doing, which is not trusting public health and not trusting that vaccines are safe and effective, and believing a lot of the misinformation online, we’re just going to see more and more of these outbreaks, especially with Robert F. Kennedy Jr. as Secretary of HHS.

MedPage Today (3/14/25)

Look at what’s happened in West Texas. You had this massive outbreak in West Texas. So he then goes on national television and says things like: The measles vaccine kills people every year. The measles vaccine causes blindness and deafness. The measles vaccine causes the same symptoms as measles. Natural measles can protect you against cancer. All of that is wrong.

But the mother of this 6-year-old girl, that perfectly healthy 6-year-old girl who died, said one of the reasons that she didn’t vaccinate was that she thought that the natural infection would protect against cancer, which is something RFK Jr. said that was wrong. So basically, misinformation kills, and I think that until we understand where the best information is, we’re going to continue to suffer this.

JJ: We’ll end it there for now. We’ve been speaking with Paul Offit, who’s director of the Vaccine Education Center at Children’s Hospital of Philadelphia. His Substack is called Beyond the Noise. Thank you so much, Paul Offit, for joining us this week on CounterSpin.

PO: Thank you.

This content originally appeared on FAIR and was authored by Janine Jackson.

Photo by Megan Lee

Veterans who get their health care from “The VA,” actually the cabinet-level Department of Veterans Affairs, need to be aware that the Trump administration is quietly working to privatize the healthcare facet (Veterans Health Administration, or VHA) of the VA.

In May of 2014, it was alleged that 40 veterans had died while waiting for appointments at the VHA hospital in Phoenix, Arizona. This claim was soon disproven, but investigation revealed that management at that hospital had created a policy of awarding bonuses to hospital employees who misrepresented appointment times. The resulting scandal led to the Veterans Access, Choice, and Accountability Act of 2014, and a three-year trial program known as Veterans

Choice. Based upon the very real circumstances wherein many veterans lived a sizable distance from the nearest VHA facility, and some of those facilities lacked the equipment or professional staff to deal with the veteran’s unique medical or mental status, the Choice program allowed a private vendor company to assign those vets to obtain care at a private or for-profit provider, with payment to that provider to come out of the VA’s budget. At least one of the vendor companies initiated a policy of paying the civilian providers exactly half of what they had billed, and putting the other half into their own corporate coffers.

By 2017, the Choice program had resulted in $2 billion in cost overruns, including $90 million in overbilling by its two main contractors. Before long, a large percentage of private providers refused to see VA/Choice referrals. The contractor companies ignored the problems and referred more and more veterans, regardless of location, to the private sector.

The Choice program was replaced by 2018’s Mission Act, which handed the ball to another vendor corporation, Community Care, which promptly outsourced even more veterans to for-profit walk-in clinics without a referral. Even worse, those private providers are not required to adhere to the VHA’s standards of care, and there is no provision for oversight by the VA to ensure quality of care. Again, payments for these questionable services come out of the VA’s budget. By 2019, the VHA had approximately 67,000 openings for doctors, nurses, psychiatrists, and psychologists, but there were no provisions to increase wages for those positions. Payouts from the VA budget to private providers chosen by Community Care have skyrocketed. Veteran suicides continued to increase at a rate far exceeding that of the general public.

Will referrals of veterans healthcare to the private sector actually result in shorter appointment times, or any improvement in the levels of care provided? According to one government study, 77 percent of all U.S. counties face severe shortages of practicing psychiatrists, psychologists,  or social workers. Fifty-five percent, all rural counties, have no mental health professionals at all. (Southwest Virginia is an example). Even when private-sector psychiatrists are available, many are unwilling to accept either private insurances or federal reimbursement. Under such “market conditions,” not only do private-sector patients wait too long for appointments, according to the National Institute of Mental Health, 40% of Americans with schizophrenia and 51% suffering from bipolar disorder go untreated in any given year.

By contrast, data available on Capitol Hill in 2018 showed that the waiting time to see a VHA mental health professional averaged four days! And, the VHA personnel are trained to deal with the unique mental issues encountered by combat veterans such as PTSD. Proponents of VA privatization have doggedly refused to require any specialized training for the professionals to whom veterans will be outsourced. While campaigning for a second term as President, Donald Trump denied any familiarity with Project 2025, a guidebook created by the ultra-conservative Heritage Foundation with wide-ranging recommendations for the second Trump regime. Currently, adhering to the Project 2025 script, Trump / DOGE are working to gut the VA which is terribly understaffed, by cutting staff another 80,000.

Even more troubling, the Veterans ACCESS Act, currently being reviewed by committees in both the House and Senate, will, if passed, increase outsourcing of VA medical and mental health patients to the private medical industry. Hidden in the depths of the ACCESS ACT like a ticking time bomb is a provision intended to dismantle the VHA system quicker than you can say “privatization,” enabling all veterans seeking help for addiction or mental health challenges to walk into virtually any private medical or mental health provider and request outpatient care without any VA authorization, referral, approval, or oversight of the care provided.

The ultimate goal of the ACCESS Act, as stated in the Project 2025 playbook, is to eliminate all VA hospitals in approximately three years, and increase the number of Community Based Outpatient Clinics (CBOCs) to re-make VA health care into a chain of facilities resembling “urgent care” clinics. Within a very few years, the VA would be transformed into an insurance company, only able to pay the private industry from its $369 billion annual budget.

This project is already under way. Elon Musk’s DOGE has already fired 2,400 VA employees, a Reduction in Force (RIF) order was issued February 26th, and the goal is to reduce the VA’s employee count by 80,000 in the short term.

It should be noted that passage of the PACT Act, allowing VA coverage of ailments related to toxic substances such as Agent Orange in Vietnam veterans, and smoke from toxic burn pits in Iraq and Afghanistan, has resulted in the addition of 400,000 more VA patients, and is expected to add another 400,000 in the near future. DOGE has also cut the VA’s research into muscular dystrophy, ALS (Lou Gehrig’s Disease), and assorted cancers.

President Trump’s new Secretary of Veterans Affairs Doug Collins has predicted that cuts to the VA’s workforce will “eliminate waste, reduce management and bureaucracy…and increase workforce efficiency.” Secretary Collins pledged to do this “without making cuts to healthcare or benefits” and warned critics that “we will be making major changes. So get used to it.”

Surveys indicate that 92% of veterans currently getting their health care from the VA prefer to get their care from it. Studies consistently show that VA health care is equal to or better than private-sector care without even considering that the VA is the only entity suited to treat medical and psychological issues specific to military service.

Again, the Veterans ACCESS Act is awaiting action in committees in both the U.S. Senate and the House of Representatives, and veterans are urgently needed to contact their Reps and Senators and urge them to deny this unscrupulous bill. A call to the U.S. Capitol switchboard at (202) 224-3121 will guide you to the specific phone number for your Representative or Senator. If you hope to have VA medical care in the (near) future, you need to call today.

The post Veterans VA Healthcare is Threatened appeared first on CounterPunch.org.

This content originally appeared on CounterPunch.org and was authored by John Ketwig.

Photo by Megan Lee

Veterans who get their health care from “The VA,” actually the cabinet-level Department of Veterans Affairs, need to be aware that the Trump administration is quietly working to privatize the healthcare facet (Veterans Health Administration, or VHA) of the VA.

In May of 2014, it was alleged that 40 veterans had died while waiting for appointments at the VHA hospital in Phoenix, Arizona. This claim was soon disproven, but investigation revealed that management at that hospital had created a policy of awarding bonuses to hospital employees who misrepresented appointment times. The resulting scandal led to the Veterans Access, Choice, and Accountability Act of 2014, and a three-year trial program known as Veterans

Choice. Based upon the very real circumstances wherein many veterans lived a sizable distance from the nearest VHA facility, and some of those facilities lacked the equipment or professional staff to deal with the veteran’s unique medical or mental status, the Choice program allowed a private vendor company to assign those vets to obtain care at a private or for-profit provider, with payment to that provider to come out of the VA’s budget. At least one of the vendor companies initiated a policy of paying the civilian providers exactly half of what they had billed, and putting the other half into their own corporate coffers.

By 2017, the Choice program had resulted in $2 billion in cost overruns, including $90 million in overbilling by its two main contractors. Before long, a large percentage of private providers refused to see VA/Choice referrals. The contractor companies ignored the problems and referred more and more veterans, regardless of location, to the private sector.

The Choice program was replaced by 2018’s Mission Act, which handed the ball to another vendor corporation, Community Care, which promptly outsourced even more veterans to for-profit walk-in clinics without a referral. Even worse, those private providers are not required to adhere to the VHA’s standards of care, and there is no provision for oversight by the VA to ensure quality of care. Again, payments for these questionable services come out of the VA’s budget. By 2019, the VHA had approximately 67,000 openings for doctors, nurses, psychiatrists, and psychologists, but there were no provisions to increase wages for those positions. Payouts from the VA budget to private providers chosen by Community Care have skyrocketed. Veteran suicides continued to increase at a rate far exceeding that of the general public.

Will referrals of veterans healthcare to the private sector actually result in shorter appointment times, or any improvement in the levels of care provided? According to one government study, 77 percent of all U.S. counties face severe shortages of practicing psychiatrists, psychologists,  or social workers. Fifty-five percent, all rural counties, have no mental health professionals at all. (Southwest Virginia is an example). Even when private-sector psychiatrists are available, many are unwilling to accept either private insurances or federal reimbursement. Under such “market conditions,” not only do private-sector patients wait too long for appointments, according to the National Institute of Mental Health, 40% of Americans with schizophrenia and 51% suffering from bipolar disorder go untreated in any given year.

By contrast, data available on Capitol Hill in 2018 showed that the waiting time to see a VHA mental health professional averaged four days! And, the VHA personnel are trained to deal with the unique mental issues encountered by combat veterans such as PTSD. Proponents of VA privatization have doggedly refused to require any specialized training for the professionals to whom veterans will be outsourced. While campaigning for a second term as President, Donald Trump denied any familiarity with Project 2025, a guidebook created by the ultra-conservative Heritage Foundation with wide-ranging recommendations for the second Trump regime. Currently, adhering to the Project 2025 script, Trump / DOGE are working to gut the VA which is terribly understaffed, by cutting staff another 80,000.

Even more troubling, the Veterans ACCESS Act, currently being reviewed by committees in both the House and Senate, will, if passed, increase outsourcing of VA medical and mental health patients to the private medical industry. Hidden in the depths of the ACCESS ACT like a ticking time bomb is a provision intended to dismantle the VHA system quicker than you can say “privatization,” enabling all veterans seeking help for addiction or mental health challenges to walk into virtually any private medical or mental health provider and request outpatient care without any VA authorization, referral, approval, or oversight of the care provided.

The ultimate goal of the ACCESS Act, as stated in the Project 2025 playbook, is to eliminate all VA hospitals in approximately three years, and increase the number of Community Based Outpatient Clinics (CBOCs) to re-make VA health care into a chain of facilities resembling “urgent care” clinics. Within a very few years, the VA would be transformed into an insurance company, only able to pay the private industry from its $369 billion annual budget.

This project is already under way. Elon Musk’s DOGE has already fired 2,400 VA employees, a Reduction in Force (RIF) order was issued February 26th, and the goal is to reduce the VA’s employee count by 80,000 in the short term.

It should be noted that passage of the PACT Act, allowing VA coverage of ailments related to toxic substances such as Agent Orange in Vietnam veterans, and smoke from toxic burn pits in Iraq and Afghanistan, has resulted in the addition of 400,000 more VA patients, and is expected to add another 400,000 in the near future. DOGE has also cut the VA’s research into muscular dystrophy, ALS (Lou Gehrig’s Disease), and assorted cancers.

President Trump’s new Secretary of Veterans Affairs Doug Collins has predicted that cuts to the VA’s workforce will “eliminate waste, reduce management and bureaucracy…and increase workforce efficiency.” Secretary Collins pledged to do this “without making cuts to healthcare or benefits” and warned critics that “we will be making major changes. So get used to it.”

Surveys indicate that 92% of veterans currently getting their health care from the VA prefer to get their care from it. Studies consistently show that VA health care is equal to or better than private-sector care without even considering that the VA is the only entity suited to treat medical and psychological issues specific to military service.

Again, the Veterans ACCESS Act is awaiting action in committees in both the U.S. Senate and the House of Representatives, and veterans are urgently needed to contact their Reps and Senators and urge them to deny this unscrupulous bill. A call to the U.S. Capitol switchboard at (202) 224-3121 will guide you to the specific phone number for your Representative or Senator. If you hope to have VA medical care in the (near) future, you need to call today.

The post Veterans VA Healthcare is Threatened appeared first on CounterPunch.org.

This content originally appeared on CounterPunch.org and was authored by John Ketwig.

Right-click here to download this episode (“Save link as…”).

New York Times (11/14/24)

This week on CounterSpin: If “some people believe it” were the criterion, our daily news would be full of respectful consideration of the Earth’s flatness, the relationship of intelligence to the bumps on your head, and how stepping on a crack might break your mother’s back. News media don’t, in fact, use “some people think it’s true” as the threshold for whether a notion gets talked about seriously, gets “balanced” alongside what “data suggest.” It’s about power.

Look no further than Robert Kennedy Jr. When he was just a famously named man about town, we heard about how he dumped a bear carcass in Central Park for fun, believes that children’s gender is shaped by chemicals in the water, and asserts that Covid-19 was “targeted to attack Caucasians and Black people,” while leaving “Ashkenazi Jews and Chinese” immune.

But once you become RFK Jr., secretary of health and human services in a White House whose anger must not be drawn, those previously unacceptable ideas become, as a recent New York Times piece has it, “unorthodox.”

Kennedy’s unorthodox ideas may get us all killed while media whistle. We hear from Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, about that.

Free Press (3/18/25)

Also on the show: For many years, social justice advocates rather discounted the Federal Communications Commission. Unlike the Federal Trade Commission or the Food and Drug Administration, whose actions had visible impacts on your life, the FCC didn’t seem like a player.

That changed over recent years, as we’ve seen the role the federal government plays in regulating the power of media corporations to control the flow of information. As the late, great media scholar Bob McChesney explained, “When the government grants free monopoly rights to TV spectrum…it is not setting the terms of competition; it is picking the winner.”

We’ll talk about the FCC under Trump with Jessica González, co-CEO of the group McChesney co-founded, Free Press.

This content originally appeared on FAIR and was authored by Fairness & Accuracy In Reporting.

Image by Mohammed Ibrahim.

On March 23, 2025, Feroze Sidhwa—a surgeon working in Gaza—posted an urgent update on the social media platform X:

“I was at Nasser Hospital in #Gaza when it was bombed today. One of my patients, a 17-year-old boy, was killed. He would have gone home tomorrow. If I had been changing his dressings, as I planned to this evening, I probably would have been killed too. Attacking hospitals is a war crime, and it needs to stop.”

The attack described by doctor Sidhwa killed at least 2 people, and injured others. And, as Shurafa and Magdy report, “like other medical facilities around Gaza, Nasser Hospital has been damaged by Israeli raids and strikes throughout the war.” Indeed, consider a few more recent headlines and stories that illustrate this harsh reality for Palestine’s medical practitioners and patients.

On March 21, 2025, Gaza Notifications posted a video announcement on X, with the caption “Breaking: The Israeli army blows up and destroys the Turkish Friendship Hospital, the only hospital in Gaza dedicated to cancer patients.”

The day before this, a Daily Brief headline from Human Rights Watch read as follows: “Israel’s Deadly Cruelty in Gaza Hospitals.” That same morning, journalist Hossam Shabat shared news that “The Israeli occupation is no longer allowing doctors and nurses to enter Gaza.” Four days later, Hossam himself was killed by the Israeli military.

A few days prior to those headlines, a doctor in Gaza reported his situation at Baptist Hospital in Gaza City. He said “It was just mostly women and children burned head to toe, limbs missing, heads missing.” Medical workers in Gaza face exceptionally challenging circumstances while trying to do their job—to make people better.

As horrendous as these stories are, they are not new. For instance, recall the lead-in story that started this essay, which detailed an attack on Nasser Hospital in March 2025. Eleven months earlier, an April 2024 story by Doctors Without Borders reads “How the Israeli army besieged Nasser Hospital: Evidence points to deliberate and repeated attacks by Israeli forces on Nasser Hospital, once the largest hospital in southern Gaza.”

One could rewind the clock back even farther, to the earlier months of what is now Israel’s 17-months-long-and-counting genocide in Gaza, and find similar stories (yes, it’s an amply documented genocide…and Dr., Nimer Sultany keeps an accessible list of research/reports outlining this reality). It is estimated that around 400 healthcare workers were abducted by the Israeli military by March 2025. During this year-and-a-half period, similar instances kidnappings and torture of medical workers, the targeting of medical vehicles (e.g. ambulances), and a full-scale annihilation of nearly all medical facilities in Gaza were amply documented

We should refer to these types of all-out-attacks on healthcare as acts of medelacide. In Latin, medela means health/healing/cure, while ‘cide refers to the deliberate killing of. So, the intentional and systematic destruction of healthcare infrastructure should be considered an act of medelacide. It is the destruction of the capacity for people to be healed, or receive remedy for their ailments in the short or long term.

This term should be thought of in relation to several other well-known socio-legal concepts. As I outline (see pages 4-5) in my research on Israel’s decimation of Gaza’s healthcare infrastructure:

“Just as genocide refers to the intentional targeting of a people for systematic destruction (OHCHR, [1948] 2024), just as ecocide refers to the systematic and perhaps irreparable damage to a region’s ecology/ environment (Stop Ecocide Foundation, 2021), and just as scholasticide refers to the intentional and systematic destruction of a country or people’s institutions of learning (OHCHR, 2024), medelacide should now enter our vocabulary as a plausible framework for understanding the intentional and systematic destruction of a country or people’s healthcare and medical infrastructure.”

As healthcare workers in Gaza face nearly impossible circumstances to care for the tens of thousands of injured and dying, Drop Site News relayed information from Dr. Marwan Al-Hums, Director of Field Hospitals in Gaza. The March 20, 2025 report outlined:

➤ The majority of martyrs arriving at hospitals in Gaza suffer from severe burns and full-body amputations.

➤ Dismembered bodies and severe burns are the predominant injuries.

➤ Since March 18, the bombing has been unprecedented in intensity and weaponry.

➤ Israel is using new American weapons after replenishing stockpiles, causing complete cell disintegration.

➤ Many injuries involve “amputation without bleeding” due to burned limbs.

➤ Medical teams are trying to reconstruct limbs for future prosthetics despite limited resources.

➤ Gaza’s Health Ministry lacks labs to test chemical weapons but has evidence for international analysis.

➤ The only DNA lab was bombed by Israel, forcing families to identify loved ones through remains or clothing.

Just one week prior to this news, we saw the following headline from the United Nations Office of the High Commissioner for Human Rights: “‘More than a human can bear’: Israel’s systematic use of sexual, reproductive and other forms of gender-based violence since October 2023.” Included in this report were the following observations:

“The Commission found that Israeli authorities have destroyed in part the reproductive capacity of Palestinians in Gaza as a group through the systematic destruction of sexual and reproductive healthcare, amounting to two categories of genocidal acts in the Rome Statute and the Genocide Convention, including deliberately inflicting conditions of life calculated to bring about the physical destruction of Palestinians and imposing measures intended to prevent births”

The annihilation of hospitals. The annihilation of doctors. The annihilation of nurses. The annihilation of life-saving care. The annihilation of the chance to improve one’s lot in life. The annihilation of the ability to bring new life into this world. The annihilation of life. Medelacide…Genocide.

The post The Destruction of Gaza’s Healthcare Infrastructure appeared first on CounterPunch.org.

This content originally appeared on CounterPunch.org and was authored by J.C. Mueller.

In the heart of the Cuban capital, the Dr. Cosme Ordoñez Carceller Teaching Polyclinic stands as a testament to the nation’s unique approach to healthcare: universal, free of charge, accessible, regionalized, community-centered, and deeply rooted in preventive medicine. Unlike the profit-driven models that dominate much of the world, Cuba’s system prioritizes equitable access, public health education, and early intervention.

At the core of this approach is a commitment to health promotion through education, disease prevention through habit management, and the integration of medical care and rehabilitation. By emphasizing proactive healthcare rather than reactive treatment, the system ensures that communities receive continuous, comprehensive support to maintain overall well-being.

During a recent visit to the Dr. Cosme Ordoñez Carceller Teaching Polyclinic in Havana, the staff detailed how the system was developed and how it ensures that no Cuban, regardless of income, is left without medical care.

The Structure of Cuba’s Healthcare System

Cuba’s National Health System operates as a hierarchical, state-run model designed to ensure seamless coordination of care. At the top, the National Assembly oversees the Ministry of Public Health, which sets national policies and directs specialized health institutes that tackle broader public health concerns.

Below the Ministry, provincial governments, answering directly to the Assembly, oversee provincial health departments, which manage larger hospitals and specialized medical facilities. These provincial bodies, in turn, delegate responsibilities to municipal governments, which run the municipal health departments and smaller hospitals that serve local populations. At the community level, municipal health departments manage Cuba’s extensive polyclinic network, the cornerstone of the country’s healthcare system. These polyclinics not only provide specialized care, diagnostics, and emergency services, but they also coordinate closely with family doctor-and-nurse teams, who serve as the first point of contact for Cuban citizens.

These frontline providers play a crucial role beyond immediate treatment, emphasizing preventive care, home visits, and alternative therapies such as nutrition counseling, acupuncture, and plant-based medicine. Despite supply shortages exacerbated by U.S. sanctions, this integrated, top-down approach ensures that resources are distributed efficiently, maintaining consistent healthcare access nationwide.

Founded in 1974, the Dr. Ordoñez Carceller Polyclinic serves approximately 13,000 residents, offering care in medical specialties such as cardiology, orthopedics, fertility consultations, and genetic testing. The clinic is named after Dr. Cosme Ordoñez Carceller (1927–2019), an epidemiologist and pioneer of Community Medicine, who championed the polyclinic model that emerged in the 1960s and 1970s. He played a key role in training young physicians in comprehensive general medicine and launched innovative programs like the Grandparents’ Circles, a senior care initiative so effective that it was replicated nationwide.

Unlike the profit-driven models that dominate much of the world, Cuba’s system prioritizes equitable access, public health education, and early intervention. The country’s healthcare approach is rooted in promoting health through education, preventing disease by managing habits, and ensuring comprehensive medical care and rehabilitation. Unlike the fragmented, for-profit U.S. healthcare model, Cuba’s integrated, community-based approach ensures better health outcomes and higher patient satisfaction. At polyclinics like Ordoñez Carceller, primary care is not just about treating illness but about education, prevention, and holistic well-being. This commitment to accessible, people-centered medicine reflects Cuba’s broader philosophy: that healthcare is not a privilege, but a fundamental human right.

Cuba’s Healthcare Achievements: A Global Leader in Public Health

Despite enduring over six decades of economic embargo, Cuba has achieved remarkable public health milestones. The following list highlights key accomplishments of both the Ordoñez Carceller Polyclinic and the Cuban healthcare system as a whole:

AIDS: Cuba identified HIV in 1983 and quickly set up a system to track and treat it. By 2014, it eliminated mother-to-child transmission of HIV and syphilis, a milestone the U.S. has yet to reach.

COVID Cuba developed two COVID vaccines, kept infections low, and even sent vaccines abroad.

Diabetes The nation has developed an effective medication that treats diabetic ulcers (skin wounds that result from poor blood sugar control)

Alzheimer’s Research: Cuba developed a drug that may help reverse Alzheimer’s effects.

Maternal-fetal medicine 99% of Cuban children are vaccinated, and the country has a lower infant mortality rate than the U.S.

Nutrition While obesity is not an issue in Cuba, malnutrition is an increasing concern due to shortages caused by the U.S. embargo

Home health Doctors make house calls to care for the elderly and new mothers.

Profit vs. Public Health: How Medical Education and Healthcare Delivery Differ in Cuba and the U.S.

The paths to becoming a doctor in Cuba and the United States could not be more different. In the U.S., medical students take on crippling debt, often exceeding $200,000, before ever treating a patient. The pressure to repay loans steers many toward high-paying specialties, leaving primary care and rural communities underserved. The system is structured around financial incentives rather than public need, reinforcing the idea that medicine is a business first, a service second.

Cuba takes the opposite approach. Medical education is fully state-funded, allowing students to focus on patient care instead of profit. Training begins immediately after secondary school, with students placed in community clinics early in their careers. By the time they specialize, they have already served in primary care settings, ensuring that the system produces physicians committed to public health, not private wealth.

A Focus on Prevention, Not Just Treatment

Cuba’s prevention-first model stands in stark contrast to the reactive nature of U.S. healthcare. While American medicine often prioritizes treatment over lifestyle interventions, Cuban doctors routinely incorporate nutrition, exercise, and disease prevention strategies into care plans. The country’s polyclinic system ensures patients receive consistent, community-based healthcare rather than navigating a fragmented, for-profit system that often leaves them behind.

The U.S. Blockade: An Unjust Barrier to Health

The U.S. embargo continues to hinder Cuba’s healthcare system by restricting access to essential medicines, medical equipment, and scientific research. Pharmaceutical and shipping companies, fearing U.S. penalties, avoid business with Cuba—leading to severe shortages of everything from aspirin to cancer treatments.

Even medical journals and online resources are blocked due to U.S. restrictions, forcing Cuban researchers to work under constraints that most Western physicians never encounter.

Yet, rather than succumbing to these barriers, Cuba has turned to self-sufficiency, investing in biotechnology, vaccine development, and herbal medicine research to compensate for limited imports. If freed from economic sanctions, Cuba’s contributions to global healthcare innovation could expand exponentially.

For decades, Cuba has exported medical expertise worldwide, sending doctors to disaster-stricken and underserved regions. These global medical brigades have provided care to millions, particularly in Latin America, Africa, and the Caribbean. Yet, rather than supporting these humanitarian efforts, Washington has sought to dismantle them. In February 2025, the U.S. expanded sanctions on Cuba’s international medical program, further restricting its ability to send doctors abroad. The move reflects a deeper failure to understand Cuba’s model of solidarity-driven healthcare, a stark contrast to the U.S. system, where medicine is often dictated by profit rather than public service.

It is within this profit-driven framework that Cuba’s medical missions are misunderstood, labeled as “forced labor” by those who cannot imagine doctors choosing service over salary. The very idea of healthcare as a human right, rather than a commodity, challenges the U.S. worldview, leading to efforts to discredit and sanction those who practice it differently.

What Could Be If the Embargo Were Lifted

Cuba’s healthcare system is a model of resilience and innovation, but its full potential remains hindered by decades of U.S. sanctions. If given access to global resources and technology, Cuban researchers could expand medical advancements in infectious diseases, chronic illness treatment, and disaster response. For now, Cuban doctors continue their work—undaunted by external pressures, committed to the principle that healthcare is a right, not a privilege.

The post How a Cuba Defies U.S. Sanctions to Lead in Healthcare appeared first on CounterPunch.org.

This content originally appeared on CounterPunch.org and was authored by Renée L. Quarterman.

At the core of this approach is a commitment to health promotion through education, disease prevention through habit management, and the integration of medical care and rehabilitation. By emphasizing proactive healthcare rather than reactive treatment, the system ensures that communities receive continuous, comprehensive support to maintain overall well-being.

During a recent visit to the Dr. Cosme Ordoñez Carceller Teaching Polyclinic in Havana, the staff detailed how the system was developed and how it ensures that no Cuban, regardless of income, is left without medical care.

The Structure of Cuba’s Healthcare System

Cuba’s National Health System operates as a hierarchical, state-run model designed to ensure seamless coordination of care. At the top, the National Assembly oversees the Ministry of Public Health, which sets national policies and directs specialized health institutes that tackle broader public health concerns.

Below the Ministry, provincial governments, answering directly to the Assembly, oversee provincial health departments, which manage larger hospitals and specialized medical facilities. These provincial bodies, in turn, delegate responsibilities to municipal governments, which run the municipal health departments and smaller hospitals that serve local populations. At the community level, municipal health departments manage Cuba’s extensive polyclinic network, the cornerstone of the country’s healthcare system. These polyclinics not only provide specialized care, diagnostics, and emergency services, but they also coordinate closely with family doctor-and-nurse teams, who serve as the first point of contact for Cuban citizens.

These frontline providers play a crucial role beyond immediate treatment, emphasizing preventive care, home visits, and alternative therapies such as nutrition counseling, acupuncture, and plant-based medicine. Despite supply shortages exacerbated by U.S. sanctions, this integrated, top-down approach ensures that resources are distributed efficiently, maintaining consistent healthcare access nationwide.

Founded in 1974, the Dr. Ordoñez Carceller, Polyclinic serves approximately 13,000 residents, offering care in medical specialties such as cardiology, orthopedics, fertility consultations, and genetic testing. The clinic is named after Dr. Cosme Ordoñez Carceller (1927–2019), an epidemiologist and pioneer of Community Medicine, who championed the polyclinic model that emerged in the 1960s and 1970s. He played a key role in training young physicians in comprehensive general medicine and launched innovative programs like the Grandparents’ Circles, a senior care initiative so effective that it was replicated nationwide.

Unlike the profit-driven models that dominate much of the world, Cuba’s system prioritizes equitable access, public health education, and early intervention. The country’s healthcare approach is rooted in promoting health through education, preventing disease by managing habits, and ensuring comprehensive medical care and rehabilitation. Unlike the fragmented, for-profit U.S. healthcare model, Cuba’s integrated, community-based approach ensures better health outcomes and higher patient satisfaction. At polyclinics like Ordoñez Carceller, primary care is not just about treating illness but about education, prevention, and holistic well-being. This commitment to accessible, people-centered medicine reflects Cuba’s broader philosophy: that healthcare is not a privilege, but a fundamental human right.

Cuba’s Healthcare Achievements: A Global Leader in Public Health

Despite enduring over six decades of economic embargo, Cuba has achieved remarkable public health milestones. The following list highlights key accomplishments of both the Ordoñez Carceller Polyclinic and the Cuban healthcare system as a whole:

• AIDS: Cuba identified HIV in 1983 and quickly set up a system to track and treat it. By 2014, it eliminated mother-to-child transmission of HIV and syphilis, a milestone the U.S. has yet to reach.

• COVID: Cuba developed two COVID vaccines, kept infections low, and even sent vaccines abroad.

• Diabetes: The nation has developed an effective medication that treats diabetic ulcers (skin wounds that result from poor blood sugar control)

• Alzheimer’s Research: Cuba developed a drug that may help reverse Alzheimer’s effects.

• Maternal-fetal medicine: 99% of Cuban children are vaccinated, and the country has a lower infant mortality rate than the U.S.

• Nutrition: While obesity is not an issue in Cuba, malnutrition is an increasing concern due to shortages caused by the U.S. embargo

• Home health Doctors make house calls to care for the elderly and new mothers.

Profit vs. Public Health: How Medical Education and Healthcare Delivery Differ in Cuba and the U.S.

The paths to becoming a doctor in Cuba and the United States could not be more different. In the U.S., medical students take on crippling debt, often exceeding $200,000, before ever treating a patient. The pressure to repay loans steers many toward high-paying specialties, leaving primary care and rural communities underserved. The system is structured around financial incentives rather than public need, reinforcing the idea that medicine is a business first, a service second.

Cuba takes the opposite approach. Medical education is fully state-funded, allowing students to focus on patient care instead of profit. Training begins immediately after secondary school, with students placed in community clinics early in their careers. By the time they specialize, they have already served in primary care settings, ensuring that the system produces physicians committed to public health, not private wealth.

A Focus on Prevention, Not Just Treatment

Cuba’s prevention-first model stands in stark contrast to the reactive nature of U.S. healthcare. While American medicine often prioritizes treatment over lifestyle interventions, Cuban doctors routinely incorporate nutrition, exercise, and disease prevention strategies into care plans. The country’s polyclinic system ensures patients receive consistent, community-based healthcare rather than navigating a fragmented, for-profit system that often leaves them behind.

The U.S. Blockade: An Unjust Barrier to Health

The U.S. embargo continues to hinder Cuba’s healthcare system by restricting access to essential medicines, medical equipment, and scientific research. Pharmaceutical and shipping companies, fearing U.S. penalties, avoid business with Cuba—leading to severe shortages of everything from aspirin to cancer treatments.

Even medical journals and online resources are blocked due to U.S. restrictions, forcing Cuban researchers to work under constraints that most Western physicians never encounter.

Yet, rather than succumbing to these barriers, Cuba has turned to self-sufficiency, investing in biotechnology, vaccine development, and herbal medicine research to compensate for limited imports. If freed from economic sanctions, Cuba’s contributions to global healthcare innovation could expand exponentially.

For decades, Cuba has exported medical expertise worldwide, sending doctors to disaster-stricken and underserved regions. These global medical brigades have provided care to millions, particularly in Latin America, Africa, and the Caribbean. Yet, rather than supporting these humanitarian efforts, Washington has sought to dismantle them. In February 2025, the U.S. expanded sanctions on Cuba’s international medical program, further restricting its ability to send doctors abroad. The move reflects a deeper failure to understand Cuba’s model of solidarity-driven healthcare, a stark contrast to the U.S. system, where medicine is often dictated by profit rather than public service.

It is within this profit-driven framework that Cuba’s medical missions are misunderstood, labeled as “forced labor” by those who cannot imagine doctors choosing service over salary. The very idea of healthcare as a human right, rather than a commodity, challenges the U.S. worldview, leading to efforts to discredit and sanction those who practice it differently.

What Could Be if the Embargo Were Lifted

Cuba’s healthcare system is a model of resilience and innovation, but its full potential remains hindered by decades of U.S. sanctions. If given access to global resources and technology, Cuban researchers could expand medical advancements in infectious diseases, chronic illness treatment, and disaster response. For now, Cuban doctors continue their work—undaunted by external pressures, committed to the principle that healthcare is a right, not a privilege.

This content originally appeared on Dissident Voice and was authored by Renée L. Quarterman.

President Donald Trump’s growing trade war against other countries is wreaking havoc on financial markets, upending the global trade system and angering long-standing U.S. allies. Trump has imposed sweeping tariffs on a range of imports, including aluminum and steel, since his inauguration. Many countries have responded with their own retaliatory tariffs on U.S. goods, though countries have also delayed or withdrawn some of the levies as the Trump administration makes near-daily changes to its trade policies. We speak with investigative journalist and author Dave Lindorff, who says the Trump administration’s drive to bring back manufacturing and other jobs that have been outsourced over the last several decades is ignoring the role of healthcare in raising costs. “The fact that we don’t have national healthcare here like they have in Canada … is making American industry not competitive,” says Lindorff.

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

Activists in Aotearoa New Zealand marked International Women’s Day today and the start of Ramadan this week with solidarity rallies across the country, calling for justice and peace for Palestinian women and the territories occupied illegally by Israel.

The theme this year for IWD is “For all women and girls: Rights. Equality. Empowerment” and this was the 74th week of Palestinian solidarity protests.

First speaker at the Auckland rally today, Del Abcede of the Aotearoa section of the Women’s International League for Peace and Freedom (WILPF), said the protest was “timely given how women have suffered the brunt of Israel’s war on Palestine and the Gaza ceasefire in limbo”.

• READ MORE: Muslim nations condemn Israel’s ‘war crimes and acts of genocide’
• International Women’s Day is for the few, not the many
• The world cannot ignore Trump’s death threat to the people of Gaza
• Gallery: NZ women call for long-term peace and justice in Palestine
• Other Gaza genocide reports

“Women are the backbone of families and communities. They provide care, support and nurturing to their families and the development of children,” she said.

“Women also play a significant role in community building and often take on leadership roles in community organisations. Empowered women empower the world.”

Abcede explained how the non-government organisation WILPF had national sections in 37 countries, including the Palestine branch which was founded in 1988. WILPF works close with its Palestinian partners, Women’s Centre for Legal Aid and Counselling (WCLAC) and General Union of Palestinian Women (GUPW).

“This catastrophe is playing out on our TV screens every day. The majority of feminists in Britain — and in the West — seem to have nothing to say about it,” Abcede said, quoting gender researcher Dr Maryam Aldosarri, to cries of shame.

‘There can be neutrality’
“In the face of such overwhelming terror, there can be no neutrality.”

Dr Aldosarri said in an article published earlier in the war on Gaza last year that the “siege and indiscriminate bombardment” had already “killed, maimed and disappeared under the rubble tens of thousands of Palestinian women and children”.

“Many more have been displaced and left to survive the harsh winter without appropriate shelter and supplies. The almost complete breakdown of the healthcare system, coupled with the lack of food and clean water, means that some 45,000 pregnant women and 68,000 breastfeeding mothers in Gaza are facing the risk of anaemia, bleeding, and death.

“Meanwhile, hundreds of Palestinian women and children in the occupied West Bank are still imprisoned, many without trial, and trying to survive in abominable conditions.”

The death toll in the war — with killings still happening in spite of the precarious ceasefire — is now more than 50,000 — mostly women and children.

Abcede read out a statement from WILPF International welcoming the ceasefire, but adding that it “was only a step”.

“Achieving durable and equitable peace demands addressing the root causes of violence and oppression. This means adhering to the International Court of Justice’s July 2024 advisory opinion by dismantling the foundational structures of colonial violence and ensuring Palestinians’ rights to self-determination, dignity and freedom.”

Action for justice and peace
Abcede also spoke about what action to take for “justice and peace” — such as countering disinformation and influencing the narrative; amplifying Palstinian voices and demands; joining rallies — “like what we do every Saturday”; supporting the global BDS (boycott, divestment and sanctions) campaign against Israel; writing letters to the government calling for special visas for Palestinians who have families in New Zealand; and donating to campaigns supporting the victims.

Gaza’s hospitals had been “reduced to rubble by Israeli bombs”, she said.

“UN reports that over 60,000 women would give birth this year in Gaza. But Israel has destroyed every maternity hospital.

“Women will be delivered in tents, corridors, or bombed out homes without anasthesia, without doctors, without clean water.

“When Israel killed Gaza’s only foetal medicine specialist, Dr Muhammad Obeid, it wasn’t collateral damage — it was calculated reproductive terror.”

“Now, miscarriages have spiked by 300 percent, and mothers stitch their own C-sections with sewing thread.”

‘Femicide – a war crime’
Babies who survived birth entered a world where Israel blocked food aid — 1 in 10 infants would die of starvation, 335,000 children faced starvation, and their mothers forced to watch, according to UNICEF.

“This is femicide — this is a war crime.”

Eugene Velasco, of the Filipino feminist action group Gabriela Aotearoa, said Israel’s violence in Gaza was a “clear reminder of the injustice that transcends geographical borders”.

“The injustice is magnified in Gaza where the US-funded genocide and ethnic cleansing against the Palestinian people has resulted in the deaths of more than 61,000.”

‘Pernicious’ Regulatory Standards Bill
Dr Jane Kelsey, a retired law professor and justice advocate, spoke of an issue that connected the “scourge of colonisation in Palestine and Aotearoa with the same lethal logic and goals”.

The parallels between both colonised territories included theft of land and the creation of private property rights, and the denial of sovereign authority and self-determination.

She spoke of how international treaties that had been entered in good faith were disrespected, disregarded and “rewritten as it suits the colonising power”.

Dr Kelsey said an issue that had “gone under the radar” needed to be put on the radar and for action.

She said that while the controversial Treaty Principles Bill would not proceed because of the massive mobilisations such as the hikoi, it had served ACT’s purpose.

“Behind the scenes is ACT’s more systemic and pernicious Regulatory Standards Bill,” she said. ACT had tried three times to get the bill adopted and failed, but it was now in the coalition government’s agreement.

A ‘stain on humanity’
Meanwhile, Hamas has reacted to a Gaza government tally of the number of women who were killed by Israel’s war, reports Al Jazeera.

“The killing of 12,000 women in Gaza, the injury and arrest of thousands, and the displacement of hundreds of thousands are a stain on humanity,” the group said.

“Palestinian female prisoners are subjected to psychological and physical torture in flagrant violation of all international norms and conventions.”

Hamas added the suffering endured by Palestinian female prisoners revealed the “double standards” of Western countries, including the United States, in dealing with Palestinians.

This content originally appeared on Asia Pacific Report and was authored by APR editor.

A strike by Southern California healthcare workers at Kaiser organized under the National Union of Healthcare Workers (NUHW) has now carried on for 20 weeks, prompting the intervention of California Governor Gavin Newsom. After months of deadlock, Kaiser refused to yield to workers’ demands for pensions and adequate time to attend to patient care duties. Over a month after Newsom’s office offered to bring both sides into mediation, Kaiser finally agreed to sit down with the Governor’s mediators, with sessions beginning on March 10. Mental health patients in particular have been left in the lurch by Kaiser’s intransigence, and the crisis is only worsening as the aftermath of the recent Los Angeles wildfires takes its toll on the area’s residents. Working People co-host Mel Buer investigates the ongoing strike in this interview with Kaiser workers Jessica Rentz and Adriana Webb.

Editor’s note: this episode was recorded on February 25, 2025, before Kaiser agreed to mediation on March 3, 2025.

Additional links/info: 

• Previous coverage of the strike from The Real News:
  • ‘What they’re offering is stabilization, not care’: Kaiser Strands Patients in Limbo as Strike Approaches Fourth Month
  • Kaiser workers’ strike enters second week in Southern California
• ABC7, February 7: “Kaiser Permanente mental health workers strike can end with help of a mediator, Gov. Newsom suggests”

Links to support the strike:

• Mutual Aid: “Adopt a Striking Worker”
• Strike GoFundMe 
• Picket Line Locations 
• NUHW Strike Page 

Permanent links below…

• Leave us a voicemail and we might play it on the show!
• Labor Radio / Podcast Network website, Facebook page, and Twitter page
• In These Times website, Facebook page, and Twitter page
• The Real News Network website, YouTube channel, podcast feeds, Facebook page, and Twitter page

Featured Music…

• Jules Taylor, “Working People” Theme Song

Studio Production:
Post-Production: Jules Taylor

Transcript

The following is a rushed transcript and may contain errors. A proofread version will be made available as soon as possible.

This content originally appeared on The Real News Network and was authored by Mel Buer.

The State of Palestine has submitted a written plea to the International Court of Justice (ICJ) asking it for an advisory opinion regarding Israel’s obligations not to obstruct humanitarian and development assistance in the territories it occupies, Al Jazeera reports.

In the submission, Palestinian officials affirmed the responsibility of Israel, as an occupying power, to not obstruct the work of the UN, international organisations, and third states so they can provide essential services, humanitarian aid, and development assistance to the Palestinian people.

Many states, as well as international groups, have submitted written pleas to the ICJ ahead of oral proceedings set to start next month.

• READ MORE: Israel threatens a second Nakba, yet denies the first ever happened
• First phase of Israel-Hamas ceasefire ends with no deal

Last July, the ICJ issued a historic advisory opinion determining Israel’s continued presence in the occupied Palestinian territory is unlawful and should come to an end “as rapidly as possible”.

Widespread ‘torture’ of Gaza medics in Israeli custody
In a separate report, the Israeli branch of Physicians for Human Rights accused the Israeli military of detaining more than 250 medical personnel and support staff since the beginning of the war on Gaza in October 2023.

More than 180 remained in detention without a clear indication of when or if they would be released, the physicians’ report said.

“Detainees endure physical, psychological and sexual abuse as well as starvation and medical neglect amounting to torture,” the report said, denouncing a “deeply ingrained policy”.

Healthcare workers were beaten, threatened, and forced to sign documents in Hebrew during their detention, according to the report based on 20 testimonies collected in prison.

“Medical personnel were primarily questioned about the Israeli hostages, tunnels, hospital structures and Hamas’s activity,” it said.

“They were rarely asked questions linking them to any criminal activity, nor were they presented with substantive charges.”

Where does Trump stand on the Gaza ceasefire?
With phase one of the ceasefire due to end today and negotiations barely started on phase two, serious fears are being raised over  the viability of the ceasefire.

President Donald Trump took credit for the truce that his Middle East envoy Steve Witkoff helped push across the finish line after a year of negotiations led by the Biden administration, Egypt and Qatar, reports Al Jazeera.

However, Trump has since sent mixed signals about the deal.

Earlier last month, he set a firm deadline for Hamas to release all the captives, warning “all hell is going to break out” if it didn’t.

But he said it was ultimately up to Israel, and the deadline came and went.

Trump sowed further confusion by proposing that Gaza’s population of about 2.3 million be relocated to other countries and for the US to take over the territory and develop it.

Israeli Prime Minister Benjamin Netanyahu welcomed the idea, but it was universally rejected by Palestinians and Arab countries, including close US allies. Human rights groups said it could violate international law.

Trump stood by the plan in a Fox News interview over the weekend but said he was “not forcing it”.

Responding to DAWN’s referral of Biden, Blinken & Austin to the ICC for investigation for aiding Israeli war crimes, @alhaq_org‘s @SJabaren says:

“Finally, we see an effort to hold” accountable “US officials who have armed, financed and politically defended Israeli atrocities.” pic.twitter.com/yCpRaogE2I

— DAWN MENA (@DAWNmenaorg) February 28, 2025

‘Finally’ an effort to hold the US accountable, says Al-Haq director
Palestinian human rights activist Shawan Jabarin has welcomed a plea by the US-based rights group DAWN for the International Criminal Court (ICC) to investigate Joe Biden and senior US officials for aiding Israeli war crimes in Gaza.

In a video posted by DAWN, Jabarin, director of the Palestinian rights group Al-Haq, said the effort was long overdue.

“For decades we have called on the international community to hold Israel accountable for its violations of international law, but time and again, the US has used its power and influence to block that accountability, to shield Israel from consequences and to ensure that it can continue its crimes with impunity,” Jabarin said.

“Now, finally, we see an effort to hold not just Israeli officials accountable but also those who have made these crimes possible: US officials who have armed, financed, and politically defended Israeli atrocities.”

This content originally appeared on Asia Pacific Report and was authored by APR editor.

The murder of UnitedHealth Group executive Brian Thompson, and the subsequent arrest of Luigi Mangione, focused media and policymakers’ attention on the savage practices of private US health insurance. In the immediate aftermath, major media outlets scolded social media posters for mocking Thompson with sarcastic posts, such as “I’m sorry, prior authorization is required for thoughts and prayers.”

As public fury failed to subside, it began to dawn on at least some media organizations that the response to Thompson’s murder might possibly reflect deep, widespread anger at a healthcare system that collects twice as much money as those in other wealthy countries, makes it difficult for half the adult population to afford healthcare even when they’re supposedly “insured,” and maims, murders and bankrupts millions of people by denying payment when they actually try to use their alleged benefits. As Rep. Ro Khanna (D.–Calif.) said to ABC News  (12/8/24), “There is no justification for violence, but the outpouring afterwards has not surprised me.”

Any reporter, editor or pundit who writes regularly about healthcare and professes to be mystified or outraged by the public reaction to Thompson’s murder should take a deep look at their own assumptions, sources and professional behavior.

FAIR reviewed coverage of healthcare in the presidential election by the New York Times, Wall Street Journal and Washington Post, as well as KFF Health News (KHN), the leading outlet specializing in the healthcare issue, whose reporting is often picked up by corporate media. The coverage by these outlets amounts to little more than sophisticated public relations for this corporate healthcare killing machine and, especially, the Republican and Democratic politicians who created and nurture it.

The coverage was marred by many of the media failings FAIR has exposed since its inception. These outlets:

• took false major-party “facts” at face value and published candidates’ platitudes without challenging their substance;
• anointed former President Donald Trump and Vice President Kamala Harris as the only legitimate horses in the race, blacking out the content of third-party candidate proposals like “Medicare for All”; and
• added insult to injury by legitimizing their own failed coverage with analysis asking why there were no major healthcare reform proposals to cover.

Tsunami of fake good news

In March 2024, I reported (Healing and Stealing, 3/23/24) that Democrats were preparing to unleash a “tsunami of fake good news” about healthcare and the Affordable Care Act to try to influence media coverage of the campaign.

Major media fell for it hook, line and sinker. No campaign tactic and media failure did more to lengthen the distance between a public brutalized by a failing healthcare system and an out-of-touch corporate media.

President Joe Biden (until he dropped out) and Harris spun a narrative of “progress” under the Affordable Care Act to attract voters. The progress narrative relied on two new healthcare policy “records”: a record-low uninsurance rate and record-high Obamacare enrollment.

In a story on why “big, prominent plans for health reform are nowhere to be seen,” the New York Times’ Margot Sanger-Katz (9/13/24) explained that the “overall state of the health system” is different than in 2019 for several reasons, including that the “uninsured rate is near a record low.”

The New York Times (1/10/24) reported that signups for the ACA set a “record”—but not that this was less than the number of people who had been kicked off Medicaid.

KHN’s Phil Galewitz (9/10/24) similarly reported:

Before Congress passed the ACA in 2010, the uninsured rate had been in double digits for decades. The rate fell steadily under Barack Obama but reversed under President Donald Trump, only to come down again under President Joe Biden.

Meanwhile, insurance plans sold on the Affordable Care Act exchanges reached a record enrollment of 21 million in early 2024, or, as the Times’ Noah Weiland (1/10/24) put it, “blowing by the previous record and elevating the health and political costs of a repeal.”

The two “facts” are both distorted and largely irrelevant to people’s actual experience of the healthcare system. As Galewitz acknowledged, because of survey lags, the uninsurance data don’t reflect the 2023–24 disenrollment of some 25 million from Medicaid, the joint federal/state insurance program for low-income Americans, which had been temporarily expanded under Covid.

But the Medicaid disenrollment is reflected in the record signups to Obamacare, where some of those who lost Medicaid coverage fled in 2024. Yet according to KHN, 6 million of the 25 million people who lost Medicaid coverage became uninsured. Most of them haven’t yet been captured in uninsured data, allowing the Democrats to have their cake and eat it too.

The fact that the uninsured data likely understate uninsurance by as much as 6 million people escaped most political coverage—the Washington Post’s Dan Diamond (9/11/24), for example, added no caveats when reporting that the Biden administration

had released data showing that nearly 50 million Americans have obtained health coverage through the Affordable Care Act’s health insurance exchanges since they were established more than a decade ago, helping lower the national uninsured rate to record lows in recent years.

The Times‘ Sanger-Katz (9/13/24) likewise failed to mention it.

Private insurance ≠ healthcare 

The lesson Kamala Harris learned, according to the Washington Post (9/11/24), is that “incremental change, not a sweeping overhaul, is the best path to improving US healthcare.”

Far more importantly, the rate of uninsurance no longer measures whether or not people have adequate healthcare, or are protected from financial ruin if they get sick or injured. Data show that people who supposedly have insurance can’t get healthcare, rendering the raw uninsurance rate a relatively meaningless measure of the burden of the crisis-stricken US healthcare system.

National surveys by the Commonwealth Fund every two years include one of the few comprehensive attempts to measure underinsurance, and the impact of medical costs on people nominally “covered.” In 2022, Commonwealth found that 46% of adults aged 19–64 skipped needed medical treatment due to out-of-pocket costs. That number included 44% of adults buying insurance through ACA exchanges or the individual insurance market—even with the much-hyped expanded premium subsidies in place.

Commonwealth didn’t release its 2024 surveys until November 21, well after Election Day. During the last two years of the Biden/Harris administration, the percentage of working age adults skipping medical care due to costs increased from 46% to 48%, no matter the source of coverage (Healing and Stealing, 11/21/24).

When people with private insurance do attempt to get healthcare, their insurers often refuse to pay for care. The slain Brian Thompson was CEO of UnitedHealth Group’s insurance subsidiary. According to an analysis of federal data by ValuePenguin (5/15/24), a consumer website run by online lender LendingTree, UnitedHealthcare denied 32% of claims submitted to its ACA and individual market plans in 2022, the highest rate in the industry.

Corporate media political reporters usually delivered the misleading progress narrative “facts” without reference to this critical context. The Washington Post’s Dan Diamond (9/11/24), explaining that Harris learned “the importance of incremental progress” as vice president after retreating from support for Medicare for All, noted the administration’s achievement of “record levels of health coverage through the Affordable Care Act,” with no reference to the Medicaid purge or underinsurance.

Substance-free coverage of a substance-free campaign 

New York Times (9/13/24): “After years of crises and emergencies, no part of the system is currently ablaze.”

The New York Times’ Margot Sanger-Katz wrote in “The Campaign Issue That Isn’t: Healthcare Reform” (9/13/24):

As you may have noticed, with less than two months until Election Day, big, prominent plans for health reform are nowhere to be seen. Even in an election that has been fairly light on policy proposals, healthcare’s absence is notable.

It’s true that neither Harris nor Trump offered any concrete proposals for improving US healthcare. Harris campaigned on “strengthening” the ACA, but her only specific “improvement” was a promise to support keeping the expanded subsidies that help people pay their ACA health insurance premiums—passed in the first year of Biden’s term—from expiring as scheduled next year. In other words, “strengthen” the ACA by maintaining its dismal status quo.

As for Trump, the Times’ Weiland (8/12/24) reported that the authors of Project 2025, the consensus right-wing NGO blueprint published by the Heritage Foundation, “were not calling for a repeal of the Affordable Care Act.” At the debate, Trump said he wouldn’t repeal unless he had a better plan, and drew mockery for saying he had “concepts of a plan.”

Ultimately, mass deportation was his primary healthcare policy (Healing and Stealing, 10/16/24, 9/10/24); the RNC Platform maintained that undocumented immigrants were the cause of high healthcare costs. (It’s nonsense. Undocumented taxpayers actually paid more in taxes that were earmarked specifically for healthcare in 2022 than the estimated total cost of healthcare for all undocumented immigrants in the US.)

What you see depends on where you look 

One reason Sanger-Katz and colleagues had a hard time finding “big” plans for healthcare is that she and her colleagues chose to look for them only in the two major parties’ platforms.

Whether Eugene Debs campaigning for Social Security from prison in 1920, Henry Wallace fighting for desegregation after walking out of the 1948 Democratic convention, or Cynthia McKinney proposing an end to the Afghan War in 2008, third-party candidates have a long track record of promoting policies dismissed as unrealistic ideological fantasies that later become consensus policy. Yet corporate media outlets repeat the same failure to pay attention every four years (FAIR.org, 10/23/08).

Green Party candidate Jill Stein, the only medical doctor in the race, supported Medicare for All as a

precursor to establishing a British-style National Healthcare Service which will replace private hospitals, private medical practice and private medical insurance with a publicly owned, democratically controlled healthcare service that will guarantee healthcare as a human right to everyone in the United States.

Stein placed special emphasis on taking “the pharmaceutical industry into public ownership and democratic control.”

Justice for All Party candidate Cornel West’s Health Justice agenda also envisioned a system “Beyond Medicare for All,” including “nationalization of healthcare industries.”

Prior to suspending his campaign and endorsing Trump, Robert F. Kennedy Jr. told Jacobin (6/9/23) he would keep private insurance for those who want it, but also have a public program “available to everybody.” Although he used the phrase “single-payer,” Kennedy described a program most similar to a voluntary “public option,” an untested idea whose ultimate impact on the breadth, depth and cost of coverage remains speculative.

Outside the world inhabited by elite media, Medicare for All is a fiscally modest proposal that receives consistent support among large segments of the US population, reaching majorities depending on the wording of poll questions (KFF, 10/26/20). In 2022, the Congressional Budget Office (2/22) estimated that a single-payer system with no out-of-pocket costs for doctor visits or hospital care, minimal copays for prescription drugs, and doctor and hospital prices at the current average would cover everyone for all medical conditions—including services that are almost never fully covered, like vision, dental and hearing—and still lower expected total national health expenditures by about a half a percent.

Even with candidates in the race proposing even broader expansion of the public role in healthcare, through nationalizing hospitals and drug manufacturing, Medicare for All remains beyond the boundary of acceptable corporate media debate. This has been true for 30 years, when FAIR (Extra!, 1–2/94) reported on media coverage of the failed Clinton administration healthcare reform effort.

Just one election cycle back, during the Democratic primaries, multiple candidates—led by Vermont Sen. Bernie Sanders, but also including Kamala Harris—supported Medicare for All, and media were forced to cover it, generally with considerable hostility (FAIR.org, 3/20/19, 4/29/19, 10/2/19). But with Harris backing away from it entirely, media found themselves returning to a place of comfortably ignoring the popular proposal.

Missing Medicare for All

Leading papers covered third parties as potential spoilers, but not as potential sources of new ideas (Washington Post, 3/14/24).

FAIR searched the Nexis, ProQuest and Dow Jones databases, and the websites of the New York Times, Washington Post, Wall Street Journal and KFF Health News, for election or healthcare policy stories and podcasts mentioning different iterations of “Medicare for All,” “single-payer” and “universal healthcare,” between January 1 and Election Day 2024. We found 89 news and 107 opinion pieces.

Ninety percent of the news articles came after Biden dropped out of the race. The coverage overwhelmingly focused on Harris’s reversal of her brief support for Medicare for All in 2019, with 96% of these stories mentioning her shift.

The ubiquitous Republican claim that Harris sought to give undocumented people free Medicare was based on the obviously false premise that Harris had not abandoned support for Medicare for All. Asked in 2019 whether her support for universal health insurance would include eligibility for undocumented immigrants, she said yes (New York Times, 10/30/24). Since that time, Harris has repudiated Medicare for All, and no Democrat has advocated enrolling the 11 million undocumented immigrants in Medicare, let alone for “free.”

KHN (8/1/24) and the New York Times (10/30/24) corrected this GOP distortion, but all four outlets left readers hard-pressed to learn any other details of Medicare for All, or other meaningful alternatives to the status quo, especially not any proposed by other candidates.

All four outlets wrote frequently about whether third-party candidates might siphon votes from Trump or Harris (e.g., Wall Street Journal, 11/10/23; Washington Post, 3/14/24; New York Times, 10/14/24). However, they blacked out the content of those parties’ healthcare policy positions, leaving readers with no information to help them decide if voting for a candidate other than Trump or Harris might benefit them.

Voters in the dark

In 2,000 words on “Where Robert F. Kennedy Jr. Stands on the Issues,” the New York Times (6/14/24) avoided any discussion of where he stands on major healthcare reform issues.

The New York Times, Washington Post, Wall Street Journal and KHN frequently mentioned one or more of the third-party candidates in other political coverage as a threat to the major-party candidates. But out of the 89 news articles bringing up Medicare for All, single-payer or universal healthcare, only three included third-party candidates at all, each one in passing as possible spoilers. Exactly zero offered any information at all about the candidates’ healthcare proposals.

For example, the New York Times published 34 news articles and podcasts mentioning a version of Medicare for All or single-payer, without a single word on the healthcare proposals of the third-party candidates who remained after Kennedy’s endorsement of Trump. One article (10/24/24) included a passing Stein spoiler reference. Another (8/22/24), on Harris’s commitment to “the art of the possible,” quoted West’s vice presidential running mate, Melina Abdullah, criticizing Harris for shifting many of her policy positions, but again without reference to West and Abdullah’s proposals for healthcare.

Times readers were more likely to get news about the healthcare reform positions of foreign political leaders than non–major-party candidates running for president of the United States. The paper ran six stories about Indonesia (2/12/24, 2/15/24, 10/19/24), Thailand (2/18/24) and South Africa (6/3/24, 6/7/24) that mentioned a politician’s position on “universal healthcare,” while blacking out discussion of third-party candidates’ healthcare proposals, except to some degree for Robert F. Kennedy Jr.

Before leaving the race, Kennedy’s half-baked notions about vaccines, activism on environmental health and food safety, and criticism of Covid lockdowns received frequent mention, but as with the other third-party candidates, his views on major healthcare reform issues went missing, including from a 2,000-word Times analysis of “Where Robert F. Kennedy Jr. Stands on the Issues” (6/14/24).

The third-party healthcare blackout was even tighter in the Washington Post. The 38 Post news articles mentioning Medicare for All or single-payer had only one reference to Stein or West—a quote from West unrelated to healthcare (8/21/24). The Post never reported either candidate’s healthcare proposals. A webpage on which reporters tracked third-party ballot access offered a short “Pitch to Voters” for each party that included no healthcare policy.

Medicare for All spin and bad facts

Like Democrats, the New York Times‘ Noah Weiland (8/22/24) largely avoided talking about what Medicare for All would do.

The four outlets’ descriptions of Medicare for All, single payer and universal healthcare were nearly as sparse as coverage of third-party candidates’ healthcare positions, and as distorted as reporting on the ACA. Only 23 of the 89 news stories included any description at all of these policies, the overwhelming majority of them a brief phrase in the reporter’s own words.

Only three New York Times stories included any Medicare for All substance, and these were barely intelligible. The most extensive was an article debunking Trump’s claims that Harris continued to support the policy, in which Noah Weiland (8/22/24) wrote nearly 1,300 words without explaining what the Medicare for All is or would do. Readers wouldn’t know that the current Medicare for All bills before Congress would cover everyone in the country with no out-of-pocket costs, and free choice of doctors and hospitals. They would, however, have learned that Harris “proposed a less sweeping plan” in 2019, which would include “a role for private plans.”

Weiland treated readers to what may be the most emphatic recitation of the ACA progress narrative. Biden’s pursuit of a “more traditional set of healthcare priorities” has yielded “explosive growth” in the ACA exchanges, he wrote. According to unnamed experts, that growth, and changes to Medicare and Medicaid, have “complicated” pursuit of Medicare for All.

Times readers would also have learned that expanding Medicaid is an incremental step toward Medicare for All, what bill supporter Rep. Ed Markey says is part of the policy’s “DNA.” In reality, Medicaid’s eligibility standards are literally the opposite of Medicare for All—means-tested coverage that requires you to prove you’re appropriately impoverished every year, and which disappears if you get a big enough raise at your job.

The vast majority of Times coverage of Medicare for All included no content whatsoever, simply mentioning it as a policy that Harris once supported, with the occasional political characterization (7/24/24) that it was one of her since-abandoned “left-leaning positions that can now leave her vulnerable to attack from Republicans.”

‘A proposal that worried many Americans’

Washington Post factchecker Glenn Kessler (9/9/24) said it was mostly true that Medicare for All would “raise taxes [and] increase national debt,” citing studies of Bernie Sanders’ plan that “estimated that national health expenditures would rise over 10 years.” He didn’t note that CBO found that under most single-payer plans, national health expenditures would rise—but much less than they would under the status quo.

The Post‘s Glenn Kessler (9/9/24) “factchecked” Republican claims that Medicare for All would “raise taxes, increase national debt and functionally eliminate private health insurance.” Calling it “mostly true,” Kessler cited the figure of $32.6 trillion over 10 years, and claimed that “four of the five key studies on the effect of the Sanders plan estimated that national health expenditures would rise over 10 years.”

Kessler skipped a big fact. When the CBO insisted that raising the minimum wage would cause 1.4 million lost jobs, his editors (4/18/21) indignantly defended the agency as “admirably apolitical.” But Kessler neglected to mention that the “nonpartisan scorekeepers” at the CBO (12/10/20) found that four of the five versions of single-payer healthcare that they analyzed would raise national health expenditures, but by significantly less  than preserving the status quo.

Healthcare reporter Dan Diamond (9/11/24) wrote the Post’s most detailed take on Harris’s about-face on a plan “to eliminate private insurance, a proposal that worried many Americans who feared losing access to their doctors.” Diamond managed not to let readers know that, in contrast to private insurance plans that penalize patients for seeing “out-of-network” doctors, Medicare for All would free patients to see any doctor they want without financial penalty.

Diamond added that Harris pulled back from Medicare for All because “polls across 2019 found that many Americans were worried that shifting to a national government-run health system could delay access to care,” without mentioning that half of all American working adults already skip treatments altogether every year (Commonwealth, 11/24).

Voters’ 2019 “worries” were likely stimulated in part by a multi-million-dollar lobbying and advertising blitz by the hospital, insurance and pharmaceutical industries, reported on by the Post‘s Jeff Stein (4/12/19), and based on the same distortions and inaccuracies Diamond and Kessler repeated five years later (Public Citizen, 6/28/19).

In a story (Washington Post, 4/3/20) on Sen. Bernie Sanders supporting the Biden/Harris administration’s drug cost control policies, Diamond reported that during the 2020 primaries, Sanders “argued that Medicare for All would help rein in high drug costs by forcing pharmaceutical companies to negotiate with the government.” It was the only positive framing of Medicare for All we could find in the Post’s coverage. Biden and Harris have done exactly what Sanders proposed, although to date they’ve only negotiated lower prices for 10 drugs, the prices won’t take effect for another year, and they only apply to our current “Medicare for Some.”

Expert content suppression 

KFF’s website limited its discussion of candidates’ healthcare proposals to the “viable contenders”—a choice that excluded virtually all ideas for improving the US healthcare system.

No outlet ignored the third-party candidates’ healthcare proposals more firmly, or took the tiny increments proposed by the major parties more seriously, than the one best equipped to inform the public about the state of US healthcare: KFF Health News.

KHN is a subsidiary of what used to be known as the Kaiser Family Foundations, but now goes by the acronym KFF. Founded with money from the family of steel magnate Henry Kaiser, tax-exempt KFF occupies a unique role as both news outlet and major source for healthcare information, calling itself “a one-of-a-kind information organization.”

KFF’s research and polling arms publish a large volume of detailed data and analysis of healthcare policy, covered widely in the media. This work lends additional credibility to KHN’s respected and widely republished news reporting.

With a staff of 71 reporters, editors, producers and administrators, as of November 1, KHN is devoted entirely to healthcare. Unlike taxpaying competitors like Modern Healthcare and Healthcare Dive—which regularly cover KFF’s research output—KHN publishes without a paywall, and permits reprints without charge. KHN forms partnerships with outlets of all sizes and focus, from an in-depth investigative series on medical debt with NPR and CBS News, to providing regular policy and political reporting to the physician-targeted website Medscape.

Excluding opinion articles, letters to the editor and brief daily newsletter blurbs linking to other outlets’ content, FAIR’s searches yielded just five KHN news stories from January 1 to Election Day that referred to Medicare for All, single-payer or universal healthcare. Two were state-focused—a one-paragraph mention of a proposed California single-payer bill in a broader legislative round-up (4/24/24), and a profile (7/15/24) of Anthony Wright, newly appointed executive director of the DC nonprofit Families USA.

The remaining three (7/21/24, 8/1/24, 9/11/24) were passing mentions without substance. KHN went the entire year without once mentioning Jill Stein or Cornel West.

KHN’s news coverage appeared to follow the lead of its affiliated research entity. KFF published a web page to “Compare the Candidates on Healthcare Policy,” last updated October 8, that declared

the general election campaign is underway, spotlighting former President Trump, the Republican nominee, and Vice President Harris, the Democratic nominee, as the viable contenders for the presidency.

The comparisons highlighted the differences rather than the similarities, and included without context the standard claim that the Biden/Harris “administration achieved record-high enrollment in ACA Marketplace plans.”

KFF had long since decided that discussion of Medicare for All is over. President Drew Altman told the New York Times (8/22/24) that KFF stopped polling on Medicare for All after the 2020 primaries because “there hasn’t been debate about it.” Yet pollsters regularly ask voters about healthcare issues that have no immediate chance of passage. The AP has asked people for a quarter century if they think it’s the federal government’s responsibility to “make sure all Americans have healthcare coverage,” and the Pew Research Center and other organizations have polled on abortion for decades, even when federal legislation was extremely unlikely.

The lack of “debate” about Medicare for All or single-payer is a flimsy excuse for blinkered coverage. In fact, KHN and the other outlets all ignored major healthcare reform stories with looming deadlines for action by the incoming president—federal approval for state-level reform (Healthcare Dive, 4/24/24). California and Oregon passed laws in 2023 instructing their governors to seek federal permission to dramatically restructure their state healthcare systems, including formation of a single-payer system in Oregon. Negotiations were supposed to begin in the first half of this year. None of these four agenda-setting outlets asked 2024 presidential candidates whether they planned to flex White House power to help major state-level reforms.

Complicit in mass death

All four of these outlets have done detailed reporting on some aspects of the extraordinarily expensive mass-killing machine that passes for the US “healthcare system.” Claims denials, aggressive collections, medical debt and massively inflated prices have all graced their pages.

But when it comes to political coverage, reporters and editors refuse to use their knowledge to challenge candidates effectively. The public’s experiences disappear, as journalists regurgitate bad facts and focus on self-evidently meaningless “proposals” framed by corporate power within their insular Beltway cultural bubble.

UnitedHealth Group executive Brian Thompson’s murder exposed the degree to which that behavior makes them complicit in mass death.

This content originally appeared on FAIR and was authored by John Canham-Clyne.

Janine Jackson interviewed Dartmouth-based Anne Sosin about Robert F. Kennedy Jr. and rural health for the February 7, 2025, episode of CounterSpin. This is a lightly edited transcript.

The Hill (1/13/25)

Janine Jackson: A Senate panel voted narrowly this week to advance the nomination of Robert F. Kennedy Jr. for secretary of the Department of Health and Human Services. Kennedy has been emphatically opposed by a range of public health experts for reasons including, but not limited to, his stated belief that vaccines have “poisoned an entire generation of American children.” Yes, his children are vaccinated, but he wishes he “could go back in time” and undo that.

Also, that Covid-19 is targeted to attack Caucasians and Black people, while Ashkenazi Jews and Chinese are most immune; that the HPV vaccine causes a higher death risk than the cancer it prevents; that fluoride causes IQ loss; that Vitamin A and chicken soup are cures for measles; that AIDS is not caused by HIV; and that we had almost no school shootings until the introduction of Prozac.

Nevertheless, Kennedy may soon be overseeing Medicare, Medicaid and the Affordable Care Act, coordinating the public health response to epidemics, as well as the approval process for pharmaceuticals, vaccines and supplies.

Our guest says RFK Jr is absolutely a threat to public health, but nixing his nomination is not the same thing as meaningfully engaging the problems that lead people to support him.

Anne Sosin is a public health researcher and practitioner based at Dartmouth College. She joins us now by phone. Welcome to CounterSpin, Anne Sosin.

Anne Sosin: Thank you so much for having me on the show.

FAIR.org (12/5/24)

JJ: There are a number of people, in lots of places, who have centered their lives perforce on concerns around food and health and medicine. And they see a guy who seems to be challenging Big Pharma, who’s saying food additives are problematic, who’s questioning government agencies. There are a lot of people who are so skeptical of the US healthcare and drug system that a disruptor, even if it’s somebody who says a worm ate his brain—that sounds better than business as usual. And so that’s leading some people to think, well, maybe we can pick out some good ideas here, maybe. But you think that is the wrong approach to RFK Jr.

AS: I think that that’s misguided. Certainly, there are some people who see RFK as a vehicle for championing their causes. And there are other people who think that we should seek common ground with RFK, that we should acquiesce, perhaps, on certain issues, and then work together to advance some other causes.

And I think that that’s misguided. I think we need to recognize what’s given rise to RFK and other extreme figures right now, but we need to make common cause with the communities that he’s exploiting in advancing his own personal and political goals.

JJ: And in particular, you’re thinking about rural communities, which have played a role here, right? What’s going on there?

AS: Yes. My work is centered in rural communities right now, and I think we need to understand the political economy that’s given rise to RFK and other figures—the social, economic, cultural and political changes that have given him a wide landing strip in rural places, as well as some of the institutional vacuums that RFK and other very extreme and polarizing figures are filling.

JJ: Expand on that, please, a little.

Anne Sosin: “Resistance to public health measures often, in my view, reflects unmet need.”

AS: So we’re seeing growing resistance in some places, including rural communities, to public health and interventions that have long been in place, including vaccination and fluoridation. And resistance to public health measures often, in my view, reflects unmet need.

Sometimes those needs are material. We see that people resist or don’t follow public health programs or guidance because they don’t have their material needs met. And those material needs might be housing, paid leave or other supports that they need. But the unmet need might also be emotional or affective, that some people may resist out of a sense of economic or social dislocation, a feeling of invisibility, or something else. And those feelings get expressed as resistance to public health measures that are in place.

And so understanding and recognizing what those unmet needs are is really important. And then thinking about how do we address those needs in ways that are productive, and don’t undermine public health and healthcare, is really important.

JJ: Vaccinations are obviously a big concern here, particularly as we may be going into another big public health concern with bird flu. So the idea that vaccines cause disease is difficult to grapple with, from a public health perspective. Vaccines can’t be a “choose your own adventure” if they’re going to work societally. And it almost seems like, around vaccination, we’re losing the concept of what public health means, and how it’s not about whether or not you decide to eat cheese, you know? There’s kind of a public understanding issue here.

AS: I think you’re correct. I think we’ve seen, just in the US, an increasing DIYification of public health, a loss of the recognition that public health means all of us. Public health is the things that we do together to advance our collective health. And the increased focus on individual decision-making really threatens all of us.

NPR (5/12/21)

And we look for it around vaccination: We have seen very well-funded initiatives to undermine public confidence in vaccination over the last several years. There has been a lot of money spent to dismantle public support and public confidence in vaccination and other lifesaving measures. And it really poses a grave threat, as we think about not only novel threats like H5N1, but also things that have long been under control.

JJ: Finally, I took a quick look at major national media and rural healthcare, and there wasn’t nothing. I saw a piece from the Dayton Daily News about heart disease in the rural South, and how public health researchers are running a medical trailer around the area to test heart and lung function. I saw a piece from the Elko Daily Free Press in Nevada about how Elko County and others are reliant on nonprofits to fill gaps in access to care, and that’s partly due to poor communication between state agencies and local providers.

And I really appreciate local reporting; local reporting is life. But some healthcare issues, and certainly some of those that would be impacted by the head of HHS, are broader, and they require a broad understanding of the impact of policy on lots of communities. And I just wonder, is there something you would like to see news media do more of that they’re missing? Is there something you’d like them to see less of, as they try to engage these issues, as they will, in days going forward?

AS: Certainly local coverage is essential, and I’m really pleased when I see local coverage of the heroic work that many rural healthcare providers and community leaders are delivering. We see very creative and innovative work happening in our rural region, in our research, in our community engagement. And so it’s very encouraging when I see that covered.

But all of the efforts on the ground are shaped by a larger policy landscape and a larger media landscape, larger political landscape. And what we see, often, is efforts to undermine the policies that are critical to preserving our rural healthcare infrastructure. We see well-funded media efforts to erode social cohesion, to undermine our community institutions, to sow mistrust in measures such as vaccination. We see other work to harden the divisions between urban and rural America, and within rural places.

And so I hope that media will pay attention to the larger forces that are shaping the landscape of rural life, and not just see the outcome. It’s easy to take note of the disparities between urban and rural places, but it’s much harder to do the deep and complex work of understanding the forces that generate those uneven outcomes across geographic differences.

JJ: All right, well, we’ll end on that important point.

We’ve been speaking with Anne Sosin, public health researcher and practitioner based at Dartmouth College. Anne Sosin, thank you so much for joining us today on CounterSpin.

AS: Thank you for the invitation.

This content originally appeared on FAIR and was authored by Janine Jackson.

Right-click here to download this episode (“Save link as…”).

(CC photo: Ted Eytan)

This week on CounterSpin: We know that once corporate news label something “controversial,” we’re in for reporting with a static “some say/others differ” frame—even if one “side” of the “controversy” is a relatively small group of people who don’t believe in science or human rights or democracy. So as the Trump White House comes out fast and furious against transgender people, their weird hatefulness lands in a public arena that generally rejects discrimination, but also in an elite media climate in which the very lives of transgender people have long been deemed “subject to debate.” We’ll hear about the current state of things from civil rights attorney Ezra Young.

New York Times (5/8/24)

Also on the show: When the New York Times reported Robert F. Kennedy Jr.’s revelation that parasites have eaten part of his brain, Kennedy, running for president at the time, offered to “eat five more brain worms and still beat President Trump and President Biden in a debate.” We’re reminded of such “jokes” now, as Kennedy looks likely to be head of Health and Human Services, along with his claims that vaccines cause autism and chicken soup cures measles. But to resist Kennedy, we need to understand what fuels those who, even if they don’t like him, believe he might be a force for good in their lives. Anne Sosin is a public health researcher and practitioner based at Dartmouth College, who encourages looking around RFK Jr. to the communities that imagine he’s speaking for them.

This content originally appeared on FAIR and was authored by Fairness & Accuracy In Reporting.

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This content originally appeared on Gaslit Nation and was authored by Andrea Chalupa.

Fox News (12/11/24) labels Luigi Mangione as a “CEO murder suspect and Ivy League graduate.”

How do murder suspects get their media nicknames? Luigi Mangione, the 26-year-old accused of shooting and killing UnitedHealthcare CEO Brian Thompson, has been called the “CEO killer” or some variation by ABC (12/24/24) and some of its affiliates (KABC, 12/20/24; KGO, 12/24/24). The name makes sense, as the victim’s stature and the place of his murder—a hotel where a company-related meeting was to take place—was the aspect of the crime that made it sensational news. This is similar to how Theodore Kaczynski became the “Unabomber,” because his targets were universities and airlines.

Yet right-wing media are using a seemingly mundane feature of Mangione’s life—his college degree from the Ivy League University of Pennsylvania—to call him some variation of the “Ivy League killer.”

This label serves a few purposes for Republican-aligned media. Clearly, it is meant to deflate the sympathy for Mangione. Coding Mangione as an Ivy Leaguer also codes him as a leftist, occluding what appear to be his much more politically heterodox views; it paints him as an out-of-touch rich kid, rather than an anti-establishment renegade with whom Americans of all walks of economic life might relate.

It would appear that the right-wing press are taken aback by the growing sympathy the American public has with Mangione (Forbes, 12/12/24; Washington Post, 12/18/24; Newsweek, 12/21/24), a result of widespread anger against health insurance companies who inflate their profits through denial of care, high premiums and delaying medical services with cumbersome administrative bloat (AP, 9/12/22; KFF, 3/1/24; Gallup, 12/9/24; Marketplace, 12/13/24).

Focusing on Mangione’s education rather than the target of his attack, the “Ivy League” angle also seeks to turn the resulting policy discussion from one about the broken healthcare system to one about the education system. It promotes the right-wing narrative that academia is full of Marxist professors who indoctrinate vulnerable youngsters with revolutionary ideas, that Mangione is responding not to the objective reality about America’s healthcare crisis but to rhetoric that’s been wrongly instilled in him and many others—and that, therefore, the lesson of this shooting is that the US education system must be reformed by the incoming Trump administration.

‘Morally perverse positions’

New York Post columnist Charles Gasparino (12/14/24) argues for using the IRS to punish private schools that tolerate views he disapproves of.

Numerous articles in the New York Post (12/9/24, 12/10/24, 12/11/24, 12/12/24, 12/18/24, 12/23/24) make mention of Mangione’s “Ivy League” education. Columnist Charles Gasparino lamented in the Post (12/14/24) that a Penn professor posted on social media support of Mangione. Gasparino wrote that while students there pay “$85,000 a year to be brainwashed with leftism,” big school endowments are the primary “funding source of the progressive indoctrination we have in the college classroom.” The solution, then, is that Trump should go after university endowments’ tax breaks, so that they’re forced to lay off indoctrinating professors.

Princeton undergraduate and pro-Israel activist Maximillian Meyer (New York Post, 12/19/24), who wrote that Thompson’s killing was “rationalized as resistance by a privileged young person with two Ivy League degrees,” likened the attacks on the health insurance industry on his campus to student sympathy with Gazans: “To far-left young Americans, on any given issue, the world is divided into two buckets: oppressor and oppressed,” he wrote.

“The students who are celebrated as our nation’s most brilliant are often adopting the most morally perverse positions,” Meyer continued. He blamed the “moral equivocation” of educational institutions, and warned that “the reckoning, from elementary school on up, must begin now.”

‘Protect vulnerable young minds’

Scott Walker (Washington Times, 12/12/24): Mangione “sadly personifies the problems in our country’s education system these days…an ardent anticapitalist, a hate-filled opponent of corporations and private healthcare and a proponent of climate change alarmism.”

At the Washington Times  (12/12/24), former Wisconsin Gov. Scott Walker made the same point under the headline “College Grad’s Arrest Shows Elite Education Breeds Hate, Not Tolerance”:

The situation on most college campuses since the Covid-19 pandemic has gone from liberal bias to outright indoctrination. Students are not taught how to think critically, but to hate America and abhor those with views that are not 100% aligned with their left-wing agenda… We must hold educators and institutions accountable for pushing these dangerous ideologies on our children and grandchildren. We must also protect vulnerable young minds from anti-American narratives and teach them to respect the values that have made our nation great.

UnHerd (12/10/24), a relative newcomer to Britain’s oversized world of pearl-clutching Tory media (Guardian, 10/28/23; Bloomberg, 9/10/24), attempted to situate Mangione in history, saying “members of the murderous Red Army Faction in Seventies Germany were almost all university graduates”; Weather Underground co-founder Bill Ayers “was the son of a CEO and graduate of the University of Michigan, a so-called ‘public Ivy.’”

Fox News similarly hyped up Mangione’s “Ivy League” pedigree, regularly applying the label to him in its headlines (e.g., 12/11/24, 12/12/24, 12/16/24, 12/23/24). “Ivy League Murder Suspect Acted Superior, Did Not Expect to Be Caught: Body Language Expert” read one Fox headline (12/13/24), desperately signaling to its audience that Mangione is not a real man of the masses.

‘Spoiled rich kid’

Former FBI agent Jennifer Coffindaffer told Newsweek (12/16/24) Mangione showed his “true colors” by hiring a lawyer. It’s not clear who Coffindaffer thinks Mangione should have used as a role model; Rosa Parks, Martin Luther King and Daniel Ellsberg all had private lawyers.

This theme occasionally bled outside right-wing media borders. Newsweek (12/16/24) made an entire article out of a post on X (formerly known as Twitter) by a former FBI agent, Jennifer Coffindaffer, who called Mangione a “spoiled rich kid” because he hired a high-priced defense attorney. “If Luigi truly believed his rhetoric, he would have gone with the public defender,” Coffindaffer avered, and therefore he’s “a hypocrite, not a hero.”

As FAIR (12/11/24, 12/17/24) has noted, centrist establishment papers like the Washington Post and New York Times, along with Murdoch outlets like the New York Post, Wall Street Journal and Fox News, have all used space to shame those with grievances against health insurance companies. They’ve told readers and viewers that, contrary to available evidence and a mountain of lived experience, the situation isn’t that bad, and we should simply accept the system for what it is.

But the right-wing media’s focus on Mangione’s education and family background is an irrelevant ad hominem attack that is meant not only to distract their audience from the well-founded reasons why so many sympathize with the shooter, but to redirect their anger toward the country’s education system, which has for so long been in the right’s crosshairs.

This content originally appeared on FAIR and was authored by Ari Paul.

The UN’s Special Rapporteur on Human Rights in the occupied Palestinian territory, Francesca Albanese, has called on “medical professionals worldwide” to suspend ties with Israel in an act of solidarity with the more than “1000 colleagues of yours” killed in Gaza over the past 14 months.

Countless more Palestinian medical workers “were arrested, tortured, disappeared”, Albanese said in a post on social media.

“Out of dismay [and] solidarity you should revolt, and urge suspension of ties with Israel until it stops the genocide [and] accounts for it. What are you waiting for,” she said.

• READ MORE: 26 killed in Gaza as Israel intensifies strikes ahead of Doha truce talks
• The Palestine tragedy – why it should matter to you and our world
• ‘Crime against journalism’: Gaza journalists slam PA’s Al Jazeera ban
• Other Israel’s war on Gaza reports

Her appeal came as about 100 New Zealand protesters held a “silent vigil” outside the country’s largest medical institution, Auckland Hospital, declaring health workers were “not a target”.

Earlier on Friday, Albanese and the UN’s Special Rapporteur on the Right to Physical and Mental Health, Dr Tlaleng Mofokeng, issued a joint statement denouncing the “blatant disregard” for the right to health in the Gaza Strip following Israel’s attack on the Kamal Adwan Hospital and the detention of its director, Dr Hussam Abu Safia.

“For well over a year into the genocide, Israel’s blatant assault on the right to health in Gaza and the rest of the occupied Palestinian territory is plumbing new depths of impunity,” the UN experts said.

Medical professionals worldwide: my colleague @drtlaleng and I have a message you should read.
Israel has killed over 1000 colleagues of yours in Gaza in 14 months. Countless were arrested, tortured, disappeared. Their “heroic actions … teach us what it means to have taken… https://t.co/aubGgZ7jsQ

— Francesca Albanese, UN Special Rapporteur oPt (@FranceskAlbs) January 3, 2025

The Auckland protesters spread in a long line outside Auckland hospital with banners declaring “healthcare workers in Aotearoa call for a ceasefire” and “stop the genocide”, and placards with slogans such as “healthcare workers and hospitals are not a target”, “Free Dr Hussam Abu Saffiya” and “hands off Kamal Adwan [a northern Gaza hospital destroyed by Israeli forces last week].

Palestinian Prisoners Society warn over ‘danger’ to Dr Hussam
The Palestinian Prisoners Society has warned of “a danger” to Dr Hussam Abu Safiyya, the director of Kamal Adwan Hospital in northern Gaza, following the Israeli military’s denial of any records proving his arrest, reports Anadolu Ajensi.

Munir al-Bursh, the Director-General of Gaza’s Health Ministry, said the ministry submitted a request through the Physicians for Human Rights organisation to inquire about Abu Safiyya’s fate, but the Israeli occupation responded by saying that it had no detainee by that name.

Al-Bursh told the Al Jazeera news channel that there was concern that the Israeli occupation may execute Dr Abu Safia after his arrest about a week ago.

In a statement, the Palestinian Prisoners Society said that Dr Abu Safiyya “is one of thousands of detainees from Gaza facing the crime of enforced disappearance”.

The group said that “despite clear evidence of Dr Abu Safia’s arrest on December 27, 2024, the occupation is denying what it had previously stated and is also dismissing the evidence, including photos and videos it published as well as testimonies from some detainees who were released.”

It held the Israeli authorities fully responsible for his fate.

It also reiterated its call for the “international human rights system to save what remains of its role amid the ongoing genocide, after its function has eroded due to a frightening state of impotence.”

Last Saturday, Gaza’s Health Ministry announced the arrest of Dr Abu Safiyya by the Israeli military in northern Gaza.

Physicians for Human Rights (PHRI) have been informed that the Israeli military has no record of Dr. Hussam Abu Safiyyah, director of Kamal Adwan Hospital, who was reportedly arrested by the occupation forces on December 27, 2024.

Despite video evidence showing his arrest, the… pic.twitter.com/S2ofhRaEQE

— Quds News Network (@QudsNen) January 2, 2025

‘Proud’ of 15 months of NZ protest
Meanwhile, the national chair of New Zealand’s Palestine Solidarity Network Aotearoa (PSNA) issued a statement today critical of the government’s inaction in the face of the ongoing genocide and the destruction of Gaza’s healthcare system as protests continued across the country.

“While the stench of decaying morality hangs over [New Zealand’s] coalition government and its MPs after 15 months of complicity with genocide, nationwide protests against Israel’s genocide continue in 2025,” said national chair John Minto.

“Over 15 months of weekly nationwide protests is unprecedented in New Zealand history on any issue at any time.

“We are enormously proud of New Zealanders who stand with the vast mass of humanity against Israel’s systematic, indiscriminate killing of Palestinians in Gaza.

“This week’s protests are the first of New Year and they will continue while our government cowers under the bedclothes and refuses to sanction Israel for genocide.”

The Gaza death toll stands at more than 45,000 — the majority killed being women and children.

“Today’s death toll of innocents killed is a repeating nightmare” for Palestine, he said while Western media highlighted “Israeli propaganda to justify the endless massacres while ignoring Palestinian voices”.

The United Nations has denounced the targeting of hospitals in the Gaza Strip, saying that medical facilities need “to be off limits”.

UN deputy spokesperson Farhan Haq said that there were more than 12,000 people in Gaza who need medical evacuation.

This content originally appeared on Asia Pacific Report and was authored by APR editor.

In the wake of the killing of UnitedHealthcare CEO Brian Thompson and the arrest of  alleged shooter Luigi Mangione, I wrote (FAIR.org, 12/11/24) about how Murdoch outlets like the Wall Street Journal and New York Post, as well as Jeff Bezos’ Washington Post editorial board, not only decried the widespread support for Mangione but fought back against legitimate criticism of the health insurance industry.

Now the New York Times is in full-scale panic mode over the widespread boiling anger against the health insurance industry the killing has laid bare (CNN, 12/6/24; PBS, 12/7/24; Reuters, 12/9/24).

‘Working-class hero’

Bret Stephens (New York Times, 12/12/24): Brian Thompson is “a model for how a talented and determined man from humble roots can still rise to the top of corporate life.”

Times columnist Bret Stephens (12/12/24) wrote that because Thompson came from small-town beginnings, whereas Mangione was from a privileged background, it was in fact the slain CEO who was the real “working-class hero.” This shows that Stephens doesn’t understand class as a relationship of power, where people like Thompson have economic power, regardless of their cultural background.

(As music critic Kurt Gottschalk noted, it also shows that Stephens doesn’t understand the John Lennon song he’s quoting from, whose lyrics advise the would-be working-class hero: “There’s room at the top they are telling you still/But first you must learn how to smile as you kill/If you want to be like the folks on the hill.”)

Stephens said that the idea that health insurance “companies represent a unique evil in American life is divorced from the experience of most of their customers.” The aforementioned FAIR piece contains plenty of evidence that contradicts Stephens’ weak claim that Americans are perfectly fine with the status quo, noting that medical bankruptcies are exploding, that polling shows growing dissatisfaction with the American healthcare system, and that studies show the American system lags behind those of peer nations. But, really, the best evidence that many customers are dissatisfied with the health insurance system is that so many of them found the murder of a health insurance CEO perfectly understandable.

Stephens, one of the Times’ several right-wing columnists, has said (2/28/20) that socialist Vermont Sen. Bernie Sanders, one of the best-known lawmakers supporting Medicare-for-All, “scares” him, because he is “now the old man who rails compulsively against ‘the billionaire class’ and wants to nationalize the health insurance industry.” Stephens (1/31/20) complained that for Sanders’ supporters, “ordinary civility isn’t a virtue,” but rather a “ruse by which those with power manipulate and marginalize those without”; if so, they offer a pretty good critique of the way Stephens himself deploys “civility” to silence dissent.

‘Tiptoe toward justifying assassination’

Ross Douthat (New York Times, 12/13/24) : Criticism of the insurance industry in the wake of Thompson’s murder “illustrates how easily toxic elements can slip into mainstream politics right now.”

Another right-wing Times columnist, Ross Douthat (12/13/24) specifically addressed the “manifestly illiberal conceit that murder is wrong, but public enthusiasm for the murder of an executive in a deplorable industry reflects the understandable anger of people pushed too far”—a position he insisted “seems to tiptoe toward justifying assassination even if you insist that you’re disavowing violence.” He dismissed the “idea that the American model of private insurance is uniquely evil and engaged in acts of social violence because it denies people too much treatment,” maintaining that all insurance systems, public or private, ration care.

But as I noted in the earlier FAIR article, the Commonwealth Fund (NBC, 9/19/24) found that the US system does, in fact, stand out among other peer nations, ranking “as the worst performer among 10 developed nations in critical areas of healthcare.” Those areas the US falls short in include “preventing deaths, access (mainly because of high cost) and guaranteeing quality treatment for everyone.” The rest of the world is doing better than us on these scores, contrary to Douthat.

Americans see the systems working in the rest of the world and know that the United States could have a better healthcare regime, but that corporate and government leaders simply choose not to.

‘We let a murderer manipulate us’

As people shared their health insurance horror stories of denied treatments and mounting bills as ways of understanding the shooter’s outburst, bioethicist Travis Rieder (New York Times, 12/13/24) shook his finger at the masses as if they were rowdy kindergarteners:

The supposed motives assigned to the shooter may well be understandable. But not everything understandable is justifiable. This tragic situation should motivate us to change the institutions and structures that have failed so many people. But not to give murder a pass, and especially not to glorify it.

Peter Coy (New York Times, 12/13/24)suggested that UnitedHealth’s vertical monopolization of healthcare is “something like a private version of a single-payer national healthcare system.”

The paper produced an audio op-ed by political scientist Robert Pape (New York Times, 12/12/24), who urged listeners to see the public reaction as part of “the growing normalization of political violence in America,” rather than as part of the growing outrage over the broken healthcare system in America. Bypassing the latter issue, he simply likened it to the attack against the Pelosis and the two assassination attempts against Donald Trump, incidents that did not spark a national outcry against an unjust policy or system. “It is terribly important right now that national political leaders at all levels condemn political violence and the murder of the healthcare CEO and condemn the outpouring of support for the murder,” Pape said.

Times opinion contributor Peter Coy (12/13/24) investigated the complexities of for-profit healthcare and offered some band-aid solutions, while avoiding any real exploration of a more social democratic approach to healthcare, despite the popularity of publicly financed universal care (Common Dreams, 12/9/24). Coy wrote:

Tragically, Thompson’s shooting wasn’t a solution to anything. “The way we let a murderer manipulate us into having the conversation he wanted is grotesque,” Michael Cannon, the director of health policy studies at the Cato Institute, who favors a free-market approach, told me.

Coy, Pape and Rieder all pay lip service to problems with the healthcare system and suggest changing it through politics—as if people haven’t been fighting for that for decades. They offer the diagnosis that public celebrations over Thompson’s death are the result of some weakness of public character, which means that the answer is reminding people that murder is wrong.

The more honest diagnosis would be that the responses are the result of a broken political system that offers no real way for people to have their healthcare grievances addressed—but that would call not for scolding screwed-over patients, but rather demanding political reform that challenges entrenched political and corporate interests that the Times has little interest in challenging.

‘To help make it work better’

UnitedHealth CEO Andrew Witty (New York Times, 12/13/24) : “We understand and share the desire to build a health care system that works better for everyone. That is the purpose of our organization.” The $23 billion in profits the conglomerate made last year was apparently just a fortuitous happenstance.

But the most banal piece of all came from Andrew Witty (New York Times, 12/13/24), the CEO of UnitedHealth Group—the parent company of Thompson’s division—who said, offering no details and no real agenda for change:

We know the health system does not work as well as it should, and we understand people’s frustrations with it. No one would design a system like the one we have. And no one did. It’s a patchwork built over decades. Our mission is to help make it work better. We are willing to partner with anyone, as we always have—healthcare providers, employers, patients, pharmaceutical companies, governments and others—to find ways to deliver high-quality care and lower costs.

While this piece offered almost nothing other than PR for a company in desperate need for positive spin, its placement on the Times op-ed page did help demonstrate why the shooter got so much sympathy in this case. People like Witty, with access to highly compensated crisis management consultants, can have their polished messaging featured in the highest perches of American media. With all of these pieces on the opinion page lambasting the public for voicing anger against executives like Thompson, there is no voice from anyone on the opinion pages explaining why they are taking part in this national movement of solidarity against insurance profiteering.

That’s a telling omission, because those stories could easily be told, especially as more news about the hideousness of this insurance Goliath emerges. Minnesota doctors have sued UnitedHealthcare, alleging it “deliberately engages in the pattern of ‘deny, delay and underpay,’” resulting in over $900,000 in unpaid independent dispute resolution awards (KMSP, 12/12/24).

ProPublica (12/13/24) investigated how the company is limiting treatment for autistic children. Earlier this year, New York’s attorney general announced that the company was forced to pay “a $1 million penalty for failing to provide birth control coverage, a violation of New York state law” (Gothamist, 6/20/24). Senate Democrats accused the company of “denying claims to a growing number of patients as it tried to leverage artificial intelligence to automate the process,” a kind of capitalist nightmare with a sci-fi twist (Fox Business, 12/6/24).

The cancer patient being denied life-saving treatment, or the mom missing meals and working two jobs to afford their child’s medicine, don’t have PR teams like Witty does to reach the Times. That is why people are expressing such vitriol right now.

ACTION ALERT: You can send a message to the New York Times at letters@nytimes.com. Please remember that respectful communication is the most effective. Feel free to leave a copy of your communication in the comments thread.

This content originally appeared on FAIR and was authored by Ari Paul.

Zeynep Tufekci (New York Times, 12/6/24) “can’t think of any other incident when a murder in this country has been so openly celebrated.”

The early morning murder of UnitedHealthcare CEO Brian Thompson was met on social media with a “torrent of hate” for health insurance executives (New York Times, 12/5/24). Memes mocking the insurance companies and their callous disregard for human life abound on various platforms (AFP, 12/6/24).

Internet users are declaring that the man police believe to be the shooter, 26-year-old Luigi Mangione, is certifiably hot (Rolling Stone, 12/9/24; KFOX, 12/10/24). A lookalike contest for the shooter was held in lower Manhattan (New York Times, 12/7/24).

If so many people are unsympathetic at best in response to such a killing, that might be a reason to revisit why health insurance companies are so loathed. The rage “was shocking to many, but it crossed communities all along the political spectrum, and took hold in countless divergent cultural clusters,” the New York Times (12/6/24) noted. Mangione was reportedly found with an anti-insurance manifesto that stated “these parasites had it coming” (Newsweek, 12/9/24), echoing a resentment largely felt by a lot of Americans, and targeted fury at UnitedHealthcare specifically.

UnitedHealthcare has always stood out for exceptionally high rate of claims denial generally in the industry (Boston Globe, 12/5/24; Forbes, 12/5/24). For example, a Senate committee found that “UnitedHealthcare’s prior authorization denial rate for post-acute care jumped from 10.9% in 2020 to 22.7% in 2022” (WNYW, 12/7/24).

The Times (12/5/24) reported that the Senate committee found that “three major companies—UnitedHealthcare, Humana and CVS, which owns Aetna—were intentionally denying claims” related to falls and strokes in order to boost profits. UnitedHealthcare “denied requests for such nursing stays three times more often than it did for other services.”

Increasing dissatisfaction

The perception of the quality of US healthcare has been on the decline since 2012 (Gallup, 12/6/24).

On top of that, Americans generally believe their insurance-centered system is a mess. Gallup (12/6/24) reported that “Americans’ positive rating of the quality of healthcare in the US is now at its lowest point in Gallup’s trend dating back to 2001.”

It continued:

The current 44% of US adults who say the quality of healthcare is excellent (11%) or good (33%) is down by a total of 10 percentage points since 2020 after steadily eroding each year. Between 2001 and 2020, majorities ranging from 52% to 62% rated US healthcare quality positively; now, 54% say it is only fair (38%) or poor (16%).

As has been the case throughout the 24-year trend, Americans rate healthcare coverage in the US even more negatively than they rate quality. Just 28% say coverage is excellent or good, four points lower than the average since 2001 and well below the 41% high point in 2012.

Ipsos (2/27/24) likewise found:

Most Americans are unsatisfied with the healthcare system, say the health insurance system is confusing and opaque, and many have skipped or delayed care because of a bad experience or the lack of timely appointments. A small, but not insignificant number, of Americans believe they have had a negative health outcome as result of their experiences within the healthcare system.

When this inefficient system doesn’t literally kill Americans, it can still kill them financially. “Almost a third of all working adults in the United States are carrying some kind of medical debt—that’s about 15% of all US households,” Marketplace (3/27/24) reported. It added: “This debt is also the leading cause of bankruptcies in the country.”

Many news outlets’ pontificators, however, were incensed that anyone would voice frustration with health insurance when an industry CEO has fallen.

‘Not the time to offer criticism’

After Brian Thompson’s killing, the New York Post (12/5/24) condemned those on social media who “swooned over his killer, speculated on his motives, and wondered if Timothée Chalamet would play him in the movie.”

Responding to the memes and the jokes, many of which were more about the unjust health insurance system than support for vigilante murder, the New York Post editorial board (12/5/24) asked:

Do the jokes point to a society that has become so desensitized by the coarseness of online discussion, so disassociated from kindness, that a baying mob cheers a man’s murder and cries out for more?

And upon Mangione’s arrest, the Post (12/9/24) complained that on social media, “tasteless trolls showered praise on the Ivy League grad.” The Post (12/11/24) also fretted about fake “Wanted” posters for insurance company executives that the paper considered a “a fear-mongering social media stunt to incite hysteria,” adding that the “murder has also spawned a stream of merchandise sympathetic towards the 26-year-old being sold by online retailers, forcing Amazon to pull them from its website.”

Fox News (12/6/24) quoted one of its own contributors, Joe Concha, saying, “I think this encapsulates the far left’s worldview: If you run a company that isn’t to their liking, you deserve to die.” The network (12/7/24) praised Democratic Sen. John Fetterman of Pennsylvania for “tearing into” a New York article (12/7/24) that the outlet characterized as saying “resentment over denied insurance claims made…Thompson’s murder inevitable.”

The dismay was felt in other corners of right-wing media. At the Free Press (12/5/24), the brainchild of anti-woke crusader Bari Weiss, Kat Rosenfield wrote:

The people celebrating Brian Thompson’s murder by turning him into an avatar for everything wrong with the American healthcare system remind me of nothing so much as Hollywood screenwriters, cunningly manipulating an audience into cheering on unforgivable acts of fictional violence.

The National Review (12/4/24) huffed:

This is not the time to offer your criticisms of the health-insurance industry. And there is never a time to believe that corporate executives are, by their very nature, evil people who deserve to be killed. Yet that is what you’ll see if you go on social media right now and look at comments on news stories about this assassination.

Yet all of these outlets at the same time have run support for Daniel Penny, the man recently acquitted for killing a Black homeless man on the New York City subway (National Review, 6/17/23; Free Press, 10/20/24; New York Post, 12/4/24; Fox News, 12/6/24). These outlets likewise expressed support for Kyle Rittenhouse after he gunned down Black Lives Matter protesters (National Review, 11/19/21; Free Press, 11/17/21; New York Post, 11/19/21; Fox News cited by Media Matters, 11/11/21), and for George Zimmerman when he shot Trayvon Martin (National Review, 6/22/20; New York Post, 7/15/13; Fox News, 7/18/12). In other words, it’s fine to defend vigilantes when they kill unarmed Black people or anti-racist activists, but when a CEO’s life is taken, we must solemnly stay silent on the reasons why such a person might be targeted or why bystanders might not be crying.

Piers Morgan (New York Post, 12/10/24) made this clear when he said “I cheered when I heard” Penny’s acquittal, and felt “shocked and saddened when I saw the footage” of the Thompson shooting. “Those two reactions would surely be the correct and appropriate ones for anyone with an ounce of fairness and humanity in their heart,” he said—because Thompson was “a non-violent, non-threatening, non-criminal man in the street,” whereas Penny’s victim was “a dangerous, mentally ill, homeless man.”

Blame it on Medicare

The Wall Street Journal (12/6/24) made the absurd claim that a medical system based on private insurance is better than any other kind of healthcare system.

It was the Wall Street Journal, the more erudite of Murdoch’s media properties, that really addressed the question of why people might hate health insurance companies. The anger was misdirected, the editorial board (12/6/24) said. Rather, we should look to federally funded healthcare if we want to get mad: “Medicare and Medicaid, two government programs, cover about 36% of Americans,” the paper observed; because they “pay doctors and hospitals below the cost of providing care…many providers won’t see Medicaid patients, resulting in delayed care.”

It’s an odd argument, given that people who receive Medicaid report being happier with their health insurance than people who get it through their employers or pay for it themselves—and people with Medicare are the happiest of all (KFF, 6/15/23). If the federal programs are underpaying healthcare providers, the obvious solution would be to increase funding for them—an initiative the Journal would be unlikely to support.

The board (Journal, 10/10/24) later dismissed critiques of the health insurance industry and passed off Mangione as a “disturbed individual” radicalized by the Internet and said it is “a dreadful sign of the times that Mr. Mangione is being celebrated.” 

Journal editorial board member Allysia Finley (12/8/24) followed up by placing the blame on the Affordable Care Act (aka “Obamacare”). “Having insurance doesn’t change people’s behavior,” she wrote, but does “cause them to use more care.” The situation, she said, “has gotten worse since Obamacare expanded eligibility” for Medicaid. This portrait of US patients overusing healthcare like sweet-toothed children let loose in a candy store is belied by (among other things) the fact that Americans live 4.7 fewer years than the average of comparable countries (KFF, 1/30/24).

The Journal editorial went on to complain that “some providers prescribe treatments and tests that may be medically unnecessary,” and so “insurers have tried to clamp down on such abuse by requiring prior authorization.” While this “can result in delayed care that is medically necessary…it’s also how insurers control costs.”

In reality, doctors are complaining that insurance bureaucrats are impeding their ability to deliver needed healthcare because of this cost-slashing system (Forbes, 3/13/23). The American Medical Association found “94% of doctors say prior authorization leads to delays in patient care” (Chief Medical Executive, 3/14/23); “one in three doctors (33%) say prior authorization has led to serious adverse events with their patients.”

Journal editorialists appear to believe that doctors are jauntily giving away expensive blood pressure medicine and signing up patients for brain surgery for no particular reason, and the only thing that can stop this carnival of care is some bureaucrat who is trained to say “no.” The reality is that the private insurance system “saves insurance companies money by reflexively denying medical care that has been determined necessary by a physician,” as pediatrician William E. Bennett Jr. (Washington Post, 10/22/19) wrote. This is why people are so unsympathetic to Thompson, who was paid an estimated $10 million annually for imposing medical austerity on patients and providers (PBS, 12/7/24).

Pity the insurance giants

The Washington Post (12/7/24) criticized those who tried to use Thompson’s killing “as an occasion for policy debate about claim denial rates by health insurance companies.” (Note that both the Post and the Wall Street Journal used the same photo of flags at half-mast.)

Right-wing media weren’t the only engaging in scolding. At the Jeff Bezos–owned Washington Post, the editorial board (12/7/24) criticized those “who excuse or celebrate the killing,” as well as those “who do not countenance the killing itself” but “have nevertheless tried to treat it as an occasion for policy debate about claim denial rates by health insurance companies, an admittedly legitimate issue.” The Post added that debate was “fine in principle, but we’re skeptical that this particular moment lends itself to nuanced discussion of a complicated, and heavily regulated, industry.”

The editors nevertheless spent a lengthy paragraph explaining to readers that “controlling healthcare costs requires difficult trade-offs,” and that “even the most generous state-run health systems in other countries also have to face” these trade-offs. The editorial attempted to summon sympathy for

insurers, whose profits are capped by federal law, [and] must contend with consumer demand for ready access to high-priced specialists and prescription drugs—and, at the same time, premiums low enough that people can afford coverage.

Note that insurance company profits are “capped” by requiring them to spend at least 80% of premiums on claims, a percentage known as their loss ratio—but those claims can be paid to providers that are owned by the insurers themselves, “a loophole that makes loss ratio requirements meaningless” (Physicians for a National Healthcare Program, 7/16/21). United Healthcare has been particularly aggressive at this, which is part of the reason its “capped” profits soared to $22.4 billion in 2023.

As for the Post’s assertion that insurance providers should keep “premiums low enough that people can afford coverage,” KFF (10/9/24) found that “Family premiums for employer-sponsored health insurance rose 7% this year to reach an average of $25,572 annually, marking the “second year in a row that premiums are up 7%.” The Center for American Progress (11/29/22) found that employer sponsored insurance “premiums have risen above the rate of inflation and have outpaced wage growth” over the course of a decade. “Escalating grocery bills and car prices have cooled, but price relief for Americans does not extend to health care,” USA Today (10/9/24) reported.

The Post added that all this talk about how Americans are being tortured by the insurance system should wait until next year, “when Congress is to consider whether to keep temporary Obamacare enhancements that have boosted enrollment.”

It is easy to see the material interests of the Washington Post‘s owner at work. Jeff Bezos’ Amazon does not run a health insurance company, but it is fully entrenched in the for-profit medical system. It offers a health insurance marketplace through AmazonFlex, acquired the healthcare provider One Medical last year (NPR, 11/12/23; Forbes, 4/5/24), and offers a pharmacy and other health services.

As one of the world’s richest people, Bezos might have another reason to be worried about people cheering on the murder of CEOs: Amazon is often hated for its monopoly-like grip on online retail (FTC, 9/26/23), as well as charges of price-gouging (Seattle Times, 8/14/24) and union-busting (Guardian, 4/3/24).

‘Last or near last’

The failure of the US healthcare system in one chart: life expectancy plotted against healthcare spending.

The Washington Post‘s line about the comparable ills of “generous state-run health systems” echoed a similar argument from the Wall Street Journal‘s editorial, which concluded:

Government healthcare is a recipe for more care delays and denials. Witness the fiasco in the United Kingdom, where the Labour government reports that more than 120,000 people died in 2022 while on the National Health Service’s waitlist for treatment. To adapt a famous Winston Churchill phrase, private insurance is the worst form of healthcare, except for all others.

The statement that the British or European health systems are worse for people than the US private insurer–dominated system is simply false. Just months ago, the Commonwealth Fund (NBC, 9/19/24) found that the United States

ranks as the worst performer among 10 developed nations in critical areas of healthcare, including preventing deaths, access (mainly because of high cost) and guaranteeing quality treatment for everyone.

The US “ranked last or near last in every category except one,” precisely because

the complex labyrinth of hospital bills, insurance disputes and out-of-pocket requirements that patients and doctors are forced to navigate put the US second to last in administrative efficiency.

The Commonwealth Fund (CNN, 1/31/23) also found that

the United States spends more on healthcare than any other high-income country, but still has the lowest life expectancy at birth and the highest rate of people with multiple chronic diseases.

Healthcare providers in Mexico and Costa Rica are huge draws for Americans in need of care who can’t make it through America’s Kafkaesque system (NPR, 3/8/23). Spain and Portugal are attracting American retirees, and good low-cost health care is one incentive (Travel + Leisure, 6/20/24).

Retreat to the castle

Apparently the CEOs that Fox News (11/13/24) is so concerned about don’t qualify as “professional elites.”

While the Washington Post’s position clearly falls in line with its material allegiance to a system where its owner sits at the apex, the positions from Murdoch are more interesting. As the Democratic Party has lost support among the working class (NPR, 11/14/24; USA Today, 11/30/24), Murdoch’s outlets have touted Donald Trump and the Republican Party as alternatives for working-class voters.

Murdoch and other purveyors of Republican propaganda have promoted the idea that Democrats serve only financial elites and Hollywood producers, and that protectionist policies under Trump will help US workers (New York Post, 7/16/24; Fox News, 11/13/24). Republicans were able to woo voters by complaining about the high price of gasoline and groceries under the Biden administration (CNBC, 8/7/24).

Now Murdoch outlets are fully retreating into their elite castle and telling the rabble to stop complaining about the lack of access to healthcare. The Republicans and their news outlets have worked hard to recharacterize themselves as something more populist, but the Thompson killing has brought back the old narrative that they are, proudly, the champions of the 1 Percent.

This content originally appeared on FAIR and was authored by Ari Paul.

New York prosecutors have charged a suspect with murder for the killing of UnitedHealthcare CEO Brian Thompson, who was gunned down in Midtown Manhattan on December 4. The suspect has been identified as 26-year-old Luigi Mangione, who was captured in Pennsylvania on Monday after a five-day nationwide search. Police say Mangione was found with a handwritten manifesto, which they have not released. Although little is known about the motive for Thompson’s killing, there has been an outpouring of rage on social media directed at the health industry, with many sharing stories of having claims for vital care denied and losing precious time with loved ones during illness. Former healthcare executive Wendell Potter, now an advocate for reform, says the anger being expressed now has always been “barely below the surface” and was one of the reasons he left the industry. “I couldn’t, in good conscience, continue to support an industry that … established themselves firmly between a patient and his or her doctor,” says Potter. “What we’re seeing, sadly, in some form or fashion probably was inevitable.”

We also speak with Derrick Crowe of the People’s Action Institute, which runs the Care Over Cost campaign, helping people fight back against health insurance claims denials. “These corporations have too much power in this country. They are blocking progress on issues like gun violence and on the epidemic of care denials in this country, either through prior authorizations or through claims denials,” says Crowe.

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

Next year, Donald Trump will have the chance to reshape the American public health system with his nomination of anti-vaccine crusader Robert F. Kennedy Jr. as secretary for health and human services. While corporate media haven’t necessarily endorsed this choice, many commentators have worked hard to downplay the danger Kennedy poses to the US public.

Dr. Rachael Bedard (New York Times, 11/15/24) says of Robert Kennedy Jr., “We can’t spend four years simply fighting his agenda.”

On one of the most influential platforms, the New York Times op-ed page (11/15/24), geriatric physician Rachael Bedard wrote that Kennedy has “seeds of truth” in his agenda: “There’s a health care agenda that finds common ground between people like myself—medical researchers and clinicians—and Mr. Kennedy.”

We shouldn’t fret too much about RFK Jr.’s vaccine positions, Bedard assured us, because “Mr. Kennedy’s skepticism on this topic may counterintuitively be an advantage.” His “statements on vaccinations are more complex than they’re often caricatured to be,” she insisted. “He’s said he was not categorically opposed to them or, as an official in the new Trump administration, planning to pull them from the market.”

Similarly, physician and media personality Drew Pinsky, aka Dr. Drew, downplayed Kennedy’s anti-vaccine stance in The Hill (11/25/24):

I know Bobby Kennedy—I’ve had him on my show—and I have talked at length with him about these issues. Kennedy isn’t a vaccine-denier or a vaccine conspiracy theorist…. Kennedy isn’t attempting to deny access to vaccines to anyone.

In Newsweek (11/27/24), Brandon Novick of the Center for Economic and Policy Research acknowledged “legitimate concern about his vaccine skepticism” but went on to argue that those concerns are “overblown”: “He promises not to prevent Americans from accessing any vaccine,” Novick wrote. “Kennedy mainly wants to require more and higher quality studies of vaccine safety and increase transparency.”

‘Better not get them vaccinated’

Seth Mnookin (Scientific American, 1/11/17): “For more than a decade, Kennedy has promoted anti-vaccine propaganda completely unconnected to reality.”

A review of RFK Jr.’s record by the AP (7/31/23) clearly documents that he opposes vaccines generally, especially when talking to right-wing audiences: “I see somebody on a hiking trail carrying a little baby and I say to him, better not get them vaccinated,” he told a podcast in 2021. (He also said, in 2023, “There’s no vaccine that is safe and effective,” but claims the podcaster cut him off before he could say something…more complex.) He has also peddled the discredited theory that vaccines cause autism (Scientific American, 1/11/17).

Of course, his dangerous anti-science views go far beyond vaccines. The Autistic Self Advocacy Network (11/22/24) laid out the extent of Kennedy’s maddening ideas:

His opposition to life-saving vaccines, his belief that HIV may not cause AIDS, his desire to increase the use of quack autism “treatments,” and his comments about putting people taking psychiatric medication in labor camps should all be immediately disqualifying. Autistic people, the disability community and the nation’s public health will all suffer if he is confirmed.

Georges C. Benjamin, executive director of the American Public Health Association (11/18/24), sees a direct threat public health under Kennedy:

Unfortunately, Robert F. Kennedy Jr. has demonstrated a consistent lack of willingness to listen, learn and act in the best interest of the health of the American people. He was identified in 2021 as a member of the “Disinformation Dozen” that produced 65% of the shares of anti-vaccine misinformation on social media platforms that contributed to the public’s mistrust in science, and likely led to morbidity and mortality.

Nowhere do Bedard, Pinksy or Novick take any of this into account when categorizing Kennedy’s views on vaccines as “more complex” or “overblown.” Unmentioned in all three pieces, for example, is that Kennedy and his anti-vax nonprofit, Children’s Health Defense, helped spread misinformation in American Samoa, where vaccination rates plummeted and a measles outbreak subsequently killed dozens of children (Mother Jones, 7/2/24). Derek Lowe of Science (8/28/24) wrote: “As far as I’m concerned, he and Children’s Health Defense have blood on their hands.”

And Novick’s blithe dismissal of health experts’ concerns misrepresents Kennedy’s promise: He did not promise “not to prevent Americans from accessing any vaccine”; he promised not to “take away anybody’s vaccines.” It’s a crucial distinction. Banning vaccines would actually be fairly difficult for a health secretary to do by fiat, so it’s an easy promise to make. But many rightly fear he would work to make vaccines less accessible—not by “pulling them from the market,” as Bedard assures readers he won’t do, but by, for instance, making decisions that would mean vaccines would in many cases no longer be covered by insurance.

And by changing vaccination recommendations, Kennedy could strongly influence vaccination rates, which would increase the possibility of deadly disease outbreaks impacting far more people than only those able to choose whether they want to be vaccinated—again, whether or not he “takes away anybody’s vaccines.”

‘Best chance of reining in corruption’

Brandon Novick (Newsweek, 11/27/24): “Kennedy represents a unique shift away from the corporate capture that has pervaded the public health agencies.”

Many of these corporate media pieces try to frame Kennedy’s position as populist outrage against the status quo, portraying Kennedy as some anti-corporate crusader  looking out for regular folks against parasitic healthcare profiteers.

Novick wrote:

Within the context of a Trump administration, Americans should strongly support Kennedy’s nomination as he is the best chance of reining in corruption and corporate power while prioritizing public health over profits.

“Kennedy has railed against price gouging, and he supports the ability for Medicare to negotiate drug prices like other nations who pay far less,” he argued. Novick added that Kennedy “seeks to stop the pervasive poisoning of Americans by large drug and food companies,” and points “to European nations which have stronger regulations.”

It’s hard to imagine the Trump White House, dedicated to destroying the administrative state, creating more federal regulations on commerce. As Greg Sargent (New Republic, 11/15/24) noted, Trump

didn’t disguise his promises to govern in the direct interests of some of the wealthiest executives and investors in the country…. Trump is basically declaring that his administration will be open for business to those who boost and assist him politically.

The notion that you can pick through an agenda like Kennedy’s and join with him on just the sensible parts is a fundamental misunderstanding of how right-wing “populism” works. Its very purpose is to deflect legitimate concerns and grievances onto imaginary conspiracies and scapegoats, in order to neutralize struggles for real change.

When the far right talks about genuine problems, your response should not be, we can work together because we share the same issues. Those issues are just the bait that’s necessary for the switch.

‘Casualty of the culture wars’

Laurie Ochoa (LA Times, 11/23/24): “Many in the food community would love to see someone break the status quo.”

But this is a mistake that commentators, eager for compromise and common ground, make again and again. Asking if there’s a “silver lining” to RFK Jr.’s appointment, Laurie Ochoa at the LA Times (11/23/24) said that while scrutiny has

rightly been on [Kennedy’s] anti-vaccine and anti-fluoride positions, some have taken note of his strong language against food additives in the processed foods so many of us consume and that are making so many Americans sick.

Houston Chronicle (11/22/24) editorial writer Regina Lankenau used her column space to ask Jerold Mande, an adjunct professor of nutrition at Harvard University, “So is there any chance that RFK Jr. under a Trump administration will be the one to disrupt Big Food?” He answered, “Yes, and I’m hopeful,” saying that Kennedy’s potential oversight of “federal nutrition programs, including school meal programs” could help him tackle processed food intake.

At the Boston Globe (11/20/24), Jennifer Block argued that “When It Comes to Food, RFK and the ‘Make America Healthy Again’ Crew Have a Point.” Block touted the right-wing pseudo-science “wellness” panel that launched the MAHA movement, writing that while it’s true that Biden-Harris have done much more for public health than Trump did in terms of nutrition and regulation of the food industry, “Yet the community voicing concerns about food and contaminants—like the people who showed up at Vani Hari’s rally in Michigan — feel as if they’ve gotten a warmer reception on the political right.”

Her evidence is that Democrats and the left have been critical of the pseudo-science wellness crowd. “But it would be a grave mistake if necessary conversations about chronic illness and our medical and food systems became another casualty of the culture wars,” she wrote.

The medical world just isn’t being open-minded enough, she wrote, arguing that the “debunkers’ credo is that anyone who’s critical of medicine or offers alternatives to pharmaceuticals will send you on a slippery slope to anti-vaccine, anti-science woo.” The problem, of course, is not that Kennedy is at the top of that slope, but that he’s already at the bottom of the hill.

‘A national disgrace’

Neil Barsky (Guardian, 11/21/24): “Should RFK Jr. be able to abandon his numerous conspiracy theories about vaccines, he can be the most transformative health secretary in our country’s history.”

Neil Barsky, founder of the Marshall Project, admitted in the Guardian (11/21/24) that Kennedy’s “anti-vaccine views are beyond the pale,” but said he understood that “our healthcare system is a national disgrace hiding in plain sight.” Barsky added, “He recognizes the inordinate control the pharmaceutical and food industries [have] over healthcare policy.”

But Kennedy does not actually propose to replace that “national disgrace”; asked whether he supported a Medicare for All system, which would be a real step toward curbing the power of the pharmaceutical industry, his response was incoherent (Jacobin, 6/9/23):

My highest ambition would be to have a single-payer program . . . where people who want to have private programs can go ahead and do that, but to have a single program that is available to everybody.

In other words, he thinks “single payer” should be one of the payers!

So it is questionable how much Kennedy really wants to address these issues. But even if one were to give him the benefit of the doubt, the pro-business, anti-regulation nature of the rest of the incoming administration suggests there is scant hope any of Kennedy’s health food talk would ever become meaningful policy.

For example, Mande’s answer that Trump would allow Kennedy to make school lunches more nutritious appears naive in view of Trump’s first term, in which he rolled “back healthier standards for school lunches in America championed by [former First Lady] Michelle Obama,” moving to “allow more pizza, meat and potatoes over fresh vegetables, fruits and whole grains” (Guardian, 1/17/22).

In fact, Kennedy already seems at odds with Trump’s pick for agriculture secretary (Politico, 11/29/24), who will be his main influence over US food policy. Big Pharma already has Trump’s ear (Reuters, 11/27/24). And Kennedy has already felt the pressure of his new boss’s love of fast food when he threw out his ideals and posed with a Big Mac and a Coke (New York Post, 11/7/24).

As SEIU President April Verrett (11/15/24) explained, none of Kennedy’s pseudo-populist sloganeering can really outweigh the danger he poses if he becomes a part of state power:

SEIU members know that healthcare must be grounded in science and evidence-based medicine. Our healthcare workers put their lives on the line to protect patients during the darkest days of the pandemic, and we would have lost many more members and loved ones if it weren’t for lifesaving vaccines. We will not stand silent as an outspoken anti-vaxxer who spread misinformation about autism and widespread public health interventions is poised to take control of one of our most consequential government agencies.

‘Legitimating his extremist positions’

Beatrice Adler-Bolton: “Media have allowed this anti-science and ableist rhetoric to be normalized at a mass scale.”

Pundits in the New York Times and elsewhere taking Kennedy at his word are part of a broader problem in the media, according to Beatrice Adler-Bolton, co-host of the podcast Death Panel. Media frame his MAHA movement to sound “like a health-focused initiative,” she told FAIR in an email, but it’s actually a “platform for dangerous rhetoric and fake science that directly undermines public health research”:

By framing RFK Jr. as a semi-legitimate voice on health issues at all, not only does it bolster the credibility of the MAHA agenda, the media have allowed this anti-science and ableist rhetoric to be normalized at a mass scale, effectively legitimating his extremist positions on vaccines, climate change and chronic disease without sufficient scrutiny, right before his appointment will be up for debate in the Senate. Truly scary stuff.

Rather than critically examining his stances, mainstream outlets often frame his views as “alternative” or “controversial,” which not only normalizes them but implicitly elevates them to the level of mainstream discourse, or further bolsters his reputation among the wellness community as a class warrior/truth teller.

This is particularly problematic in the context of his potential role at HHS, where his views could directly influence policy, research and local health department budgets, drug approvals, healthcare safety guidelines, disability determinations, disease surveillance, health statistics, public health disaster and epidemic preparedness, and so much more, making the media’s soft treatment of him even more dangerous.

‘Failures of the pandemic response’

“Covid-19 attacks certain races disproportionately,” Kennedy claimed (New York Post, 7/23/23), citing this as evidence that the virus “is ethnically targeted.”

These efforts to find a silver lining in the Kennedy appointment, strenuously searching for common ground on which progressives and medical professionals can work with him, necessarily involved distorting the record in order to create a potential good-faith ally who doesn’t exist. Bedard’s piece in the Times, for example, twisted the facts in writing about the context for Kennedy’s rise:

There’s been no meaningful, public reckoning from the federal government on the successes and failures of the nation’s pandemic response. Americans dealt with a patchwork of measures—school closings, mask requirements, limits on gatherings, travel bans—with variable successes and trade-offs. Many felt pressured into accepting recently developed, rapidly tested vaccines that were often required to attend school, keep one’s job or spend time in public spaces.

The Biden administration did, in fact, reflect on the Covid pandemic to better plan for upcoming pandemics (NPR, 4/16/24; STAT, 4/16/24; PBS, 4/16/24), as scientific journals and government agencies have looked at the last pandemic to come up with planning for the future. The House Committee on Oversight and Accountability (11/14/24) recently held a hearing on the subject, and the Government Accountability Office (7/11/23) offered nearly 400 recommendations on improving pandemic planning. It might be fair to evaluate how well this effort is going, but that’s not what Bedard wrote.

And the Biden administration’s vaccine mandates were popular when they were being rolled out (Gallup, 9/24/21)—as one might expect when an effective preventive measure is introduced to combat a contagious virus killing hundreds of thousands of Americans.

Meanwhile, the fresh face that Bedard hopes will give us a meaningful reckoning, the one that the Biden administration supposedly failed to give us, endorsed a xenophobic, antisemitic conspiracy theory to explain the coronavirus (New York Post, 7/23/23): “Covid-19 is targeted to attack Caucasians and Black people. The people who are most immune are Ashkenazi Jews and Chinese.”

Bedard sanewashed this lunacy, saying that RFK Jr. “is right that vaccine mandates are a place where community safety and individual liberties collide.” “Official communication about vaccine safety can be more alienating to skeptics than reassuring,” she declared.

If someone wrote that traffic lights are a place where road safety and drivers’ liberties collide, and that traffic enforcement was alienating to red light skeptics, the Times would laugh it off. Yet the Times let a doctor give oxygen to such nonsense, even as she admitted that vaccines are only effective when an overwhelming majority of the population gets them.

Places like the Times have also published criticism of Kennedy (New York Times, 11/18/24), including a thorough look at his role in the American Samoa crisis (New York Times, 11/25/24). But corporate media have no obligation to bend the truth to offer the “other side” of an anti-vaccine extremist who is only taken seriously because his last name happens to be Kennedy.

This content originally appeared on FAIR and was authored by Ari Paul.

The Supreme Court appears poised to uphold Tennessee’s ban on gender-affirming care for transgender youth after it heard arguments Wednesday in United States v. Skrmetti. The Biden administration and the American Civil Liberties Union argued that the law, which bans hormone therapy for transgender children but not cisgender children, is a form of sex discrimination, but right-wing justices who make up the court’s majority appeared to reject that argument. ACLU lawyer Chase Strangio, who has now become the first openly transgender lawyer to argue before the Supreme Court, describes the stakes and analyzes the reactions of the justices during the landmark case, which is expected to be decided next year. “It is precisely the role of the courts to step in when the government infringes on the individual constitutional rights of minority groups,” says Strangio. “People are suffering. They just want to be able to live their lives, and this law takes those opportunities away from them.”

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

“Why is it that the issues that most of the public agrees with — healthcare, living wages, voting rights, democracy — why is it that those issues weren’t more up front?” We speak to Bishop William Barber about Joe Biden and Kamala Harris’s failed election campaigns, Donald Trump’s election as president and the urgent need to unite the poor and working class. Barber is the national co-chair of the Poor People’s Campaign, president and senior lecturer at Repairers of the Breach and a co-author of the book White Poverty: How Exposing Myths About Race and Class Can Reconstruct American Democracy. He urges the Democratic Party to recenter economic security and poverty alleviation in its platform and draws on historical setbacks for U.S. progressive policies to encourage voters to “get back up” and “continue to fight.”

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

We speak with Human Rights Watch researcher Milena Ansari about the organization’s new report detailing the torture of Palestinian medical workers in Israeli prisons. HRW spoke with eight doctors, paramedics and nurses who were picked up in Gaza before being transferred to the notorious Sde Teiman camp and other facilities, where they say they suffered beatings, starvation, humiliation, electric shocks and other forms of abuse. The men also describe threats of sexual violence during brutal interrogations and seeing another prisoner bleeding after being gang-raped with an M16 rifle by three soldiers. The findings track with other reports from researchers and survivors, and HRW has called on the International Criminal Court to investigate Israel for its attacks on healthcare workers. “We’re really ringing the alarm about the situation inside the Israeli custody and detention facilities,” says Ansari, who says evidence is mounting of a “systematic pattern of ill-treatment and abuse.”

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

On Monday, Public Citizen wrote to U.S. Health and Human Services Secretary Xavier Becerra calling on the government to facilitate generic competition using its authority under existing law. Public Citizen Access to Medicines Director Peter Maybarduk issued the following statement:

“Novo rakes while healthcare breaks. Novo’s outrageous prices force health programs to ration treatment, sacrifice services or both. Novo sells its semaglutide (GLP-1) drugs at more than 100 times the estimated production cost, and with nearly $50 billion in sales, made up its R&D costs in the last few months alone. In fact, Novo’s self-enrichment through stock buybacks and dividends more than doubles the corporation’s entire R&D investments since Ozempic’s launch.”

Separately, North Carolina State Treasurer Dale Folwell wrote to Sec. Becerra last week, urging the federal government to intervene in its unsuccessful efforts to lower GLP-1 drug prices, overcome Novo’s patent monopoly and negotiate generic entry. The Treasurer said if the State Health Plan were to continue to cover weight loss drugs, it would have to double its premiums to families of public employees. It is past time for Novo to cut prices, but Novo has refused, even though state health programs working to serve families have asked time and time again.

Since Novo will not take responsibility, the federal government must, by unlocking generic competition with Novo’s outrageously priced patented drugs.

This content originally appeared on Common Dreams and was authored by Newswire Editor.

Imagine that you’re the parent of a child who suffers from a rare mental health condition that causes anxiety, depression and suicidal ideation. Psychiatric medications and therapy do not work for this condition.

There is a treatment that has been shown to work in adults, but there’s very little research in kids, apart from a few small studies that have come out of the Netherlands, where they are prescribing these treatments. Doctors in your own country, however, won’t prescribe it until your child is 18, to avoid any unwanted side effects from the medication.

Meanwhile, your child has suffered for years, and attempted suicide multiple times. As a parent, what do you do? Do you take your kid overseas, or let them continue to suffer?

“Awareness of transgender children is growing,” the Guardian (8/13/08) reported 16 years ago.

This is precisely the situation that parents of trans kids in Britain were facing 16 years ago, when the Guardian (8/13/08) ran a story on their efforts to get the country’s Gender Identity Development Service (GIDS) to prescribe puberty blockers for their kids. The Guardian noted how grim the situation was for these kids and their parents:

Sarah believes that anyone watching a teenager go through this process would want them to have the drugs as soon as possible. Her daughter was denied them until the age of 16, by which point she already had an Adam’s apple, a deep voice and facial hair….

“It takes a long, long time to come to terms with. It took us about two years to stop crying for our loss and also for the pain that we knew our child was going to have to go through. No one would choose this. It’s too hard.”

Short-lived success

Dr. Hilary Cass told the BBC (4/20/24) that “misinformation” about her work makes her “very angry.”

After years of struggle, UK parents successfully lobbied the NHS to start prescribing gender-affirming medical treatments for minors under 16 in 2011. Their success, however, was short-lived.

In April, NHS England released the findings of a four-year inquiry into GIDS led by Dr. Hilary Cass, a pediatrician with no experience treating adolescents with gender dysphoria. On the recommendation of the Cass Review, which was highly critical of adolescent medical transition, the NHS services in England, Wales and Scotland have stopped prescribing puberty blockers for gender dysphoria. The British government also banned private clinics from prescribing them, at least temporarily.

Though there is much more evidence now to support gender-affirming care than in 2008, there is also a much stronger anti-trans movement seeking to discredit and ban such care.

British media coverage has given that movement a big boost in recent years, turning the spotlight away from the realities that trans kids and their families are facing, and pumping out stories nitpicking at the strength of the expanding evidence base for gender-affirming care. Its coverage of the Cass Review followed suit.

US media, unsurprisingly, gave less coverage to the British review, but most of the in-depth coverage followed British media’s model. Underlying this coverage are questionable claims by people with no experience treating minors with gender dysphoria, and double standards regarding the evidence for medical and alternative treatments.

More evidence, worse coverage

The most impactful—and controversial—recommendation of the Cass Review is that puberty blockers or cross-sex hormones on those under 16 should be confined to clinical research settings only, due to the supposed weakness of the studies underpinning gender-affirming treatments for minors, and the possibility of unwanted side effects:

While a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.

This stands in direct opposition to guidelines and recommendations from major medical associations, such as the American Academy of Pediatrics, the Endocrine Society and the World Professional Association of Transgender Health (WPATH), which support gender-affirming medical interventions for youth.

WPATH (5/17/24) expressed bewilderment at the Cass Review’s approach, and noted that its reviews “do not contain any new research that would contradict the recommendations” of those groups, which were updated in 2022.

So what could explain the divergence? For starters, the review took place in the context of a rising anti-trans culture in England, and the NHS took the highly unusual approach of excluding experts on pediatric gender-affirming care from the review.

At the same time, the Cass Review, and the NHS England Policy Working Group that preceded it, had clinicians on its team with ties to advocacy groups that oppose gender-affirming treatment for minors, so its bias was questioned even before the review was released. The Cass Review has been a major boon for these advocacy groups, as its recommendations are exactly what those groups have been calling for.

‘Arbitrarily assigned quality’

“It’s a bad-faith claim that we don’t have enough evidence for pubertal suppressants or gender-affirming hormones,” a Harvard Med School psychiatry professor told Mother Jones (5/10/24).

The systematic review on puberty blockers conducted by the Cass Review excluded 24 studies, with reviewers scoring this research as “low quality.” But Meredithe McNamara, assistant professor of pediatrics at Yale, told FAIR that the scale the Cass Review used to grade study quality is not typically used by guideline developers. Under this methodology, the authors excluded many studies from consideration for what she describes as “arbitrarily assigned quality.”

A recent white paper from the Yale Law School Integrity Project, co-authored by McNamara, explains the flaws more in depth:

They modified the scale in an arbitrary way that permitted the exclusion of studies from further consideration, for reasons irrelevant to clinical care. For instance, in the York SR on social transition, the modified NOS asked if study samples were “truly representative of the average child or adolescent with
gender dysphoria.” There is no such thing as the “average child or adolescent with gender dysphoria”—this is an inexpertly devised and meaningless concept that is neither defined by the authors nor used in clinical research. And yet it was grounds for excluding several important studies from consideration.

The Yale report highlights the problems that come from assigning authors who are unfamiliar with essential concepts in gender care. For example, puberty blockers are not intended to reduce gender dysphoria, but rather halt the effects of puberty. The systematic review looked at gender dysphoria reduction as a metric of the treatment’s success, however, which the Yale report says was an “inappropriate standard.”

Moreover, even studies scored as low quality by more standard scales are not uncommon in medicine, and do not mean “poor quality” (despite Cass’s slippage between the two) or “junk science.” Doctors can and do often make treatment recommendations based on evidence that is rated low quality. A 2020 study in the Journal of Clinical Epidemiology (9/2/20) found that 53% of treatments are supported by either “low quality” or “very low quality” evidence. Many commonly prescribed antidepressants, for example, have low-quality evidence for use in populations under 18—but many families decide, with the help of a doctor, that it’s still the best choice for their child.

This is why the guidelines supported by WPATH do not deviate from the norms of medical practice in recommending puberty blockers based on the large amount of evidence we do have. As with all medical treatments, WPATH recommends doctors should inform patients and their parents of the potential risks and benefits, and allow them to decide what is best. This approach aligns with evidence-based medicine’s requirement to integrate the values and preferences of the patient with the best available evidence.

‘Shaky foundations’

Of eight articles the Guardian ran on the Cass Review, only one (4/9/24) quoted any trans youth or their parents.

Cass also conducted a second systematic review on cross-sex hormones, which excluded 19 studies for being “low quality.” In spite of their exclusion, the systematic review still found “moderate quality” evidence for the mental health benefits of these treatments, a fact that Cass omits from her BMJ column (4/9/24) published concurrently with the review’s release, where she claims that pediatric gender medicine is built on “shaky foundations.”

These “shaky foundations” of “poor quality” evidence that Cass trumpeted were largely gobbled up by media, despite the criticisms of both expert groups like WPATH, and trans kids and their parents. Guardian readers almost certainly wouldn’t know that the amount of data we have on these treatments since the paper’s 2008 piece has expanded considerably: Every single one of the 103 studies on puberty blockers and cross-sex hormones for minors that the Cass Review found was published after 2008. That’s not the story that’s being told; in fact, it’s not even mentioned in the Guardian’s initial story (4/9/24) on the findings of the Cass Review, which put Cass’s “shaky foundations” quote in its headline.

That story exemplifies the problem with the frequent media scrutiny of evidence quality that is completely devoid of the circumstances under which trans youth and their parents have sought these treatments for more than a decade. In fact, these teens and their parents have been all but erased from the paper’s coverage.

The Guardian released eight stories and a podcast on the Cass Review in the first month of its coverage. Only two trans youth and one parent were quoted across these nine pieces.

Readers can’t fully understand why trans youth and their parents would seek out a treatment with “low-quality” or “moderate-quality” evidence without understanding their circumstances. And they can’t fully judge a policy decision to restrict these treatments without understanding how much more evidence we have now than we did when desperate parents were seeking them out abroad.

Same problem across the pond

WBUR‘s interviewer (5/8/24) did not challenge Cass on her nonsensical statements, such as her assertion that “let[ting] young people go through their typical puberty” is the best way to “leave their options open.”

Some US outlets have, unsurprisingly, followed the British pattern in their coverage of the Cass Review, not questioning Cass’s tendentious interpretations, and sidelining the voices of trans youth and their parents.

Boston NPR station WBUR (OnPoint, 5/8/24) aired a lengthy interview with Cass. For almost two hours, host Meghna Chakrabarti gave Cass a friendly platform to pontificate on such matters as how pornography might be causing more kids to identify as trans, without asking her to substantiate her claims:

So we looked at what we understand about the biology, but obviously biology hasn’t changed suddenly in the last 10 years. So then we tried to look at, what has changed? And one is the overall mental health of teenage girls, in particular, although boys, to some degree. And that may also be driven by social media, by early exposure to pornography, and a whole series of other factors that are happening for girls.

While Chakrabarti raised some criticisms of the Cass Review, she never pressed Cass on her answers. For instance, when the host quoted WPATH’s statement that the Cass Review would “severely restrict access to physical healthcare for gender-questioning young people,” Cass suggested that trans youth will still be able to access treatment “under proper research supervision”—yet such research has yet to be announced. Chakrabarti did not press her on when these studies will start, what the criteria for participation will be, or what parents and kids are supposed to do in the meantime. Nor did she ask how long it will take to get into a study; currently the GIDS wait times are over six years.

Cass repeatedly argued that the key for youth seeking gender-affirming care was to “keep their options open.” Yet Chakrabarti never questioned how preventing young people from accessing puberty blockers helps achieve this, even when Cass argued that trans boys shouldn’t receive hormone treatment because male hormones “cause irreversible effects.” By this logic, the Cass Review should have required all trans girls to receive puberty blockers to prevent those same “irreversible effects.” Cass’s double standard also doesn’t take into account that estrogen puberty likewise causes irreversible effects that are not fully or easily reversible, such as height, voice and breast growth.

Incredibly, Cass described decisions about these treatments as very individual ones that need to be made with patients and doctors—which happens to be what WPATH recommends, and what the Cass Review has made virtually impossible. Cass told WBUR:

And for any one person, it’s just a careful decision about balancing, whether you have arrived at your final destination in terms of understanding your identity, versus keeping those options open. And that’s a really personal decision that you have to take with your medical practitioner, with the best understanding that we can give young people about the risks versus the benefits.

Rather than asking how exactly this squares with the Cass Review recommendations that have, at least for now, shut down all NHS medical gender-affirming care, Chakrabati changed the subject.

Chakrabarti’s segment also had a second part, which could have been used to interview an expert who disagreed with Cass’s findings. Instead, she interviewed two pediatric gender clinicians—one of whom, Laura Edwards-Leeper, had been a speaker at a conference against gender-affirming care in 2023—who offered no criticism aside from the fact that requiring mental health treatment for social transition would be impractical in the US, due to a lack of national healthcare.

‘Under political duress’

“There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access,” Cass told the New York Times (5/13/24)—before adding, “under a research protocol,” even though such research has yet to be announced.

The New York Times (5/13/24), in a published interview conducted by reporter Azeen Ghorayshi, also ignored the realities facing trans kids in Britain as a result of Cass’s recommendations. Cass accused the American Academy of Pediatrics (AAP) of not being forthright about the evidence around gender-affirming treatments, and suggested its motivations are political:

I suspect that the AAP, which is an organization that does massive good for children worldwide, and I see as a fairly left-leaning organization, is fearful of making any moves that might jeopardize trans healthcare right now. And I wonder whether, if they weren’t feeling under such political duress, they would be able to be more nuanced, to say that multiple truths exist in this space—that there are children who are going to need medical treatment, and that there are other children who are going to resolve their distress in different ways.

Ghorayshi agreed with Cass, asking her how she would advise US doctors to thread this needle:

Pediatricians in the United States are in an incredibly tough position, because of the political situation here. It affects what doctors feel comfortable saying publicly. Your report is now part of that evidence that they may fear will be weaponized. What would you say to American pediatricians about how to move forward?

This entire line of questioning ignored that this issue is politicized in Britain as well. In March, former Prime Minister Liz Truss proposed a legislative ban on gender-affirming medical treatments for minors, which the government later implemented temporarily. The British government has also implemented recommendations that make social transition in schools extremely difficult. Ghorayshi could have pressed Cass on the political situation in her own country, rather than speculating on how doctors in the US are reacting to the one here.

Cass also presented the widely discredited theory that an exponential rise in the number of children and adolescents seeking gender-affirming care over the past decade is evidence of a “social contagion”:

It doesn’t really make sense to have such a dramatic increase in numbers that has been exponential. This has happened in a really narrow time frame across the world. Social acceptance just doesn’t happen that way, so dramatically. So that doesn’t make sense as the full answer.

This gigantic leap in logic goes completely without follow-up by Ghorayshi. Exponential rises can happen easily when a number is low to begin with. According to Cass’s own report, there were fewer than 50 referrals to GIDS in 2009. And while that number increased to 5,000 for 2021–22, this is 0.04% of the approximately 14 million people under the age of 18 in Britain.

Despite Cass’s claims to the contrary, these numbers could easily show that while very few adolescents were comfortable being out as trans at the outset of the 2010s, increased social acceptance has made that possible for more of them. Ghorayshi, however, does not press her to show any evidence for her highly unscientific theory.

The therapy trap

A BBC report (5/7/24) cited Cass suggesting “‘evidence based’ treatment such as psychological support” as an alternative to puberty blockers, even though her review found no studies showing psychotherapy as an effective treatment for gender dysphoria.

One of the underlying problems with the Cass Review is that where it (dubiously) claims that medical interventions are not supported by evidence, it pushes psychotherapy as an effective treatment for gender dysphoria—with even less evidence. Most media have blindly accepted this contradiction.

In an article headlined “Cass Review Author Calls for ‘Holistic’ Gender Care,” the BBC (5/7/24) reported on Cass’s claim to the Scottish parliament implying psychotherapy and “medications” are “evidence-based” ways to treat gender-dysphoric children.

However, she told MSPs a drawback of puberty blockers, which she said had become “almost totemic” as the route to get on to a treatment pathway, was they stopped an examination of other ways of addressing young people’s distress—including “evidence-based” treatment such as psychological support or medication.

The BBC did not interrogate this claim. This is especially egregious in light of the fact that Cass’s own systematic review found no studies that show psychotherapy is an effective means of improving gender dysphoria. Moreover, it deemed nine of the ten studies of psychosocial support “low quality.”

Dan Karasic, a psychiatrist who has worked with patients with gender dysphoria for over 30 years, and an author on WPATH’s current treatment guidelines, told FAIR that there’s no evidence for her claim that psychiatric medications could be effective either:

There is absolutely no evidence to support Dr. Cass’s suggestion to substitute antidepressants for puberty blockers. It’s telling that Cass suggests an intervention utterly devoid of any evidence—antidepressants for gender dysphoria—over established treatments.

‘Alternative approaches’

The Washington Post (4/18/24) featured an op-ed criticizing the “poor quality of evidence in support of medical interventions for youth gender dysphoria”—by someone pushing evidence-free psychotherapy treatment for youth gender dysphoria.

The Washington Post (4/18/24) accepted this same fallacy when it published an op-ed on the Cass Review by Paul Garcia-Ryan. Garcia-Ryan is the president of the organization Therapy First, which supports psychotherapy as the “first-line” treatment for gender dysphoria. Garcia wrote that in light of the Cass Review’s findings on the evidence behind gender-affirming treatments, psychotherapy needed to be encouraged:

The Cass Review made clear that the evidence supporting medical interventions in youth gender dysphoria is utterly insufficient, and that alternative approaches, such as psychotherapy, need to be encouraged. Only then will gender-questioning youth be able to get the help they need to navigate their distress.

Garcia-Ryan provides no evidence that psychotherapy is an effective alternative to the current treatment model that he is criticizing—which is no surprise, given the Cass Review’s findings. This is especially disturbing, given that his organization has published “clinical guidelines” for treating “gender-questioning” youth.

One of the case studies in the Therapy First’s guidelines involved an adolescent struggling with gender dysphoria, who described their family situation—where they don’t “feel understood and supported,” and their parents “don’t think trans exists”—to a therapist. The therapist then hypothesized that the gender dysphoria may be caused by an “oedipal process,” a subconscious infatuation with the father that the child “dealt with…by repudiating her femininity and her female-sexed body.”

Op-ed pages certainly exist to represent a diversity of viewpoints. But opinion editors have a duty to not let them be used for blatant misinformation. Though Garcia-Ryan protests that Therapy First is “strongly opposed to conversion therapy,” the sort of psychoanalysis he champions has a long, dark history of being used in conversion therapy. The American Psychoanalytic Association did not depathologize homosexuality until nearly 20 years after the American Psychiatric Association did.

‘Notably silent’

The Washington Post (5/3/24) ran another pro-Cass op-ed from Benjamin Ryan, who it described as “covering LGBTQ health for over two decades”; it didn’t mention that much of that coverage has been in right-wing publications like the New York Sun and New York Post.

Rather than publishing any op-eds critical of the Cass Review for balance, the Washington Post (5/3/24) added a second op-ed a week later by freelance journalist Benjamin Ryan, who has recently published several pieces on trans issues for the conservative New York Sun and New York Post. Ryan criticized the American Psychiatric Association (APA) for being “notably silent” on Cass’s findings, and citing the fact that the only panel at its 2024 conference contained supporters of gender transition:

The program for the 2024 APA annual meeting lists only one panel that touches on pediatric gender-transition treatment, titled “Channeling Your Passion and ‘Inner Outrage’ by Promoting Public Policy for Evidence-Based Transgender Care.”

The panel notably includes Jack Turban, a University of California at San Francisco child psychiatrist and a vocal supporter of broad access to gender-transition treatment.

A letter to the editor in the Washington Post (5/10/24) noted that abstracts for the APA were due before the final Cass Review was published, so it would not have been possible to submit a panel examining its findings. This is something the Post could have easily factchecked.

In the US, gender-affirming care bans for minors have taken place amongst a similar backdrop of relentless media assault, based on similarly poor sources (FAIR.org, 8/30/23) and bad interpretations of data (FAIR.org, 6/22/23). The coverage of the Cass Review shows just how much US media have taken their cues from the Brits.

Research assistance: Alefiya Presswala, Owen Schacht

This content originally appeared on FAIR and was authored by Lexi Koren.

Reuters (6/14/24) reported that the US military was behind social media messages like ““COVID came from China and the VACCINE also came from China, don’t trust China!”

Canada-based news agency Reuters (6/14/24) revealed that the Pentagon, beginning in spring 2020, carried out a year-long anti-vax messaging campaign on social media. Reuters reported that the purpose of the clandestine psychological operation was to discredit China’s pandemic relief efforts across Southeast and Central Asia, as well as in parts of the Middle East.

“We weren’t looking at this from a public health perspective,” a “senior military officer involved in the program” told Reuters. “We were looking at how we could drag China through the mud.”

The Reuters report straightforwardly implicated the US military in a lethal propaganda operation targeting vulnerable populations, centrally including the Filipino public, to the end of scoring geostrategic points against China:

To Washington’s alarm, China’s offers of assistance were tilting the geopolitical playing field across the developing world, including in the Philippines, where the government faced upwards of 100,000 infections in the early months of the pandemic.

The findings were unequivocal. In conjunction with private contractors, the US military created and employed fake social media profiles across popular platforms in multiple countries in order to sow doubt, not only about China’s Sinovac immunization, but also about the country’s humanitarian motivations with respect to their dispersal of pandemic-related aid. The news agency quoted “a senior US military officer directly involved in the campaign in Southeast Asia”:  “We didn’t do a good job sharing vaccines with partners…. So what was left to us was to throw shade on China’s.”

Failure to pounce

This New York Times headline (7/3/24), pointedly critical of the Pentagon’s anti-vaccine disinformation, did not appear in the Times newspaper, but only in a subscriber-only newsletter.

One might be forgiven for assuming that US news media editors would pounce on the fact that the most powerful institution in the US, and quite possibly the world, promulgated anti-vax material on social media over the course of a year. However, nearly a month later, the Wall Street Journal, Washington Post, Politico, CNN and MSNBC have yet to cover the news.

The New York Times, which has consistently covered anti-vaccine disinformation (7/24/21, 8/1/21, 12/28/22, 3/16/24) and extremism (3/26/21, 4/5/21, 8/31/21, 6/14/24), has yet to cover the Pentagon’s unparalleled anti-vax indoctrination efforts in its news section; it ran one subscriber-only newsletter opinion piece (7/3/24) on the story nearly three weeks after Reuters‘ revelations.

Meanwhile, independent (Common Dreams, 6/14/24; WSWS, 6/16/24) and international sources (Al Jazeera, 6/14/24; South China Morning Post,  6/16/24, 6/17/24, 6/18/24) immediately relayed the revelations.

‘Amplifying the contagion’

Given the Times’ track record in the fight against vaccine disinformation, one might expect to see that paper in particular give this blockbuster news front-page status. After all, the Pentagon was busy secretly inculcating anti-vax attitudes in its targets when Neil MacFarquhar of the Times (3/26/21) warned that “extremist organizations are now bashing the safety and efficacy of coronavirus vaccines in an effort to try to undermine the government.”

In a New York Times Magazine thinkpiece (5/25/22), Moises Velasquez-Manoff took stock of the “nightmarish and bizarre” conspiratorial “skullduggery swirling around vaccines”:

The process of swaying people with messaging that questions vaccines is how disinformation—deliberately fabricated falsehoods and half-truths—becomes misinformation, or incorrect information passed along unwittingly. Motivated by the best intentions, these people nonetheless end up amplifying the contagion, and the damaging impact, of half-truths and distortions.

Anxiety and doubt around immunizations, readers were told, “may be seeping into their relationship with medical science—or governmental mandates—in general.”

Surely this line of reasoning applies as much if not more so to the Pentagon’s anti-vaccine propaganda offensive in Asia and the Middle East: The US military’s own skullduggery has primed countless victims around the world to be more skeptical of medical technology in general.

Even if Americans weren’t targeted by the Pentagon’s scheme, their tax dollars were employed to materially endanger people throughout Asia and the Middle East, and to undermine public health mandates in general. And in the midst of a global pandemic, infections anywhere threaten peoples’ lives everywhere. But the threat of anti-vax disinformation is apparently not a high priority for the establishment press if the US military is implicated.

In keeping with a rich history of obsequious editorial decision-making when it comes to the Pentagon’s activities abroad, this remarkable lack of attention on the part of the Times and the rest of the corporate US press serves as yet another example of corporate media’s timorous attitude towards structural power in this country.

This content originally appeared on FAIR and was authored by Tyler Poisson.

Janine Jackson interviewed professor and Physicians for a National Health Program co-founder David Himmelstein about the problems with Medicare Advantage for the June 28, 2024 episode of CounterSpin. This is a lightly edited transcript.

Common Dreams (6/10/24)

Janine Jackson: For decades, people in this country have been suffering and dying due to the cost of healthcare, while public majorities have been saying they want a different system. For decades, US corporations and their political and media megaphones have been telling us that, yes, things as they are are difficult, but a more humane universal healthcare policy is just not possible, not because the policies that would allow doctors to provide the care they deem appropriate, and people to receive that care without going bankrupt, aren’t logistically doable—they are, after all, done in other countries—but because they are not, as the New York Times has repeatedly phrased it, “politically viable.”

So while you’ve likely heard about people choosing between rent and healthcare, and about people rationing their medications, and you have never once heard of people marching in the street chanting, “What do we want? Managed competition! When do we want it? Now!”—here we still are.

The latest gambit is Medicare Advantage, the private sector “alternative” to traditional Medicare in which currently more than half of the eligible Medicare population is enrolled. We were told it would encourage insurers to provide better care at lower cost. New research says, nope, that’s not what’s happening.

Here to help us understand is David Himmelstein, co-author of the new analysis, “Less Care at Higher Cost: The Medicare Advantage Paradox,” appearing in JAMA Internal Medicine. He teaches at Hunter College and Harvard Medical School. He’s a researcher at Public Citizen and co-founder of Physicians for a National Health Program. He joins us now by phone from upstate New York. Welcome to CounterSpin, David Himmelstein.

David Himmelstein: Thanks for having me.

JJ: So the concept of Medicare Advantage is that insurance companies get a lump sum for each patient, the amount of which depends on the person’s health, and it was presented as a way to bring down out-of-pocket costs while also still providing better care. The analysis that you have just carried out showed that that is not at all what’s happening. Talk us through what you found.

David Himmelstein: “The private insurance companies have ripped off taxpayers to the tune of more than half a trillion dollars.”

DH: What we found is that the taxpayers are overpaying these Medicare Advantage private plans by tens of billions of dollars each year. In fact, $82 billion last year alone, and $612 billion since 2007. That’s overpayments compared to what it would have cost to cover those same people in the old public Medicare program. So, in effect, the private insurance companies have ripped off taxpayers to the tune of more than half a trillion dollars, and most of that goes to either their bottom line, or to the paperwork that they carry out to realize those profits. In fact, 97% of the total overpayment stayed with the insurance companies. Only 3% went to the perks that they offer to entice people to enroll in their plans rather than staying in traditional Medicare.

JJ: When you say overpayments, what are the mechanisms of that? How is that working?

DH: The plans really trick the system in a couple of ways. One is that they seek out healthy, low-cost enrollees who are going to be inexpensive for them to cover. So they get the lump sum payment from the Medicare program, but the insurance company doesn’t actually need to pay for care. In fact, for 19% of Medicare enrollees, they cost nothing in the course of a year. So when an insurance company enrolls them, they get something like $10,000 or $12,000 a year, and they pay for no care at all. So that’s one thing—enroll healthy and inexpensive people and avoid sick ones.

The second is: make your benefits tailored to be unpleasant and unsustainable for people who are sick and expensive. So don’t approve rehab care, which Medicare traditional pays for, but the Medicare Advantage plans usually don’t. So if someone needs that rehab care, they’re really pushed to choose to go back to traditional Medicare.

And the third way is by inflating the amount Medicare pays them by making the people who enroll in the Medicare Advantage plans and those private plans look sicker on paper, and that increases how much Medicare pays, but in many cases doesn’t actually increase what it costs the plans to cover them. So they’ve leaned heavily on doctors to, say, add as many diagnoses as you can, even if they don’t cost anything, or don’t imply the need for more care. And, over the years, they’ve also taken to sending nurses into enrollees’ homes, not to help them out, but to try and discover additional diagnoses that could up the payment.

So they avoid the sick, they try and evict the sick once they are sick, and they make people look sicker in order to increase the payment they get from Medicare. And those things together result in what the official Medicare Payment Advisory Commission—so this is the non-partisan commission that advises Congress—they said it costs 22% more to cover a patient under Medicare Advantage than it would’ve cost to cover them under traditional Medicare. And as I said, that’s an $83 billion difference last year alone.

JJ: And you have mentioned taxpayers, and I just want to underscore it, the harms here are not just to the enrollees who are having inflated diagnoses, and then not necessarily getting the care they need, but the harms are even to those who are not enrolled in these plans, right?

DH: Absolutely. I mean, as taxpayers, we’re all paying for it. And the tragedy is, Medicare needs improvement. Medicare enrollees are saddled with high copayments and deductibles, and a lot of services that aren’t adequately covered, like dental care and eyeglasses. And if we took that $600-plus billion that’s been really thrown away in overpayments to Medicare Advantage plans, we could upgrade Medicare coverage for all enrollees, and the taxpayers wouldn’t be paying any more. But at this point, the taxpayers are being ripped off, and Medicare enrollees aren’t getting what they need.

JJ: Let me just extend you from there. What are the recommendations that come out of this research? What can people be calling for?

DH: We’re 40 years into this experiment with privatizing Medicare, the Medicare Advantage program. And what we conclude in this analysis is, it’s time to end that experiment. If we had a 40-year failing experiment on any drug, we’d say, take that drug off the market. It’s time to take Medicare Advantage off the market, and to use the money that we’ve been overpaying them to upgrade coverage for Medicare recipients overall.

We need to go further than that. We need a single-payer, Medicare for All, upgraded system for all Americans. And, frankly, we could save huge amounts on the insurance middlemen, not just in Medicare, but in other sectors as well. I mean, for people with private insurance, they’re being ripped off for the overhead of the private insurers and the vast profits they make. So the immediate call is, let’s abolish Medicare Advantage and upgrade Medicare for seniors. But the longer term call is, let’s move everybody into an upgraded Medicare for All program.

JJ: Just, finally, the phrase “not politically viable” doesn’t leave my head, because it’s corporate news media telling the people to cut our hopes and needs to fit the desires of wealthy companies, which of course is not how some of us define politics. But time and again, people show that they are not too dumb to understand how a single-payer system would work, despite years of misinformation around it. People still, in majorities, call for it. And I guess I wish media would listen to people about solutions, and not just catalog the harms of the current system. Do you have any thoughts about what journalism and journalists could do to move us forward on this?

DH: Well, they need to go beyond the talking points that are supplied by the insurance industry and the rest of the people making huge profits off of our healthcare system–the drug companies, and many of the hospitals, and, frankly, the higher-paid doctors as well. So we need to have a rational system, and the news media needs to actually portray the—I would call them crimes that are being perpetrated on the American people, and not say, “we can’t do better;” we know we can do better–and actually have the in-depth reporting on why it is that a reform could and would work in this country.

JJ: All right, then. We’ve been speaking with David Himmelstein, and you can access the analysis we’ve been talking about through JAMANetwork.com. David Himmelstein, thank you so much for joining us this week on CounterSpin.

DH: Thanks again for having me.

This content originally appeared on FAIR and was authored by Janine Jackson.

Common Dreams (6/10/24)

This week on CounterSpin: Headlined “The Cash Monster Was Insatiable,” a 2022 New York Times piece reported insurance companies gaming Medicare Advantage, presented as a “low-cost” alternative to traditional Medicare. One company pressed doctors to add additional illnesses to the records of patients they hadn’t seen for weeks: Dig up enough new diagnoses, and you could win a bottle of champagne. Some companies cherry-picked healthier seniors for enrollment with cynical tricks like locating their offices up flights of stairs.

Such maneuvers don’t lead to good health outcomes, but they serve the real goal: netting private insurers more money. There is now new research on the problem, and the response. We hear from David Himmelstein, co-founder of Physicians for a National Health Program and co-author of this new analysis of Medicare Advantage.

(CC photo: Jim Naureckas)

Also on the show: You may get the impression from media that marijuana is legal everywhere now, that it’s moved from blight to business, if you will. It’s not as simple as that, and many people harmed by decades of criminalization have yet to see any benefit from decriminalization. Tauhid Chappell has tracked the issue for years now; he teaches the country’s first graduate-level course on equity movements in the cannabis industry, at Thomas Jefferson University. We’ll get an update from him.

Plus Janine Jackson takes a quick look at recent press coverage of Julian Assange.

This content originally appeared on FAIR and was authored by CounterSpin.

On the first day of Black History Month, we take a look at how racism shapes healthcare in America. We speak with Dr. Uché Blackstock about her new book, Legacy: A Black Physician Reckons with Racism in Medicine. The instant New York Times best-selling book tells her family’s story through multiple generations of Black women physicians while revealing the history of racism that created today’s disparities in medical training and treatment in America. “I use my mother’s story and my story to really emphasize how deeply embedded systemic racism is in our country, in the past and in the present,” says Blackstock. “There is nothing biologically wrong with Black people … but there is something very wrong with the social institutions, not just healthcare, within our country that are deeply embedded with bias and racism.”

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

A year ago, I returned to journalism after 26 years working in the labor movement. The most surprising aspect of the job change has been discovering how many healthcare stories are nearly indistinguishable from those written or broadcast 10, 20 or 30 years ago.

Like many healthcare investigative reports, this Atlantic story (12/22) focuses on a problem that was identified decades ago (Healthcare Financing Review, Fall/93).

The recent avalanche of medical debt coverage (FAIR.org, 5/8/23) simply rehashes 20-year-old award-winning coverage. Many other issues that consume media attention—facility fees (News and Observer, 12/16/12; Axios, 4/7/23), overpayments to private insurers by Medicare (Healthcare Financing Review, Fall/93; Atlantic, 12/22), Wall Street exploitation of physician practices (Fortune, 6/21/99; Bloomberg, 5/20/20)—are presented as shocking recent scandals, when they’re not.

Private health insurance is a 90-year-old failed social experiment. Media coverage of it has been failing for nearly as long, primarily because of an unwillingness to bluntly dismiss meaningless policy solutions.

The fragmented, money-driven US healthcare industry keeps itself in power and profit by exploiting dozens of lucrative regulatory and market loopholes. They let politicians wet their beaks in the resulting spoils, through campaign contributions, feel-good attendance at a constant stream of industry-sponsored media events and conferences, and the promise of lucrative jobs on the other side of the revolving door. The politicians then spend lots of time furrowing their brows about particular narrow loopholes and proposing unenforceable regulatory tweaks for them. The net result is to legitimize the underlying system as functional.

Key academic and think tank sources for reporters and pundits grind out hundreds of thousands of words and powerpoint slides every year about particular abuses, the details of which make for shocking reading or viewing. The experts earnestly propose the minor regulatory tweaks that politicians want to spend time on.

When enacted, after years of study and debate, those tweaks rarely make a difference. When they do, the industry simply picks up the other dozen tools at its disposal to maim, kill and steal from us.

Most healthcare outrages follow an easily recognizable pattern. Public exposure of an abuse is met with consumer notice and complaint-driven regulations, followed years later by recognition that those regulations had failed, and abolition of the narrow “problem.” By which time, of course, several new, egregious corporate behaviors will have captured the attention of the public and policymakers, starting the cycle over again.

This endless cycle is essential to the preservation of the most deadly and wasteful healthcare financing system among the world’s wealthy nations. It’s why, as FAIR (5/8/23) reported last year, if we continue on the path of incremental “progress” begun by the Affordable Care Act, Americans can expect everyone to have health insurance that covers our medical needs without the threat of bankruptcy in about 500 years.

Cut your healthcare reading time

Stat (3/13/23) sounds the alarm that denial of needed medical care to seniors may be done by computers rather than by bureaucrats.

FAIR readers spend a lot of time consuming media. As a public service, we’ve compiled a few tips on how best to absorb media reporting on healthcare issues. If you follow these rules, you can cut the amount of time you spend reading healthcare coverage, and more clearly identify the issues that matter.

1. Assume the problem is at least 20 years old: We’ve suffered four years of hysteria about private equity firms “taking over” US healthcare. When it comes to acute care hospitals and physician practices, it’s bunk (FAIR.org, 1/16/24). The current wave of private equity purchases of physician practices is indistinguishable from a similar Wall Street buyout boom in the late 1990s. Then as now, it collapsed in a wave of bankruptcies. The big winners, then as now, are the big “charitable” hospital systems affiliated with churches and universities that dominate healthcare.

Congress may pass, eventually, private equity transparency laws. Those laws will be useless when Wall Street lawyers create some other corporate structure to use for looting medicine a decade or two from now, once doctors have forgotten how lousy their lives became the last time Wall Street came knocking. There’s nothing new under the corporate-theft sun.

2. Ignore technology, whether panic or hype: The latest example of the cycle is “OMG Medicare Advantage AI!.” According to widespread reporting, private insurance companies are now using AI to illegally deny claims for Medicare patients, triggering a series of lawsuits (Stat, 3/13/23; Axios, 12/13/23).

Yeah, and? For over 50 years, privatized Medicare managed care—stretching back decades before the current “Medicare Advantage” brand—has cost the government hundreds of billions of dollars (American Prospect, 1/24/22), and denied claims to ensure their profits. Why should patients care whether insurers kill them with AI or by having underpaid, medically illiterate bureaucrats pull requests for prior authorization off of the last fax machines in the country and deny claims? How about just stopping the mass killing?

The same holds true for breathless speculation about AI transforming medical practice for the better (e.g., Business Insider, 12/23/23; Orlando Business Journal, 12/14/23; Axios, 1/2/24). Fifteen years ago, electronic medical records promised to give doctors seamless access to coordinate care across specialties. That fantasy quickly crashed against the realities of the fragmented corporate control of US healthcare. After hundreds of billions of dollars in subsidies, and hundreds of billions more in software installation and management contracts—further subsidized by tax exemptions when “nonprofit” hospitals are buying the medical records software—the primary result of electronic medical records has been to add administrative work and accelerate physician burnout, according to a review of an extensive body of academic literature (BMJ Open, 8/19/22).

Unless the technology in a story is a specific advance in surgical or diagnostic technique, or is used to further exploit healthcare workers, it can safely be ignored.

3. Skip the last two paragraphs: Most stories about problems with healthcare financing end with comically inadequate suggestions for policy responses. From focusing on hospital charity care instead of universal health insurance (KFF, 11/3/22), to restrictions on facility fees (Fox31 Colorado, 2/22/23) or private equity transparency and restrictions on arcane real estate deals (Atlantic, 10/28/23), healthcare media specialize in identifying non-solutions to the ongoing crises of un- and under-insurance, extreme costs and systemic inequity. For the moment, you can safely skip the last two paragraphs of an exposé, and assume that reporters are chronicling the latest stream of squid ink from their political sources. When the headlines and leads change to “Politicians Still Wasting Time on Distractions so the Healthcare Industry Can Continue Looting,” it may be worth starting to read to the end again.

Giving the game away

A congressional letter (11/3/23) to the Biden administration asked for a multiyear study of one aspect of a problem identified at least 17 years ago.

A recent letter to the Biden administration from 26 Democratic House members offers a clear example of this persistent mismatch between problems and proposed solutions. The administration was finalizing rules governing Medicare Advantage, and the letter signers expressed concern “that the new rule might not adequately address MA plans’ increased reliance on artificial intelligence (AI) or algorithmic software to guide their coverage decisions.”

They urged the Biden administration to study (“assess”) the guidance generated for insurance decisions by AI tools compared to third-party clinical guides, and the extent to which AI tools adjust their algorithms based on successful patient appeals or changes in patients’ conditions. They added that insurers should be required to report data on prior authorizations, and promise (“attest”) that their coverage guidelines aren’t more restrictive than traditional Medicare.

The letter’s second paragraph gives the game away. It cites a report by the Department of Health and Human Services inspector general that found “widespread and persistent problems related to denials of care and payment in Medicare Advantage.” According to the report, MA plans’ own internal appeals processes overturned 75% of claims denials, which “raises concerns that some Medicare Advantage beneficiaries and providers were initially denied services and payments that should have been provided.”

The OIG report is six years old. It cites a 2007 review that found similar results. So the authors asked for a multiyear data and analysis project that would examine only one of several techniques used by Medicare Advantage insurers to refuse to pay for healthcare, a problem identified at least 17 years ago.

Covered with a straight face

Common Dreams (11/3/23) covered the congressional request to change the name of the program that allows private insurers to loot Medicare.

This is all covered with a straight face, even in some alternative news outlets. In a story on the letter, Common Dreams (11/3/23) noted that Progressive Caucus members Mark Pocan (D-Wisc.), Ro Khanna (D-Calif.) and Jan Schakowsky (D-Ill.) have proposed renaming Medicare Advantage the “alternative private health plan.”

The move defies satire. Medicare Advantage is at least the fourth name for private Medicare managed care in 50 years (“risk contracting,” “Medicare+Choice,” “Medicare Part C”). Each name change erases the program’s track record of failure and abuse.

The letter’s signers don’t even dare propose just getting rid of AI in Medicare Advantage coverage decisions, never mind abolishing Medicare Advantage altogether and fully funding original Medicare so that elderly and disabled Americans will actually have decent insurance coverage (Healing and Stealing, 10/11/23). Common Dreams failed to note this, or to remark on the obvious political reason for the timidity.

The leadership of both political parties is committed to allowing private insurers to loot Medicare. It’s an election year, and Democratic politicians don’t want to embarrass their White House leader by mentioning this fact. So readers are left with a report on how private insurers are abusing patients, met by actions by political figures that simply kick the can down the road for years of “study.”

Watching Congress and the administration waltz to the tune of regulating the use of AI by Medicare Advantage contractors may hold a perverse fascination, like a good horror movie. But it’s part of a cycle of useless reform that keeps advocates and politicians on the five-century slog to universal coverage. Media should stop enabling this phenomenon.

The post Skip the Last Two Paragraphs—and Other Time-Saving Tips for Healthcare News Consumers appeared first on FAIR.

This content originally appeared on FAIR and was authored by John Canham-Clyne.

If you get healthcare news from major media outlets, the industry press or even medical journals, you might conclude that private equity investors are “taking over” US healthcare. But when it comes to hospitals and doctors, you’d be wrong.

Intense media coverage of the small part of the healthcare system owned by private equity focuses public attention on policies that won’t affect the twin crises of access and out-of-control costs (NBC, 5/13/20).

Many reporters and researchers have mistaken an episodic cycle of cynical profit-taking as a “takeover.” The reporting focuses public attention away from the power of hospital chains affiliated with universities and churches, which employ far more doctors than private equity, and the US’s refusal to exert political control of the medical industry to rein in costs and cover everyone.

One of the widely reported “abuses” by private equity–owned providers—“surprise bills” for doctors’ care delivered in hospitals— is simply the exercise of the market forces that are supposed to control costs and expand coverage, but have been failing for a half century.

US media have been in private equity panic mode for several years now. An early entrant informed the American Prospect’s readers “How Private Equity Makes You Sicker” (10/7/19). Time (7/31/23) asked readers, “What Happens When Private Equity Buys Your Doctor’s Office?”; the New York Times (7/10/23) phrased the question as “Who Employs Your Doctor? Increasingly, It’s a Private Equity Firm.” NBC (5/13/20) reported, “Private Equity Firms Now Control Many Hospitals, ERs and Nursing Homes,” and asked, “Is It Good for Healthcare?”

KFF Health News is in the midst of a series called “Patients for Profit: How Private Equity Hijacked Healthcare.” Bloomberg (5/20/20), Common Dreams (11/29/22), Public Citizen (3/21/23), Atlantic (10/28/23), NPR (11/7/23) and a host of others have weighed in.

A bad idea

Profit-focused healthcare is a bad idea, and private equity–controlled companies have outsized influence on nursing homes and specialty hospitals, where patients are held for a long time. There is evidence that private equity–owned nursing homes kill even more patients than the rest of that chronically underfunded and understaffed industry.

But when it comes to general acute care hospitals and physician services, the degree of private equity control has been exaggerated, often with sloppy academic research. Private equity firms employ far fewer doctors than hospitals and insurance companies do, own less than 5% of general acute care hospitals, and are showing signs of exiting these segments of healthcare.

“Private equity” is just one of many vehicles for private investment. (See “What Is ‘Private Equity,’ Anyway?”) Presenting a particular corporate structure as uniquely destructive ignores the history of boom-and-bust cycles of Wall Street investment in hospitals and doctors, and confuses readers about the ultimate winners.

The unfortunate outcome of this misunderstanding is that most media analysis promotes policy changes that apply only to private equity—like increased transparency from private equity firms, limits on some abusive real estate transactions, and post-acquisition restrictions on staffing cuts. These will do nothing to restrain extreme US healthcare costs, to expand access to healthcare or to stop actors with different corporate structures from engaging in the same abusive behavior.

Let’s do it again

This Bloomberg piece (5/20/20) about “how private equity is ruining healthcare” has an anecdote about toilet paper shortages that could have come from a story about how Wall Street-backed firms were ruining healthcare two decades earlier (Fortune, 6/21/99).

The current private equity investment boom in physician practices differs little from the late 1990s, when Wall Street–backed physician practice management companies (PPMs) bought doctors’ practices by the hundreds, and then collapsed in a wave of bankruptcies. Those acquisitions were made not by private equity–controlled entities, but by companies whose stock traded openly on markets like the New York Stock Exchange and NASDAQ, known as “publicly traded” companies.

Media narratives about doctors’ experiences in the earlier Wall Street dive into medicine are nearly identical to current private equity reporting. Doctors start off hoping well-capitalized firms will bring administrative efficiency and growth, while allowing them to focus on patients. They end with unsustainable debt, bankruptcy, fraud and extreme corporate cost-cutting. Two decades apart, Fortune and Bloomberg reported identical iconic toilet paper shortfalls under lurid headlines:

As the top administrator at the 120-doctor Diagnostic Clinic in the Tampa Bay area, Robert Dippong had $250,000 in spending authority before his group became part of MedPartners in 1996. The day after the purchase, he recalls, “I couldn’t even buy toilet paper.”

—”Vulgarians at the Gate: How Ego, Greed and Envy Turned MedPartners From a Hot Stock Into a Wall Street Fiasco” (Fortune, 6/21/99)

A doctor at Advanced Dermatology says that waiting for corporate approvals means his office is routinely left without enough gauze, antiseptic solution and toilet paper.

—“How Private Equity Is Ruining American Healthcare” (Bloomberg, 5/20/20)

When the dust settled in 1999, there were two big winners in the US acute healthcare system: large tax-exempt “charitable” hospital systems, and hospital companies whose stock is sold openly on Wall Street. Not only have these players consolidated their power by acquiring smaller, financially weaker hospitals, they spent the last two decades buying up physician practices, thanks in part to the efforts of the George W. Bush and Obama administrations.

Shortly after the Wall Street–backed PPM industry imploded, the George W. Bush administration issued new Medicare payment regulations that allowed doctors employed by hospitals to charge more than traditional private practices (Federal Register, 8/1/02). Treatment in a doctor’s office is paid on a different schedule than the same treatment at a hospital’s outpatient department. The 2002 rules legally transformed doctors’ offices, miles away from a hospital’s campus, into a wing of its outpatient department. These changes allowed hospitals to add large “facility fees” on top of fees for doctors’ services, creating a big incentive for hospitals to buy doctors out.

The News and Observer (12/16/12) ran a Pulitzer-finalist series more than ten years ago describing how this process socked patients with large unexpected bills, as Duke University Medical Center and UNC Health bought up doctors across North Carolina. (More on facility fees at Healing and Stealing—10/21/23.)

Corporate consolidation of physician practices accelerated in 2009, when President Barack Obama signed a law requiring a shift to electronic medical records, which created new requirements for capital investment by physicians. Heavily endowed tax-exempt hospital chains and publicly traded hospital corporations were happy to help with those investments—in exchange for ownership or control of a practice.

Who doctors really work for

While there are, as the New York Times (7/10/23) noted, some markets where private equity–backed physician practices have monopoly power, 72% of all US metropolitan areas have no meaningful private equity market power, and often face physician monopolies owned by nonprofit hospitals.

A widely reported April 2022 study—prepared by healthcare consultants Avalere for the Physicians Advocacy Institute (4/22), a nonprofit founded with money from settlements of class action lawsuits by doctors against insurance companies—found that nearly 70% of doctors are now employees, not owners of their practices.

And who employs them? Hospitals, mostly. According to the study data, 70% of doctors who are employees—52% of all US doctors—are employed by hospital systems. The remaining 30% of employed doctors—22% of all US doctors—are employed by “other corporate entities,” which “include health insurers, private equity firms, umbrella corporate entities that own multiple physician practices, etc.”

Private equity employers are only a slice of that remaining pie. Becker’s Payer Issues (2/16/23), a health insurance industry trade newsletter, reported last February that the largest employer of physicians in the US is health insurance giant UnitedHealth Group, with 70,000 “employed or aligned” physicians. Nine months later, the company disclosed that the number of “employed or affiliated” doctors had jumped to 90,000 (Becker’s Hospital Review, 11/29/23).

“Aligned” and “affiliated” doctors are not necessarily direct UnitedHealth employees, but insurers and major drug store chains account for a large chunk of doctors employed by “other corporate entities” (New York Times, 5/12/23).

The research on the private equity “takeover” of physician practices reveals the relatively small industrial power of those firms. A study by nonprofit and UC/Berkeley researchers warned that in 28% of US metropolitan statistical areas (MSAs), a single private equity firm had gained 30% market share in at least one of 10 specialties, and in 13%, a single firm had gained 50% market share in at least one specialty. The study was reported widely in the business press, and formed the basis for a major New York Times story (7/10/23).

Looking through the other end of the telescope, 72% of all US metropolitan areas have no meaningful private equity market power in any specialty at all. Many of the MSAs threatened by private equity are far smaller than nearby areas facing monopoly threats from university- and church-affiliated hospitals.

The Johnstown, Pennsylvania, MSA has 129,000 people. Johnstown has a PE firm with 50% market share in at least one specialty. Seventy miles away, the Pittsburgh MSA, with 2.3 million people, does not. What Pittsburgh does have is the headquarters of the tax-exempt University of Pittsburgh–affiliated UPMC health system, which generated $26 billion in revenue last year, and sits atop $23 billion in assets. UPMC has recently been the subject of antitrust scrutiny from state and federal legislators (WPXI, 1/19/23) and employs more than 5,000 doctors.

Falling off the same cliff

Even as the “takeover” drumbeat reached a crescendo, Envision Healthcare, the largest private equity–owned physician practice in the US, declared bankruptcy last May (Stat, 5/15/23).

In a dissection of the 1990s’ PPM crash, the late Princeton economist Uwe Reinhardt (Health Affairs, 1–2/00) pointed out how the value of the PPM companies’ stock depended on a constant growth that was obviously impossible to sustain.

The companies first paid for practices with cash and stock trades. Since, beyond skimping on toilet paper, there are few “efficiencies” from owning practices in different regions, the cash soon ran out, and companies borrowed money to keep the buying spree going. That, wrote Reinhardt, “can spell disaster in periods of revenue downturns,” as the cost of paying back loans exceeds incoming profits. PPMs wound up on a fast track to bankruptcy court.

The PE investment wave has also loaded practices with debt, and is falling off the same cliff, as conditions that prompted firms to buy doctors’ practices have changed.

Decades of US policy have encouraged nearly all US health plans to use administrative rules and financial coercion to strip patients of the ability to choose their doctors and hospitals (KFF Employer Health Benefits Survey, 2023). Limiting choice to contracted physician and hospital “networks” is supposed to save money, as insurers pay providers discounted rates in exchange for higher patient volume. As cost control, it has been failing for 50 years, but as an economic opportunity for financial manipulators, it works wonders.

Emergency medicine doctors who resisted becoming hospital employees have been a prime target for PE money, taking advantage of the fact that hospitals must treat patients who show up at the emergency room (NBC, 5/13/20). If a practice that staffs a hospital’s ER doesn’t have a contract with an insurer, they bill at sticker prices much higher than the network discount. So in recent years, patients who went to network hospitals for emergencies have sometimes been treated by “out of network” emergency doctors, who bill them and their insurers at the shockingly higher rates—an appealing situation for private equity.

However, new state and federal laws have curbed surprise billing. The new laws, along with a shrinking pool of doctors who haven’t already been bought out by hospitals or insurers, have touched off a wave of debt-fueled bankruptcies and sell-offs similar to the 1990s. Even as the “takeover” drumbeat reached a crescendo, Envision Healthcare, the largest private equity–owned physician practice in the US, declared bankruptcy last May (Stat, 5/15/23). American Physician Partners, “one of the nation’s biggest employers of emergency physicians,” followed suit in July (American Prospect, 7/29/23).

The real hospital bad guys

American Prospect (10/7/19) explained that “private equity makes you sicker” because “consolidated hospitals harm patients with higher prices and worse outcomes”—but private equity has very little to do with hospital consolidation.

When it comes to hospitals, Philadelphia is ground zero for misdirected media attention on private equity. In 2018, Paladin Healthcare Capital, a private equity firm controlled by investor Joel Freedman, purchased Hahnemann Hospital, promising to invest in needed improvements. Freedman instead drove the hospital into bankruptcy, after selling the land under it to another company he controlled. It’s now the site of a condo development.

Sen. Bernie Sanders (I–Vt.) made Hahnemann a symbol of his support for Medicare for All in the run-up to the 2020 primaries (CBS News Philadelphia, 7/15/19). Hahnemann became the go-to example of private equity’s aggressive takeover of hospitals with the intent of selling them to real estate developers. Eileen Applebaum, co-director of the Center for Economic and Policy Research, led with the Hahnemann story in her influential American Prospect reporting (10/7/19) on private equity, warning that

private equity firms are using borrowed money to assemble medical empires across the country. Not only do consolidated hospitals harm patients with higher prices and worse outcomes, but the shaky financial pictures that result habitually lead to massive cost-cutting and closures of unprofitable facilities, which put entire communities at risk of losing access to medical care.

But private equity has almost nothing to do with hospital industry consolidation. By the time Freedman bought and closed Hahnemann, and its St. Christopher’s Hospital for Children affiliate, they were isolated facilities, neglected by their previous owner. And they were under withering competitive pressure from tax-exempt charitable hospitals affiliated with local universities: Temple University, Thomas Jefferson University and the University of Pennsylvania.

‘More symptoms than disease’

The New Yorker (5/31/21) was right to note that “the story of Hahnemann is as much about the structural forces that have compromised many American hospitals…as it is about the motives of private equity firms.”

In 2021, New Yorker writer Chris Pomorski (5/31/21) published a more nuanced retrospective take on “The Death of Hahnemann Hospital.” While detailing Freedman’s managerial incompetence and the transaction that left the land under the hospitals in Freedman’s hands and out of bankruptcy as the hospital closed, Pomorski pointed out the primary villain: The hospital had been the victim of Wall Street–backed neglect for 20 years by the company that sold the hospital to Paladin—the $19 billion publicly-traded Tenet corporation.

Private equity’s maneuvers with Hahnemann, wrote Pomorski,

are more symptoms than disease. The story of Hahnemann is as much about the structural forces that have compromised many American hospitals—stingy public investment, weak regulation and a blind belief in the wisdom of the market—as it is about the motives of private equity firms.

Beyond that insight, however, Pomorski missed the bigger story in Philadelphia. As press reports noted (e.g., US News, 7/10/19), Hahnemann was a hospital that primarily treated poor patients. When it closed, patients struggled to find care at other locations, and the abrupt closure placed a heavy burden on surrounding hospitals.

Penn and Temple saw ER visits increase by 12%, and Jefferson, less than a mile from Hahnemann, by 20%, with ambulance volume doubling as emergency patients who lived close to Hahnemann dialed 911 instead of finding their own way to the emergency room. A doctor told Pomorski that the ER became so crowded, ambulances were often diverted to other hospitals, a situation known to cause unnecessary deaths. An emergency physician told Pomorski that “the ER became the scene of ‘daily human tragedies.’”

Beyond absorbing the sudden spike in patient volume and the stress it brought to frontline caregivers, at the institutional level, Jefferson and Penn played another role in Hahnemann’s woes: They were among its agents and beneficiaries.

While Tenet was neglecting Hahnemann, wealthy university hospitals were building medical empires, with “satellite hospitals, physician practices and urgent-care centers.” Pomorski quotes a Hahnemann executive criticizing Freedman for failing to negotiate higher insurance rates to stave off bankruptcy.

Telling details

Philadelphia’s non-profit hospitals had the money for a huge building spree (Philadelphia Inquirer, 10/30/21), but not to absorb the doctors and patients from a private equity–backed hospital that went under.

The details are telling. Hahnemann’s competitors, like other large tax-exempt systems, flex their market power to drive up prices. They commanded prices so much higher than Hahnemann that the executive thought it might cost insurers less to give Hahnemann a small raise than to shift its patients to the charitable competitors.

After interviewing two patients who struggled to find specialist doctors when Hahnemann closed, Pomorski also interviewed Jefferson CEO Bruce Meyer. Jefferson hired eight Hahnemann-affiliated ob-gyn doctors to care for Hahnemann patients, but Pomorski neglected to ask why Jefferson didn’t simply hire the rest of Hahnemann’s specialists immediately and absorb their patients. After all, Jefferson had the money to start building a new $762 million specialist physician office tower three-fourths of a mile from the Hahnemann site, months before the New Yorker piece ran (WHYY, 9/10/20).

Penn was in an even stronger position to deal with the challenges. When Hahnemann closed, Penn was already building a palatial new $1.6 billion, 504-room hospital across the street from the existing Hospital of the University of Pennsylvania (Philadelphia Inquirer, 10/30/21). The “Pavilion” opened just four months after the New Yorker piece, and includes a new two-story state-of-the-art emergency department, with 61 private rooms (Penn, 10/21/21).

Some problems in nearby ERs were likely inevitable, given that Freedman closed Hahnemann suddenly. But sitting two miles from Hahnemann with a $21 billion endowment, Penn had the resources necessary to figure out how to transition Hahnemann’s patient volume to new locations. The ultimate outcome of Hahnemann’s demise for Penn, Jefferson and Temple is a market with one less competitor, one less hospital willing to take lower rates from insurers.

The real hospital story in Philadelphia is that major nonprofit health systems are at the tail end of a 15-year, $9 billion building boom. The Pavilion is reportedly the largest capital project in Penn’s history (Philadelphia Inquirer, 10/30/21), but soon won’t even be the priciest hospital in its own neighborhood. The closely allied Children’s Hospital of Pennsylvania (CHOP), which shares a campus with Penn’s hospital, is building its own $1.9 billion new tower (Philadelphia Inquirer, 3/1/20). CHOP says they won’t need to borrow money for the project, but will pay with cash on hand, profits and contributions.

As this article was going to press, Jefferson Health announced a proposed merger with Lehigh Valley Health System. If approved, the merger would create a 30-hospital system across eastern Pennsylvania. The new Jefferson system would become Pennsylvania’s largest employer, surpassing the current champion—the University of Pennsylvania. The combined systems generated $13.8 billion in revenue last year (WHYY, 12/19/23). The question is whether all those billions in construction and revenue will afford Hahnemann’s low-income patients better or even the same treatment as they found at Hahnemann.

Who’s taking over whom?

In Connecticut, a private equity firm is selling its hospitals to a multi-billion-dollar university-affiliated tax-exempt chain—but that doesn’t fit the “takeover” narrative.

The idea that Hahnemann could become a pattern has been a critical element in the private equity takeover, or “hijacking,” narrative. According to CNN (7/29/19), “advocates worry other private equity firms may try it with struggling hospitals in gentrifying neighborhoods all over the US.” In reality, Hahnemann is an example of grotesque wealth extraction from a dying hospital bludgeoned by neglect from a publicly traded company and competition from massively endowed urban “nonprofit” hospitals. Private equity won’t be “taking over” those winners any time soon.

In Connecticut, the reverse is happening. In 2015 and 2016, private equity firm Prospect Medical Holdings bought three tax-exempt hospitals and converted them to for-profit status (CT Mirror, 5/25/16). Prospect bought the financially struggling hospitals after the collapse of a bid from a short-lived partnership between publicly traded Tenet and Yale-New Haven Health, the state’s largest tax-exempt chain, because Tenet found state regulators’ proposed conditions to protect the public “too burdensome” (CT Mirror, 5/31/15).

Prospect’s purchase and conversion was supposed to inject capital into financially struggling Waterbury, Manchester and Rockville hospitals. Eight years later, Prospect is selling all three hospitals. The buyer? Yale-New Haven Health.

The deal gives Yale-New Haven an anchor in Waterbury, Connecticut’s fifth-largest city, where the only other hospital is owned by Trinity Health, a nationwide tax-exempt Catholic chain with 101 hospitals (and a “family” of “nearly 36,500 physicians”). As is common, Prospect moved the real estate to a different subsidiary and leased the land back to its hospital entity, a maneuver documented in detailed local reporting (CT Mirror, 11/16/23).

Yale-New Haven wants state subsidies to deal with the hospitals’ financial distress, even though the YNH system had more than $4 billion in net assets at the end of the 2022 fiscal year, and drives patients to its facilities in close partnership with Yale University, which runs the state’s largest physician specialty practice and has a $41 billion endowment.

Blaming vultures for the kill

When a private equity firm shuts down failing rural hospitals, KFF Health News (6/15/22) presents this as a story about the danger of private equity rather than a collapsing rural healthcare delivery system.

Beyond Hahnemann, rural hospitals are a major focus of private equity media coverage. Some long form reporting on rural hospitals acknowledges the transient nature of private equity investment, but coverage still tends to blame vultures who are actually feeding on carcasses killed by others.

Rural hospitals have been in systemic crisis for decades. A 2022 report (Bipartisan Policy Project, 5/22) estimated that more than 20% are at risk of service reductions or closure. Before closure, desperate owners often cut staff and shut down services, requiring some patients travel long distances for certain types of care. As with Hahnemann, private equity firms have taken advantage of the crisis in some areas, buying hospitals and stripping assets, but the death throes most often are brought on by other owners and failed policy.

In a 3,000 word story headlined “Buy and Bust: When Private Equity Comes for Rural Hospitals,” KFF Health News (6/15/22) described how Noble Health, a three-year old PE firm bought and closed Audrain Community Hospital and Callaway Community Hospital in rural Missouri. Reporter Sarah Jane Tribble makes the anguish and anger of caregivers and patients palpable, but, as with Hahnemann, Audrain was on life support when Noble pulled the plug:

Audrain had struggled before Noble came calling, said Dr. Joe Corrado, a longtime surgeon at the hospital: On an average day in 2019, 40% of beds were empty, as more treatments moved to the outpatient setting and some patients drove an hour to larger hospitals for specialty care.

Distorted research fuels panic 

The story of HCA, which has repeatedly switched from a publicly traded to a privately held for-profit company (New York Times, 8/14/12), illustrates the danger of focusing on corporate structure rather than on the US healthcare system’s perverse economic incentives.

Distorted academic research has fueled the past four years of private equity media panic. The KFF Health News piece on rural hospitals cited a 2021 Health Affairs study (5/21) showing that private equity investments in hospitals “increased 20-fold from 2000 to 2018, and have only accelerated since.” But the study doesn’t credibly support the idea that private equity is “taking over” hospital care at all.

The researchers found “a total of 42 private equity acquisitions involving 282 unique hospitals occurred during the period 2003–17,” which means it took private equity 15 years to make deals involving 5% of US hospitals. The vast majority of these hospitals were owned by private equity for a short period of time, and 74% of the deals involved hospitals that were already for-profit, many bought from companies with their own track records of fraud and national reports of patient abuse.

More than half of the hospitals were bought in just one 17-year-old deal that bears little resemblance to the stories common in major media today. In 2006, Bain Capital bought HCA, the largest for-profit hospital company in the US (CNN, 7/20/06). It was the third time the company “went private.” Six years later, HCA started selling stock publicly again, giving a windfall to Bain and the family of former Senate Majority Leader Bill Frist, whose father founded the company (New York Times, 8/14/12).

Before the Bain deal, when the company was known as Columbia/HCA and its stock traded publicly, the hospital chain coughed up what was then the biggest Medicare fraud settlement in history, and faced national publicity about quality of care concerns (Department of Justice, 6/26/03; Vanity Fair, 8/1/98).**

In reality, hospital ownership patterns have been relatively stable since 2000, except that public hospitals are slowly disappearing. According to KFF reporting of American Hospital Association data (2000, 2021), at the turn of the century 61% of community hospitals were private not-for-profits, 15% were for-profit and 24% public. In 2021, 58% of the nation’s community hospitals remained nonprofit, and 24% were for-profit, with much of their growth at the expense of public facilities, whose share dropped to 18%.

Data downloaded from the nonprofit Private Equity Stakeholder Project shows that just 390 hospitals are owned by private equity firms, or less than 7% of all hospitals (PE Hospital Tracker, accessed 12/12/23). The majority are psychiatric, long-term acute care and rehabilitation hospitals, specialty facilities whose reimbursement patterns are attractive to private equity investors. Less than 4% of general acute care hospitals are owned by private equity firms.

The Hospital Tracker has useful data (it’s maintained by former colleagues of mine), but the PE Stakeholder Project’s research isn’t immune from pumping numbers up with “takeover” hot air. The web page for the tracker says “34% of private equity hospitals serve rural areas,” a claim repeated by Stakeholder Project researchers in a Health Affairs article (12/18/23) headlined “Private Equity: The Metastasizing Disease Threatening Healthcare.” Thirty-four percent sounds like a big number, but 34% of less than 7% isn’t much. According to the tracker’s data, less than 5% of all rural hospitals are owned by private equity firms.

Bad behavior all around

A Wall Street Journal series (7/25/22–12/26/22) makes clear that ostensibly nonprofit hospitals have the same profit-maximizing behaviors that openly commercial hospitals do.

While some media have fed the public a litany of private equity horror stories, other journalists continue to report that “Nonprofit Hospitals Are Big Business,” as the title of a 2022 Wall Street Journal series (7/25/22–12/26/22) puts it. The Journal and others, including outlets simultaneously reporting on the private equity “takeover,” have demonstrated that tax-exempt and publicly traded hospitals yield to no one in their commitment to wealth extraction and harmful operations, including:

Staff cuts: Private equity coverage often focuses on hospital cost-cutting. At the same time, systematic staffing reductions by Ascension Health prompted an in-depth New York Times investigation (12/15/22) that found that the 140-hospital Catholic system “spent years reducing its staffing levels in an effort to improve profitability, even though the chain is a nonprofit organization with nearly $18 billion of cash reserves.”

Price increases: KFF Health News and others have reported that insurance payments to gastroenterologists, ophthalmologists and dermatologists in private equity practices are higher than those in non–private equity practices, based on a 2022 study by Johns Hopkins and Harvard researchers (JAMA Network, 9/2/22). The study found that payments to PE-owned practices were 11% higher than a control group.

However, the researchers only compared the prices to doctors in the shrinking universe of independent practices, excluding those “with other corporate ownership and hospital or health system affiliation” from the control group.While the independent doctors had lower prices, including hospital-owned practices may have yielded a different result. A 2018 Journal of Health Economics study (4/22/18) found that “the prices for the services provided by [hospital] acquired physicians increase by an average of 14.1% post-acquisition,” and by more “when the acquiring hospital has a larger share of its inpatient market.”

Closure of Services: Eliminating unprofitable services is a constant theme of reporting on private equity–owned hospitals, especially in rural areas. According to the Wall Street Journal (4/11/21), after then–publicly traded Lifepoint merged two hospitals in Riverton and Lander, Wyoming and rebranded them SageWest, the company closed Riverton’s ob/gyn unit, forcing patients to travel the 30 miles to Lander to deliver babies. Under community pressure, Lifepoint announced that they’d reopen the services, but the company reversed itself again after being bought by the private equity firm Apollo.

These closures and consolidations are endemic to the crisis-wracked rural hospital landscape, regardless of ownership. In Connecticut, rural residents waged an identical three-year community struggle to maintain ob/gyn services after tax-exempt Hartford HealthCare bought Windham Hospital. The conflict received both local and national coverage (US News/NBC, 11/21/21). The state finally approved the closure this month, so patients will have to make the 17-mile trek to the nearest ob/gyn unit. Now the tax-exempt owners of two of the state’s three other rural hospitals, Nuvance Health and Catholic Church-affiliated Trinity Health, have also applied to close their ob/gyn services (CT Mirror, 12/11/23).

Wrong focus yields useless policies

The Atlantic (10/28/23) recognizes that private equity’s interest in healthcare is ebbing, but its reform proposals are focused on this admittedly vanishing problem.

Media healthcare misdirection matters because it fuels useless policy solutions, most evident in the conclusions of long form articles in leading opinion magazines and health research journals. After regaling readers with shocking stories and sometimes misleading data, the articles typically wind up pointing to a suite of policies like those found in the recent Health Affairs article (12/18/23) from Private Equity Stakeholder Project staffers Emily Stewart and Jim Baker, and a piece by Joseph Nocera and Bethany McLean in the Atlantic (10/28/23): increased transparency, making it easier to sue private equity owners, and restrictions on financial manipulations like real estate sale-leaseback arrangements.

To their credit, Nocera and McLean inform their readers that private equity firms “appear to have lost interest in acquiring more” hospitals, but the story’s conclusion focused only on solutions to this admittedly vanishing problem, in particular Sen. Elizabeth Warren’s Stop Wall Street Looting Act.

Some of these proposals are sound general public policy, and banning private equity from nursing homes altogether probably makes sense. But a set of proposals targeting one specific corporate structure that controls relatively small slices of physician and hospital services for financial regulation has no chance to meaningfully improve a healthcare system that sends thousands of people to unnecessary deaths, and millions into debt and bankruptcy each year. These policies are a get-out-of-jail-free card for politicians on healthcare policy, allowing them to hold shocking hearings without actually fixing the country’s mess.

Until public officials decide to treat healthcare as a public good, the cycles of exploitation and patient harm will continue, regardless of the corporate structure of hospitals and physician practices. The Atlantic chose to highlight Warren’s bill as potential policy, but could have pointed in a different direction. Warren’s original cosponsors include House Progressive Caucus Chair Pramila Jayapal (D-Wash.), lead sponsor of the House version of the Medicare for All Act.

The residents of Riverton, Wyoming, have recognized the need for public investment in rural healthcare. They’ve formed a medical district to raise money for a new, publicly controlled hospital. After five years of organizing and planning, the community broke ground in July (Riverton Ranger, 7/15/23).

The community’s work is inspiring, but it also closes a circle that indicts generations of political leaders across the US for failing to accept responsibility for our healthcare system. Decades before private equity giant Apollo bought LifePoint, and years before Riverton’s Hospital was included in a group of rural hospitals that Columbia/HCA spun off to form publicly traded LifePoint, what is now called SageWest Riverton Hospital was a public hospital, controlled by the local community.

*In 2014 and 2015, I lobbied for UNITE HERE! on parts of two bills that dealt with these issues.

**I worked with SEIU on a campaign to organize Columbia/HCA workers in Las Vegas from 1997–99.

The post Private Equity ‘Takeover’ Is Not Driving Healthcare Crisis appeared first on FAIR.

This content originally appeared on FAIR and was authored by John Canham-Clyne.

On the Post cover were fewer than a dozen AK-47s and matching magazines, as well as a few tactical vests. In its subhead, the Post called this “proof Hamas used hospital as  military base in stunning war crime.”

Many other media outlets reported Israel’s claims—and accompanying photos and videos the IDF offered as evidence—with little pushback other than Hamas’s denials and an acknowledgment that the outlet could not independently verify the claims. “IDF ‘Found Clear Evidence’ of Hamas Operation out of Al-Shifa Hospital, Says Spokesperson,” was an NBC News headline (11/15/23); Fox News (11/15/23) had “Watch: Israel Finds Weapons, Military Equipment Used by Hamas in Key Gaza Hospital After Raid, IDF Says.”

Israel’s assault on Al Shifa hospital provoked widespread international outrage, so a great deal hinged on its claim that the hospital was being used as a military base. But there are many reasons to question this display of weaponry, questions that imply that not only did the Israeli military make a weak case, but that some media outlets and pundits were too quick to take this presentation at face value.

The laws of war

Israeli computer animation (YouTube, 10/27/23) depicting what was claimed to be “the main headquarters for Hamas’ terrorist activity” beneath Al Shifa Hospital.

While civilian infrastructure, and in particular medical infrastructure, are protected under the laws of war, the Israeli government claimed that the hospital’s protection was nullified because Hamas was using it as a military base, using the medical staff and patients as human shields.

The IDF released a 3D animation (YouTube, 10/27/23) depicting Al Shifa as “the main headquarters for Hamas’ terrorist activity,” with a warren of underground chambers hiding crates of weapons, missiles, barrels and meeting rooms bedecked with Islamic flags.

The US government supported this line of thinking (ABC News, 11/16/23). The Wall Street Journal editorial board (11/14/23) spelled out the argument:

The law of war in this case is clear: Under the Fourth Geneva Convention, Hamas’s use of Al Shifa for military purposes vitiates the protected status granted to hospitals. Israel is still required to give warning and use means proportionate to the anticipated military advantage, and it has.

But the law of war is not, in fact, clear in the way the Journal claims. “Even if there is a military facility operating under the hospital, this does not allow Israel to bomb the site,” the Israeli human rights group B’Tselem (11/7/23) said in a statement before the hospital raid.

Even if a hospital were used for “acts harmful to the enemy,” that does not give that enemy “the right to bombard it for two days and completely destroy it,” Mathilde Philip-Gay, an expert in international humanitarian law at France’s Lyon 3 University, told the Guardian (11/17/23).

“Even if the building loses its special protection, all the people inside retain theirs,” Rutgers Law School international law expert Adil Haque told the Washington Post (11/15/23). “Anything that the attacking force can do to allow the humanitarian functions of that hospital to continue, they’re obligated to do.” The director of the hospital, Mohammad Abu Salmiya, said that 179 patients died while the facility was surrounded by Israeli forces and had to be buried in a mass grave (Al Jazeera, 11/14/23). (Abu Salmiya was later arrested by Israeli forces along with other Palestinian medical personnel—Al Jazeera, 11/11/23.)

After the raid, viewing the evidence, Human Rights Watch was not at all persuaded. “Hospitals have special protections under international humanitarian law,” said Human Rights Watch UN director Louis Charbonneau (Reuters, 11/16/23):

Doctors, nurses, ambulances and other hospital staff must be permitted to do their work and patients must be protected. Hospitals only lose those protections if it can be shown that harmful acts have been carried out from the premises. The Israeli government hasn’t provided any evidence of that.

“The IDF says attacks are justified because Hamas fighters use the hospital as a military command center,” Amnesty International Australia (11/27/23) noted. “But so far, they’ve failed to produce any credible evidence to substantiate this claim.”

Shrugging off skepticism

The Washington Post‘s Jennifer Rubin (11/20/23) dismissed demands that Israel produce evidence of the “command-and-control center” it said justified its assault on the Al Shifa hospital.

Washington Post columnist Jennifer Rubin (11/20/23) shrugged off skepticism of the evidence presented about the hospital, scorning critics who demanded proof that the hospital was a “command center”—which she dismissed as “a generic term without definition and without legal significance.” Rubin insisted: “It was used as a military facility. Period.”

AP (11/23/23), however, pointed out that it was the Israeli military, not the military’s critics, who had promised evidence that the hospital served as “an elaborate Hamas command-and-control center under the territory’s largest healthcare facility.” After the hospital’s capture, former Israeli Prime Minister Ehud Olmert told Euronews (11/17/23) that Al Shifa was not Hamas’s headquarters after all: “Khan Younis, which is in the southern part of Gaza Strip, is the real headquarters of Hamas,” he said.

Another Post columnist, Kathleen Parker (11/17/23), admitted that details of the military’s find were scarce and that perhaps media shouldn’t jump to conclusions, but then immediately said the photographic release “seems” to vindicate Israel:

As media teams try to understand what’s happening there, details are few, leaving much room for speculation and/or affirmation of one’s preferred narrative.

Even so, the video, which has been replayed by dozens of news outlets, seems to confirm what Israel has long claimed that Hamas uses innocent Palestinians as barricades by installing their headquarters and arsenals beneath schools, hospitals and other public institutions in a vast complex of subterranean tunnels.

About that supposed headquarters beneath the hospital: While Israel showed off images of a “tunnel” under the hospital, Newsweek (11/15/23) pointed out that it’s long been known that the facility had an extensive sub-basement—because it was built by Israel in 1983.

Catastrophe for hospitals

Middle East Eye (11/15/23): “While Israel says its military has been conducting a ‘precise and targeted operation’ at Al Shifa, Palestinians at the hospital say civilians trying to flee have been fired upon.”

Israel’s assault on Gaza has generally been a catastrophe for Gaza hospitals (UN News, 11/13/23; BBC, 11/13/23), and there has been considerable damage to Gaza hospitals in previous Israeli assaults (Guardian, 3/24/09; Newsweek, 7/30/14; Guardian, 5/16/21).

And the Israeli operation at the hospital was certainly stunning. The Middle East Eye (11/15/23) reported:

Troops broke through the northern walls of the complex, instead of entering via the main gate to the east, at around 2 am local time on Wednesday, according to local sources and health officials.

They went building to building inside the large facility, removing doctors, patients and displaced people to the courtyards before interrogating them, Middle East Eye has learned.

Some people were stripped naked, blindfolded and detained, according to doctors who spoke to Al Jazeera Arabic, one of the few international channels with access to sources within the hospital.

This isn’t to say media outlets shouldn’t scrutinize what Hamas fighters do in civilian areas, but there is a lack of skepticism in media—especially for television news and tabloids that depend on gripping photography—when it comes to Israel’s presentation of its findings in Gaza that lead to more murkiness.

Research assistance: Pai Liu, Keating Zelenke

The post Press Relayed Israeli Claims of Secret Hospital Base With Insufficient Skepticism appeared first on FAIR.

This content originally appeared on FAIR and was authored by Ari Paul.

Janine Jackson interviewed Public Citizen’s Peter Maybarduk about Paxlovid price-gouging for the October 27, 2023, episode of CounterSpin. This is a lightly edited transcript.

NPR (12/31/19)

Janine Jackson: There are a number of crises that the Covid pandemic did not create, but certainly threw into relief. It has always been disgusting, frankly, that pharmaceutical companies are permitted to sell necessary, life-improving and life-saving drugs at many times the cost of their development and production, keeping them out of the hands of those who can’t afford them, and leading some who can just about afford them to ration them dangerously. It’s a particularly callous aspect of the US profit-driven system—so out of keeping with basic tenets of public health that one kind of wonders how long it can be allowed to continue.

We’re looking at the latest example of this right now with a Covid-19 treatment. Here to tell us about it is Peter Maybarduk, director of Public Citizen’s Access to Medicines group. He joins us now by phone from DC. Welcome back to CounterSpin, Peter Maybarduk.

Peter Maybarduk: Great to be with you.

JJ: I’m sure that people won’t be shocked to hear that the company in question right now is Pfizer, though they’re hardly alone in these sort of practices. What is this most recent outrage that folks are concerned about?

PM: So Pfizer has more than doubled the price of its Covid-19 treatment Paxlovid—nirmatrelvir plus ritonavir—to the US government from around $530 a course up to $1,390 for a list price now. And that despite the fact that Pfizer’s already made $18 billion off this drug in global sales, and they’re raising the price right at a time when it hurts most, because will, obviously, to fight and to fund pandemic response has diminished greatly, and the US government is transitioning its response to the commercial market.

So there’s very limited public resources now, in the United States and around the world, to ensure continuity of treatment. And in order to make up for the loss of volume, Pfizer has decided to increase prices, but that’s going to suppress demand further; that’s going to make it harder worldwide to access Covid treatment for people that need it.

And it’s also been pointed out that the cost of production of this drug is a mere $13. And when you look at it that way, Pfizer is increasing prices to 100 times the cost of production for this drug.

JJ: I just take a pause there, and we’ll come back to it, but let’s just lay out there: Paxlovid is an important drug; it’s not an ancillary drug. It has been shown to be impactful, and then, globally, access to it has not been what it should have been.

Public Citizen (10/17/23)

PM: So we put out a study just last week finding that there’s been more than 8 million cases of unmet need in 2022 alone, looking in last year’s data; that basically more than 90% of need for Covid treatment, as measured by high-risk infections, was unmet in developing countries.

And this despite the fact that manufacturers have pointed to what they consider to be a supply glut; they say they’re making enough of the drug. But, again, the problem has been monopoly, single source of supply; opaque agreements about who is getting the drug and when; and very high prices have suppressed demand. So that if you look at high-risk infections in the Global South, if you look at even just people over 65—which is what we looked at, but it’s a significant undercount, because it doesn’t give you people with preexisting and ongoing conditions, and other vulnerabilities—you see that very, very, very few of those individuals received Paxlovid when they needed it.

JJ: It just seems, in a way, like there’s at least two different conversations going on, one of which is about: There’s a global health crisis, how do we address it? And then another one that’s like, well, we have these pharmaceutical companies, and they need to make money. And it’s almost as though there’s no overlap.

I mean, I just saw Pfizer’s CEO, a week ago, saying, “We remain proud that our scientific breakthroughs played a significant role in getting the global health crisis under control.” It sounds like, from what you’re saying, that, actually, they could have played a much different role in actually working towards getting the global health crisis under control.

Peter Maybarduk: “Pfizer has decided to charge high prices to the few, rather than affordable prices to the many, in order to meet its benchmarks.”

PM: It’s very frustrating to us that health authorities have relegated so much power to the pharmaceutical companies. In many ways, Covid-19 is a pandemic where prescription drug corporations have determined who receives what treatment or vaccine when, at least at a population level, at a sort of country-by-country level. And health agencies have been on the receiving end of that; they haven’t always known what price another country’s paying, they haven’t known what’s their place in line, the terms and conditions.

And, of course, global health authorities haven’t been able to effectively prioritize and indicate that we must prioritize population A, B and C, in these ratios, in order to end the pandemic as quickly as possible. Instead, drug corporations have really been in the driver’s seat, working privately, secretly, on their own logic’s terms, of where they can make the most money, or what public relations and pandemic concessions they want to make. And, unfortunately, that’s continuing here in this case.

Pfizer could choose to be a good partner at this stage, like set any sort of R&D ideas aside. They’ve made $18 billion off this drug. It’s a bonanza. And there’s an opportunity now to meet the funding shortfall with solidarity and with public health interest. Pfizer can afford to say, “We’re actually going to reduce the price of the drug, because there is a funding shortfall, so that more people can get it, so that we can make up the access gap.”

And you almost don’t hear about that anymore, because prices have been high enough, and funding limited enough, that the world has kind of given up. There was, if you roll the clock back a year or two, there was an ambitious call for a global test-treat programming. So all over the world, you could get a Covid test, and then have a straight path to the appropriate treatment that you needed.

And what materialized is a small pilot program in a dozen countries, instead of that great global ambition, and a very significant factor there has been that the treatments are too expensive for developing countries, or for the global effort, to pay for. And so, instead, we just have this shadow of an effort. We’re almost giving up on the idea that treatment can be available to everyone.

And if you walk around in public health circles, you’ll sometimes hear, well, there’s no demand; countries aren’t ordering the treatment. Then you have to think about why. And if you are a health ministry that’s squeezed for resources, you have to make tough decisions about, you know, hospital beds and available protocols against malaria. Do you shell out what was then $250, minimum, probably $250 to $500, I think, and probably now potentially going to be more, to Pfizer for this treatment? Or do you hold on that, not least given you don’t even know when you’ll receive it, because of those shortages.

And it might be different if the drug actually costs something like that. But knowing Pfizer’s production costs are far lower, $13, perhaps less, and the revenue they’ve made so far, it’s a conscious choice on Pfizer’s part to make it harder to prescribe Paxlovid, and to make up for that by charging a premium. Essentially, Pfizer has decided to charge high prices to the few, rather than affordable prices to the many, in order to meet its benchmarks.

Common Dreams (10/19/23)

JJ: And that’s a public health decision. It’s not a corporate—it is a corporate, capitalist decision, but it’s a public health decision in its impact. And I just want to say, finally, you’ve been quoted saying Pfizer is treating Paxlovid like a Prada handbag, a luxury for the few, rather than a treatment for the many. Meanwhile, Pfizer CEO took home $33 million last year, having been gifted a 36% raise from 2021. I think that folks can see that this is stomach-churning and confusing and weird and bad, but what Pfizer is doing is incentivized, or at least they’re not being prevented from doing it. So where are the checks, or where are the guardrails, on this sort of behavior? What do we do about it?

PM: Yeah, that’s part of the problem, is that we have insufficient guardrails. HHS recently negotiated a deal with Pfizer to keep people without insurance on treatment in coming years, and to contribute courses to a national stockpile. So HHS has taken some appropriate steps to ensure continuity of treatment here. But why did HHS have to pay the high prices that it paid? Could it have negotiated lower prices?

I think it is a significant concern, and undergirding it all is the patent monopoly that allows Pfizer to exclude competitors from the market; again, the drug is inexpensive to produce, and had we authorized generic competition, we probably could have an affordable supply by now, bringing these prices down to earth. We’re not paying for research and development here, we’re paying for a monopoly.

And we were among a number of organizations that called on the Biden administration early on to issue a compulsory license, or exercise certain rights it has under law, to authorize affordable generic competition with expensive patented Paxlovid, and bring alternatives online. And, of course, the government hasn’t acted on that proposal because of the lobbying power of the pharmaceutical industry.

So right now we’re kind of stuck, but there are reforms that we can make to prevent this sort of thing from happening again. And there’s going to be ongoing discussions about that. I mean, you saw this week, in the hearings for a new NIH director, we saw Senator Sanders taking a stand and saying we have to take responsibility for medicine pricing in our executive policies, and there will be an upcoming review by HHS and Commerce of government authority to act against drug monopolies in certain circumstances. So it’s an ongoing conversation, but our government has too few tools, and does not sufficiently use the tools that it has.

JJ: We’ve been speaking with Peter Maybarduk, director of Public Citizen’s Access to Medicines group. You can learn more about their work online at Citizen.org. Thank you, Peter Maybarduk, for joining us this week on CounterSpin.

PM: Thanks so much.

The post ‘Drug Corporations Have Really Been in the Driver’s Seat’ appeared first on FAIR.

This content originally appeared on FAIR and was authored by Janine Jackson.

Paxlovid tablets

This week on CounterSpin: Advertising critics have long noted that a company’s PR tells you, inadvertently but reliably, exactly what their problems are. The ad features salmon splashing in crystalline waters? That company is for sure a massive polluter.

That’s the lump of salt with which to take the recent announcement from the US Department of Health and Human Services that their new deal with Pfizer “extends patient access” to Covid treatment drug Paxlovid and “maximizes taxpayer investment”—as the HHS works with the drug company to “transition” Paxlovid “to the commercial market.” The announcement doesn’t note that this “transition” entails hiking the cost of the treatment to more than $1,300 for a five-day course, or 100 times the cost of production.

We discuss this outrage, and what allows it, with Peter Maybarduk, director of the Access to Medicines group at Public Citizen.

(image: Truthout)

Also on the show: CounterSpin listeners, more than many, recognize news media as a keystone issue—important not simply in their own right but to all of the other issues we care about. The media lens—the points of view that they show us day after day, those they obscure or ridicule—affects the way we understand the world, our neighbors and what’s politically possible. That’s why we see the fight for a thriving media ecosystem as bound up completely with the fights for social, racial, economic and environmental justice. We talked about that nexus with Maya Schenwar, author and editor at large of Truthout, and director of a new project, the Truthout Center for Grassroots Journalism.

The post Peter Maybarduk on Paxlovid, Maya Schenwar on Grassroots Journalism appeared first on FAIR.

This content originally appeared on FAIR and was authored by Fairness & Accuracy In Reporting.

WHO Regional Director for the Eastern Mediterranean, Dr. Ahmed Al Mandhari, spoke with UN News’s Khaled Mohamed about the urgent need to protect all aspects of healthcare, warning that unless fuel supplies are replenished in Gaza, there will soon be no electricity to treat desperate patients.

He said teams were standing by at the Egypt-Gaza frontier, waiting to bring lifesaving aid into the besieged enclave. 

This content originally appeared on UN News - Global perspective Human stories and was authored by Khaled Mohamed.

WHO Regional Director for the Eastern Mediterranean, Dr. Ahmed Al Mandhari, spoke with UN News’s Khaled Mohamed about the urgent need to protect all aspects of healthcare, warning that unless fuel supplies are replenished in Gaza, there will soon be no electricity to treat desperate patients.

He said teams were standing by at the Egypt-Gaza frontier, waiting to bring lifesaving aid into the besieged enclave. 

This content originally appeared on UN News - Global perspective Human stories and was authored by Khaled Mohamed.

“My call again and again is to respect the international law when it comes to protecting the safety of healthcare facilities and the people inside these ambulances,” said Dr. Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean, in an interview with UN News. 

Mr. Al Mandhari emphasised to Abdelmonem Makki the heightened need for humanitarian assistance to Gaza and discussed ongoing WHO efforts to prevent a wider humanitarian disaster. 

This content originally appeared on UN News - Global perspective Human stories and was authored by Abdelmonem Makki.

“My call again and again is to respect the international law when it comes to protecting the safety of healthcare facilities and the people inside these ambulances,” said Dr. Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean, in an interview with UN News. 

Mr. Al Mandhari emphasised to Abdelmonem Makki the heightened need for humanitarian assistance to Gaza and discussed ongoing WHO efforts to prevent a wider humanitarian disaster. 

This content originally appeared on UN News - Global perspective Human stories and was authored by Abdelmonem Makki.

In the largest strike of healthcare workers in U.S. history, 75,000 Kaiser Permanente healthcare workers across the country walked off the job this week, seeking higher pay, better staffing, improvements in their pension plans and other benefits. We go to the picket line in Clackamas, Oregon, to speak with Meg Niemi, president of SEIU Local 49, and Keven Dardon, a patient access representative and a member of the union local’s bargaining team, on the final day of the strike outside of Kaiser Permanente’s Sunnyside Medical Center. “Kaiser can do better,” says Dardon, explaining how the union’s demands for better working conditions will allow its employees to provide patients with better care. Adds Niemi, “If we cannot reach an agreement, we’ll be out here again.”

This content originally appeared on Democracy Now! and was authored by Democracy Now!.

Photo by Jon Tyson

The U.S. Justice Department accused Martin’s Point Health Center in Portland, Maine, of Medicare fraud. According to a settlement announced on July 31, the Center will return $22.5 million to federal authorities while not admitting to wrong-doing.

Revelations from whistle-blower Alicia Wilbur, once a Martin’s Point manager, prompted an investigation. She will receive $3.8 million for her pains, as per the False Claims Act

Martin’s Point received extra Medicare funding by means of exaggerating the seriousness of illnesses of older patients in its care. Other health centers and big insurance companies across the nation have done likewise. Many have been investigated and punished.

The Medicare Modernization Act (MMA) of 2003 launched Medicare Advantage (MA) plans. Multi-specialty medical centers, hospital networks, and insurers made use of MA plans as they delivered care or provided health insurance. Doing so, they took advantage of a section of the MMA that authorized extra Medicare funds being released for the care of sicker patients.

To receive funds, the insurers and healthcare centers, Martin’s Point among them, inflated their numbers of sick patients by assigning additional diagnoses to them. Old and even inconsequential diagnoses became active problems. Complicated clinical situations seemed to emerge. So-called “upcoding,” the adding-on of new diagnostic codes, tapped into extra Medicare funding. The money became general-purpose largesse.

The New York Times cites an insurance company that “mine[d] old medical records for more illnesses.” Insurers sent “doctors or nurses to patients’ homes” to find diagnoses. Medical records often lacked documentation of new diagnostic codes.

Martin’s Point, originally a public health hospital for sailors, became a group medical practice caring mostly for military families. It expanded its patient population and after 2007 enrolled older people into its Medical Advantage plan. Soon the organization was operating six multi-specialty centers in Maine and New Hampshire, and caring for 60,000 MA beneficiaries.

This ostensibly non-profit organization took in revenue of $472,119,641 in 2020. It registered $40,107,975 as net income. Former CEO David Howe’s salary in 2020 was $937,418.

Reporter Joe Lawlor ─ who did much to elucidate the Martin’s Point affair ─ cites lawyer David Lipschutz of the Connecticut-based Center for Medicare Advocacy: “These Medicare Advantage plans are getting grossly overpaid” and “incentives are in place for Medicare Advantage plans to maximize profits.”

According to one study, MA plans offered by insurance companies yield an excess of money coming in over payments going out that is “about double” the spread shown by other kinds of health insurance.

It’s no surprise. The legislation that created Medicare in 1965 tied the funding of older people’s healthcare to social security and payroll deductions. It created the Centers for Medicare & Medicaid Services to deliver federal funds directly to hospitals and care providers. The MMA of 2003 upset these arrangements.

Medicare funds began flowing to healthcare centers and big insurance companies. These became intermediaries as they provided care or paid for it, while attending to their business interests. The door opened up to profiteering and chicanery.

The purveyors of healthcare plans or health insurance use MA plans as bait for institutional consumers looking for a bargain. They target companies, governmental agencies, and public service employers. Many of these entities, through union contracts, have to provide healthcare benefits for current and retired employees. They want to hold back on spending.

Healthcare activist and analyst Kay Tillow explains how MA plans accomplished that. They shifted Medicare benefits to the privatized Medicare Part D prescription-drug plan. They also implemented the Employer Group Waiver Plans authorized by the enabling legislation. The so-called “egg-whip” (EGWP), allows MA plans to skirt traditional Medicare guidelines. They “impose conditions on the promised benefits.”

These include limiting, delaying, and/or denying care, plus subjecting decisions of physicians and other care-givers to “prior authorization.” Approved providers are rationed through geographical limitations. And “co-payments will escalate with the gravity of the illness.” MA plans offer ways to cut back on care and, on that account, costs go down.

By moving retired former employees into the privatized MA plans, employers can register savings of 50% or more, one analyst reports. They appeal to working-age people nearing retirement and to the already-retired through coverage they offer for prescription drugs and often for dental, eye, and hearing care. The insurance companies and healthcare networks vigorously market their MA plans.

The packaging of MA plans for retirees with health plans for workers works to reduce employer costs. Not only are active workers usually healthier than their elders and their care costs less, but also funds pocketed from MA plans may be shifted to paying for workers’ care.

“The more the [MA] plans are overpaid by Medicare, the more generous to customers they can afford to be,” according to the New York Times. Generosity comes easily: overpayments of Medicare funds to Medicare Advantage plans presently exceed $75 billion annually.

Conclusions are in order:

• Moving Medicare into the profiteering realm has undermined its original goal of expanding access to care.

• The prospect for equitable healthcare for all is nil what with the lure of big profits.

• To imagine that profit-making might be removed from healthcare, and from no other sector, would be magical thinking, only to be overcome when cutbacks on capitalism take place.

•The U.S. connection between paying for healthcare and employment status stymies attempts at universalizing healthcare. Plans fashioned to serve organized labor are limited by their nature and are divisive. The healthcare aspirations of other working people remain unfulfilled.

Meanwhile, enrollment in the privatized MA plans has grown, now to the point of at least equaling the population of retirees depending on traditional Medicare. More federal spending on MA plans is “accelerating the rate at which the Medicare trust fund is being exhausted.” Maintaining the quality and quantity of care provided under traditional Medicare will be no easy task.

This content originally appeared on CounterPunch.org and was authored by W. T. Whitney.

The New York Times‘ coverage (8/23/23) of a controversy at a Missouri gender clinic led with a photo of Jamie Reed, a former employee who has called for a moratorium on gender-affirming treatment.

The New York Times has taken a lot of heat recently for its coverage of transgender issues. More than 370 current and former Times contributors signed an open letter detailing how the Times has covered trans issues with “an eerily familiar mix of pseudoscience and euphemistic, charged language.” The contributors emphasized the Times’ coverage of adolescent gender-affirming care, and detailed how its articles are being cited in court by states seeking to ban these treatments.

Though the Times’ immediate response was underwhelming, critics had hoped that the paper might take their criticisms to heart in future coverage. That hope was dashed when the Times doubled down with a nearly 6,000-word story about the unsubstantiated claims made by former Washington University in St. Louis gender clinic employee Jamie Reed.

The piece by Azeen Ghorayshi, headlined “How a Small Gender Clinic Landed in a Political Storm” (8/23/23), serves as a greatest-hits album of all of the Times’ problematic coverage on adolescent gender-affirming care, filled with familiar tropes and tactics the paper of record has used to distort the issue.

‘Both sides’ framing

The St. Louis Post Dispatch‘s coverage (3/5/23) of the controversy put the focus on the patients and their parents.

In February, Jamie Reed, a former employee of the Transgender Center at Washington University in St. Louis, wrote a first-person account for the Free Press (2/9/23), a media company run by former Times reporter Bari Weiss, who left the paper because she said it was censoring viewpoints that go against progressive orthodoxy. Reed accused the clinic of rushing kids into transition, and failing to properly inform them and their parents of the effects of hormone treatments. The same day, Missouri Attorney General Andrew Bailey announced an investigation into the clinic, and revealed that Reed had signed a sworn affidavit detailing her claims.

The St. Louis Post Dispatch (3/5/23) and the Missouri Independent (3/1/23) each interviewed dozens of adolescents and their parents whose accounts contradicted Reed’s claims about the center’s practices. Reed refused to be interviewed by either publication to discuss the discrepancies. Instead, she went to the New York Times, which was more than willing to frame her allegations in a positive light.

The Times uses a “both sides” framing to set up its story on Reed:

Ms. Reed’s claims thrust the clinic between warring factions. Missouri’s attorney general, a Republican, opened an investigation, and lawmakers in Missouri and other states trumpeted her allegations when they passed a slew of bans on gender treatments for minors. LGBTQ advocates have pointed to parents who disputed her account in local news reports, and to a Washington University investigation that determined her claims were “unsubstantiated.”

The reality was more complex than what was portrayed by either side of the political battle, according to interviews with dozens of patients, parents, former employees and local health providers, as well as more than 300 pages of documents shared by Ms. Reed.

That framing suggests an equivalence between the politicians weaponizing Reed’s claims in order to ban youth access to gender-affirming care, and advocates for the people whose rights are being taken away. But what evidence does the paper provide to back up its claim that the clinic was misleading the public?

Misleading numbers

In the ninth paragraph of a story on puberty blockers, the New York Times (11/14/22) reported that there are an estimated 300,000 US teenagers between 300,000 who identify as transgender, “and an untold number who are younger.” Forty-two paragraphs later, the Times admitted that the number of trans kids on puberty blockers—i.e., the subject of the st0ry—is a tiny fraction of that, with only 4,780 getting the costly medication paid for by insurance.

Ghorayshi reports that the university found in its internal investigation that none of its 598 patients receiving hormonal medications reported “adverse physical reactions.” She juxtaposes this with a list Reed and clinic nurse Karen Hamon privately created of 76 so-called “red flag cases”:

The list eventually included 60 adolescents with complex psychiatric diagnoses, a shifting sense of gender or complicated family situations. One patient on testosterone stopped taking schizophrenia medication without consulting a doctor. Another patient had visual and olfactory hallucinations. Another had been in an inpatient psychiatric unit for five months.

On a different tab, they tallied 16 patients who they knew had detransitioned, meaning they had changed their gender identity or stopped hormone treatments.

The suggestion, of course, is that the university is covering something up. But having a “complex psychiatric diagnos[i]s,” a “shifting sense of gender” or a “complicated family situation” in no way equates with having an adverse outcome to hormonal treatment. Nor, for that matter, does changing one’s gender identity or stopping hormone treatments.

What’s more, the Times does not report being able to confirm a single adverse physical reaction. In contrast, it does report that it found one of Reed’s claims about a child who had experienced liver damage to be misleading:

Heidi’s daughter indeed had liver damage, a rare side effect of bicalutamide. But she had been taking the drug for a year, records show, and had a complicated medical history. She was immunocompromised, and experienced liver problems only after getting Covid and taking another drug with possible liver side effects.

As for patients who detransitioned, the paper offers two examples that appear to come from Reed, and one it communicated with directly. That’s a total of three detransitions out of 598 patients receiving hormonal medications, or 0.5%.

The Times’ use of Reed’s unverified “red flag list” is perhaps its most egregious use so far of misleading numbers in its coverage on adolescent gender-affirming care. But it’s certainly not the first. The Times (11/14/22) misled its readers in its nearly 6,000-word article on puberty blockers by leading with the fact that 300,000 people between 13 and 17 identify as transgender. Only halfway through the lengthy piece do we find out that only 5,000 of them are on puberty blockers. As Assigned Media (11/14/22) noted:

There are over 25 million youth between the ages of 13 and 17. The percentage of US children ages 13–17 on puberty blockers, therefore, calculates to .02%. The percentage of trans-identifying youth on blockers, according to this article’s own numbers, would be less than 2% of trans-identifying youth. This kind of choice, to include a large number that’s not really representative of the problem, is a common one we’ve found in right-wing outlets that engage openly in anti-trans propaganda to further GOP political goals.

Overemphasis on regret

A parent of a patient at the St. Louis gender clinic posted on Twitter (8/24/23) to complain that she and other parents felt their perspectives were downplayed in the New York Times piece.

As in other Times stories on trans healthcare, a small number of detransitioners get a disproportionate amount of column space. The paper reports having interviewed 18 patients and their parents who said they had great experiences with the clinic. It quotes two of these patients and one parent, and spends a total of 173 words describing their experiences.