The Case For Building America’s Plan The organized interests side of American politics built its connective infrastructure decades ago. The civic side never did — and that asymmetry is not an accident, it is the explanation for why motivated, engaged people keep showing up and watching nothing change. This series documents that structural gap and … Read more
The Partnership for America’s Health Care Future is a Washington-based coalition of hospital, health insurance, and pharmaceutical industry lobbyists. It was formed in 2018 with one documented purpose: to prevent Medicare for All, the public option, and any structural reform to the American healthcare system from advancing. It spent $60 million in two years. It … Read more
The pharmaceutical industry’s core defense of American drug prices is that research and development is expensive, risky, and requires the returns that high prices generate. The documented reality is more complicated. The foundational research underlying most major drugs was funded by the National Institutes of Health — meaning American taxpayers — before private manufacturers acquired … Read more
The American health insurance industry is not a system built to deliver care. It is a financial intermediary — a layer of profit-taking inserted between patients and the providers who treat them. That distinction matters because it shapes every argument in this hub. Understanding the insurance industry requires understanding what it actually does. Insurers collect … Read more
The American hospital market has been reorganized. What was once a landscape of independent community hospitals — locally governed, operating within defined geographic areas, competing for patients on the basis of quality and access — has been consolidated into large regional and national systems whose market position is measured not by the care they deliver … Read more
Medicare turned sixty years old in 2025. For most of those years it operated on a straightforward logic: the federal government paid doctors and hospitals directly for the care they delivered to Americans over 65. No network. No prior authorization for most services. No shareholder. Administrative overhead around two percent. More than half of the … Read more
Behavioral health — mental illness and addiction — remains structurally separate from physical healthcare in the United States. That separation is not accidental and it is not clinical. It is the product of decades of insurance design, reimbursement decisions, and regulatory choices that treated the mind as categorically different from the body. The consequences are … Read more
The United States has no coherent system for financing long-term care. Medicare does not cover it in any meaningful way. Private long-term care insurance collapsed as a viable market because the actuarial math made it unprofitable. What remains is a patchwork: Medicaid for those who have spent down their assets to near poverty, unpaid family … Read more
The United States spends more on healthcare per person than any other wealthy country and produces worse population health outcomes than most of its peers. Every other high-income nation has achieved universal coverage. Every one of them spends less. The gap between what Americans pay and what they get is one of the most thoroughly … Read more
Student activism has shaped American civic life for generations. The energy, the urgency, and the moral clarity that students bring to civic work are genuine assets — not just for the movements they join, but for the broader civic system those movements are part of. And yet the pattern repeats. A wave of organizing builds … Read more