As COVID-19 has ravaged the U.S., many progressive health care activists and organizations such as National Nurses United have illustrated how the pandemic has only made worse what was already intolerable about our for-profit medical system, and continued to demand universal, publicly financed, single-payer health care. Some on the anti-vax right have instead used the “preexisting conditions” of our health care system to discredit the people and measures which are trying to stop the pandemic, often disingenuously coopting progressive arguments in the process.

The profit-driven nature of our health care system and the pain that it causes the U.S. people have not just galvanized some in support of single-payer, but unfortunately have also helped to seed the ground for the mistrust that cynical political actors have cultivated to make people hostile to public health measures. The following are examples of said cynical political actors doing just that:

• Former President Donald Trump has claimed on more than one occasion that doctors and hospitals are part of a conspiracy to enrich themselves by saying patients died of COVID when they actually didn’t.
• Conservative activist Candace Owens tweeted: “‘The Covid vaccine saves lives, which is why the government is making it free!’ K. So explain to me why insulin and asthma inhalers cost so much money. If the vaccines are really about the government trying to save your life — why do life-saving medicines cost so much?”
• One of the central talking points of the anti-vax movement has been that Big Pharma was involved in inventing or manipulating the pandemic in order to push vaccines to enrich itself.

All of these claims are false, but they appear to some to have validity because they rest at least tangentially on facts: Hospitals and health insurance are too expensive. We are constantly bombarded with horror stories about the ridiculous expenses of medical care: $54,000 for a COVID test, $16,000 for having a baby, $1,000 for an ambulance, and those examples are all just from insured people. Tens of millions have no insurance, and GoFundMe has become the indispensable website for the insured and uninsured alike. Then there is the genre of allegedly heartwarming news stories of people overcoming dystopian reality, like the girl selling lemonade to pay for brain surgery or the high school robotics team constructing a special wheelchair for a little boy when insurance wouldn’t pay for it. As if to put a fine point on the absurdity, just recently a story made the rounds of someone who sat in a local emergency room for hours and left without any treatment, then received a bill for $700.

Adding to this ongoing scam, pharmaceutical companies do their share to bilk patients for their medications. From pharma bros and Sen. Joe Manchin’s daughter jacking up prices on their company’s respective drugs, to something as common as insulin being much more costly in the U.S. than elsewhere, Big Pharma plays a significant role in why our health care system is as expensive and dysfunctional as it is. Its attempts to reap as much profit as possible from the COVID vaccine program, even at the expense of leaving much of the world unvaccinated, do not recommend it, either.

In the face of all this, the government has hung the sick, and ultimately all of us, out to dry. Consider the absurdity of Trump and President Joe Biden, both opponents of single-payer health care, in last year’s campaign endorsing free treatment and vaccines for COVID, while ignoring the financial plight of people suffering from every other disease, ailment and injury, and denouncing efforts to guarantee those people coverage as unworkable and socialistic. As the rest of the developed world has figured out how to provide health care to all their citizens, we still maintain a system in which an estimated 45,000 people die every year from lack of health care, and in which, one study found, 500,000 people cite medical bills as either a primary or contributing cause of bankruptcy annually.

Why? Because hospital, health insurance and pharma corporations each have corrupt, symbiotic relationships with our legislators and regulators which run counter to the general welfare. This has become especially clear as the reconciliation “Build Back Better” bill has been sliced and diced by Senators Manchin and Kyrsten Sinema and a select number of House Democrats, all of whom think it’s a bridge too far to make sure seniors can afford their prescriptions, eyeglasses and the teeth in their heads. Follow the money and one finds that this is not primarily an issue of dearly held ideological differences but rather rank corruption and influence-peddling. Sinema has received oodles of cash from the health care and pharma industries, Manchin was a beneficiary of his daughter’s company’s largesse, and Democratic representatives who voted against drug pricing reform have been funded by Big Pharma.

All of this is true, and it’s a sad, infuriating mess, but it does not mean doctors and hospitals are inventing COVID cases. It doesn’t mean vaccines are a scam, and it doesn’t mean the pandemic is either fake or engineered.

The bad faith arguments which the right concocts on these subjects have no need of being coherent. When Trump accuses the doctors and hospitals of inventing COVID cases for money, he doesn’t suggest nationalizing health care like Britain’s National Health Service. When Owens asks why medications are so expensive, she doesn’t endorse Medicare for All. When the anti-vaxxers complain about Big Pharma’s ill-gotten gains, they aren’t out there supporting Sen. Bernie Sanders’s plan to let Medicare negotiate for lower drug prices for seniors. Each of these three potential policy solutions is instead met by these factions with the same standard chorus of “Socialism! Tyranny!”

However false the claims are, however fake the concern, the right has no doubt been effective in how they use the faults of the health care system to attack doctors and civil servants who are charged with protecting the health of the public.

Right-wing ideologues and politicos, though they are some of the main defenders of for-profit health care and beneficiaries of its lucre, are still astute enough to recognize that the system they hail is highly dysfunctional and hurts a lot of people — physically, emotionally and financially. They recognize that the profit motive of the hospital, insurance and pharmaceutical industries creates perverse incentives to maximize private gain at the expense of the public good. They recognize that this situation persists precisely because these industries have incredible control over government health care policy.

They recognize all these problems, but they won’t identify any of them as such to the public, nor do anything to solve them. They merely expose edges of this reality to their followers as it suits their purposes — in this case, to make political hay out of saying the government and Big Pharma are trying to oppress and/or kill you. In so doing, they encourage selfish and self-destructive behavior during a pandemic and let loose a deluge of anger and violence against local, state and federal health officials, doctors, teachers, school boards, store clerks, food service workers and flight attendants.

There are many factors involved in creating this dynamic, but one is no doubt the rapacious nature of our economy as a whole, and of the health care system in particular, which brutalizes the public. This status quo of societal and political indifference to sickness and bankruptcy reinforces the kind of Thomas Hobbesian mentality that the right is trying to instill — “the war of all against all” — as they seek to shred not only the patchwork social safety net, but also just basic norms of civil society, such as taking minimal precautions to protect others. As long as we make health care a commodity rather than a right, the cynical, dishonest arguments that are currently trying to discredit public health officials and measures will only endure: “They didn’t care about you then, what makes you think they care about you now?”

Whereas the right is attempting to scapegoat public health officials for the problems caused by a for-profit system, they are not the ones with the power to make insulin or chemo free at the point of service, like vaccines. It is the politicians who are the ones who need to either be convinced, replaced or circumvented. How do we do this? In some respects, it seems like this issue, as with so many others, is perpetually in the doldrums. Our political system, especially at the federal level, is frozen by legalized bribery and prevented from addressing actual problems in a substantive way. Therefore, the fact that polling shows a majority favor a single-payer system is inconsequential to most of our representatives in an allegedly representative democracy.

Moreover, simply the structure of government in the United States is a unique impediment. Because a party has to control both houses of Congress as well as the presidency at the same time in order to get most things done, most things don’t get done. Even when Democrats do hold this trifecta, there seems to always be a catch. This time it’s Manchin and Sinema, last time it was then-Senators Joe Lieberman and Ben Nelson.

To demonstrate the degree to which our system bogs down progress, whereas President Harry Truman started pushing for single-payer at roughly the same time as the United Kingdom, they have had the National Health Service since the late 1940s, but here we are. President Lyndon Johnson was only able to get Medicare and Medicaid through because an inordinate number of liberals were elected to Congress in his 1964 landslide.

Since the advent of Reaganism and the capitulation of the Democratic Party to neoliberalism and privatization, some strides have been made, although they have tended to be more market-based. To wit, both President Barack Obama and Biden ran on the public option, and neither produced it.

This invariably gets into the status of the Democratic Party: Is it the only way to get to the goal, or is it hopelessly compromised by vested interests? That discussion is at least as old as former Democratic presidential nominee William Jennings Bryan, and there are valid points all around, but one thing that is certainly necessary is a greater focus on primaries and removing the Democrats who are the most captured by corporate power. If enough who oppose single-payer are removed, others will begin to accept it.

The numbers are there. A significant majority of Democrats favor a Medicare for All system, the exit polling from the 2020 Democratic primaries demonstrates this. But because Biden beat Sanders, the corporate media and establishment party functionaries spun that as the voters agreeing more with Biden’s policy views rather than their impression of his “electability.”

Often it seems that the party is more intent on strangling any social democratic policies than it is on opposing the rise of fascism, but in carrying out the former, they lay the groundwork for the latter. The dynamic described in this article is only one example of such: The precarity to which we expose so many people and the suffering they endure is hastening the rise of authoritarianism. Time was when Democrats understood this, as with President Franklin Delano Roosevelt implementing the New Deal in part as a bulwark against it.

If change at the federal level is a remote possibility, a state-by-state approach is another route. Canada did not adopt universal health care all at once, it started in Saskatchewan after decades of activism on the part of agrarian and labor groups. Creating local and state organizations around single-payer and associated issues is a critical piece of building power and momentum. Doing so around preexisting union, faith and other networks could be especially impactful. As much as voting in the right people is necessary, ultimately there also need to be groups and spaces outside the partisan framework which are issue-oriented and not subservient to a party’s immediate electoral fortunes.

Ballot measures are an especially potent example of this. On issues from raising the minimum wage, to legalizing marijuana, to expanding Medicaid, voters in a wide range of states, including deep red states, have voted for significant progressive change through ballot measures. Organizers in the states that have yet to expand Medicaid are working on this for the 2022 and 2024 elections. This isn’t single-payer, but defending and extending existing public health care programs like Medicare and Medicaid is critical in and of itself and to realizing that eventual goal. Find out what activism is going on in your neighborhood, state or region, and plug in or create the spark yourself.

Much of the work of convincing people on the policy substance has already been done; it is largely a question of translating belief into action. Let’s use progressive arguments for progressive ends.

This post was originally published on Latest – Truthout.