The Sickness In Our Health Care System

Why insurance costs more than cash, why Repeal and Replace was doomed, and the apology I owed Bobby Kennedy.

Health policy stars in DC do not grow up dreaming about ERISA and the House Ed & Workforce committee. They dream about Ways & Means, or Senate Finance. So that’s where they go. Because, for decades, that’s where the health care fights happen.

And that’s why we end up fighting forever over the 20 million people in the ACA exchanges while 160 million Americans on employer-sponsored plans get fleeced by PBMs, carriers, Big Pharma and fake-charity hospitals - and nobody in this town lifts a finger for them.

Then, when a new administration shows up and needs political appointees, they go to the committees where the staffers are, and stack HHS with people who have never done serious policy work for employer-sponsored market.

Nick Solheim at American Moment had me on the Moment of Truth podcast this week and we went through all of it.

• How I watched us try to do Repeal and Replace in 2017 with a Congress that hadn’t written a replace bill (and then watched the Frankenstein that came out of that process die in the Senate - and thank God it did).

• Why price transparency actually got done (the internal fight with our own libertarian wing was brutal).

• Why insurance is now more expensive than paying cash most of the time.

• Why every time Bobby Kennedy or Marty Makary tries to do the job we hired them for, our own side lets them get torched — when what we should be doing is laying our bodies on the train tracks for them, the way the other team does for their own.

Also, the apology email I wrote to Bobby Kennedy after I helped run him out of the first Trump White House. He was gracious. I self-flagellated. You can tell I’m Catholic.

Give it a listen. Let me know what you think.