Shutdown Fight: Why Defending American Healthcare Isn’t Enough

Democrats need to decide on their vision for America. Soon

I am doing this full time thanks to paid subscribers, No paywalls 3 pieces a week and 3 livestreams a week if you aren’t a paid subscriber consider becoming one

Shutdown Fight: Why Defending American Healthcare Isn’t Enough

Democrats are fighting back. They’ve forced a government shutdown, framing it as a noble last stand for “healthcare.” They’re fighting to preserve enhanced Obamacare subsidies and to stave off a trillion-dollar cut to Medicaid. And if they win? They will have done nothing more than avert disaster. They will have successfully defended the status quo.

My biggest gripe in this moment isn’t the political maneuvering—it’s that we’re having a fight over a system that is rotten at its core. One party is trying to bleed it dry, the other is trying to keep its heart faintly beating, but no one is admitting the body is already dead.

Let’s be brutally honest about what they’re fighting to save. We spent $5.2 trillion on healthcare in 2024. And what did that buy us? Twenty-five million people with no insurance at all. Tens of millions more with insurance who still skip care because they can’t afford it—37% of insured adults postpone or avoid treatment because of cost. Eighty-one percent of US counties are healthcare deserts. Over 120 million Americans live without adequate access to pharmacies, hospitals, or trauma centers. We have crushing shortages of doctors, nurses, and mental health providers—76 million Americans in primary care shortage areas, 122 million in mental health deserts.

The most infuriating part of this is that if American healthcare were as efficient as Japan’s, we wouldn’t be spending $5.2 trillion a year. We’d be spending under $2 trillion—saving more than $3 trillion annually. And yet despite all that waste, they’re beating us on almost every measure that matters. They live longer. They stay healthier into old age. And our mothers die in childbirth at five to six times their rate. We pay more than double, and we die younger.

This isn’t a system that needs a some upgrades. It’s a system that needs an extreme makeover.

What I believe with all my heart is that Americans are desperate. Desperate because we see our economic system failing us generation after generation. Desperate because our towns are eroding. But also desperate for a vision. We want a country that we can be proud of, with ideals and values we can stand for even when it’s hard or scary or uncomfortable. A country that not only doesn’t support genocide, but does everything it can to stop it. A fair and free America

And we know something is profoundly wrong when the earnest question of our time is “should billionaires exist,” but almost no one asks, “should homelessness exist in the same country as a billionaire?”

So what makes this shutdown fight so uninspiring for me is that I’m not sure the Democrats even know why they’ve done it. If they won in a landslide in 2026 and 2028, what would they do? Would they just clean up Trump’s destruction and try to restore the old broken system? Or would they finally admit that our institutions are broken and must be rebuilt from the ground up?

Because here’s the truth: nobody is going to fight tooth and nail for Medicare Part A and D, or a subsidy that phases in at 182.3% of poverty. People fight for what serves them plainly and clearly. They fight for programs that are universal, guaranteed, and visible. You don’t need a lawyer or a calculator to access Social Security. You don’t need to know your percentage of poverty to drink from a public fountain.

That’s what a real vision for healthcare has to be: universal, abundant, and public. And it means confronting a fundamental truth—the private, for-profit model has failed, and it’s been propped up by public money all along.

The very infrastructure of American medicine was a public good. The Hill-Burton Act—a massive public works program—funded nearly 40% of the nation’s hospital beds, building 2,000 hospitals across 4,000 communities. Today, many of those same hospitals are in the hands of for-profit chains and private equity firms that extract wealth while patients die.

Innovation tells the same story. We’re told high drug prices are the cost of discovery, but the foundational science for every single one of the 356 new drugs approved between 2010 and 2019 was funded by us, the taxpayers, through the National Institutes of Health. We fund the high-risk discovery. Then private companies patent the results and sell them back to us at the highest prices on Earth. Socialized risk, privatized reward.

A real vision for healthcare would reclaim this system for the public good—not just insurance, but the supply itself: the hospitals, the clinics, the labs, the drug and equipment manufacturing.

This isn’t a fantasy. We’ve done it before. In World War II, the U.S. launched the Cadet Nurse Corps, training 124,000 nurses in record time to prevent the collapse of our civilian hospitals. We mobilized on a national scale because the need was existential.

The need is existential again.

If we’re going to spend $5.2 trillion a year, it ought to buy us an overwhelming abundance of care. Healthcare so plentiful that denying it to someone would be as unthinkable as denying them water. So obvious and universal that people will fight for it because they know it belongs to them.

That is a fight worth having and a vision worth building. It’s time we welcomed the hatred of those who profit from keeping us sick.

Spread the word. Restack, like, comment, forward the email. Help get this message out there.

Corbin