Tactical Subversion of Democracy & Healthcare

September 24, 2022

Topics: Risk Adjustment

Summary: A NY Times video op-ed describes how the GOP is taking steps to control the US electoral process at multiple levels, ultimately deciding key elections and thus subverting fair representation. This echoes years of health insurers and other profit-seekers increasingly controlling US healthcare at multiple levels, deciding medical services rules and payments and thus subverting broad access to care.

Inside the Completely Legal G.O.P. Plot to Destroy American Democracy (video)
NY Times
September 21, 2022
By Johnny Harris and Michelle Cottle

The Opinion Video film above aims to unpack one of the most dire threats to democracy, which includes a sophisticated plot to control not only who can vote, but which votes get counted.

… Mr. Trump and his Republican enablers have been working to rig future elections to their advantage. (Of course it’s the people shrieking most loudly about fraud that you really need to watch.) The former president has convinced his followers that … the only way to save America is for MAGA patriots to take over the system to ensure that the “right” candidates win going forward. His allies have been busy engineering such a legal takeover, and key pieces of the plan are already in place.

In this short film, we shine a light on those machinations, so that those who care about democracy can act to stop them.

Comment by: Jim Kahn & Kenneth Colón

There’s a jarring parallel between current GOP tactics to control the voting process and longstanding efforts by for-profit health insurers, drug companies, and large provider organizations to control the care process.

As presented vividly by the NY Times video op-ed, the GOP – reacting to adamant but evidence-free claims of vote fraud in the 2020 presidential election – is laying the groundwork for creating such evidence in 2022 and 2024. They’re installing large numbers of Republican voting staff and officials to generate a flood of spurious claims of voting irregularities. This will create delay and doubt, setting the stage for GOP election officials to select (not elect) the winners. Thus, voters are deprived of their voice, and majority rule is overturned. It’s legal so far, but destroys democratic norms in blind pursuit of victory.

Similarly, corporations – leveraging adamant but evidence-free claims that unconstrained utilization drives high health spending – are advancing the role of for-profit models in healthcare. Insurers are the main offenders, pushing up the prevalence of high profit capitation in Medicare and Medicaid. Drug companies, pharmacy-benefit managers, and large provider groups are quite pleased to join in. The corporate players adopt slick business mechanisms throughout, ensuring that big slices of health care money are delivered to shareholders at each step. Tactics include narrow networks, risk adjustment and selection gaming, flawed denials of prior authorizations and bills, secret pricing contracts, and huge deductibles and cost-sharing for beneficiaries. This deprives patients of broad access to care, driving up illness and death rates. It’s legal, but immoral.

Preserving democracy and saving healthcare are linked – elevating fairness and empowerment of the majority over the interests of the few.