Let me say the thing everyone already knows but has somehow decided to just accept.
We have the worst healthcare system in the world for the amount of money we pay. Not one of the worst. The worst. We are paying Maserati prices and driving off the lot in a Corolla. We are paying for a mansion and getting handed the keys to a trailer. We are sitting in the most expensive restaurant in the world and being served the worst meal.
But here's the part that takes it from outrageous to absolutely unhinged.
You don't just pay Maserati prices and get a Toyota Corolla. You pay Maserati prices, you get the Toyota Corolla, and then — then — they come for your house. They come for your car. They come for your jewelry. You are pawning everything you own, everything you worked for, everything you built — just to pay for the worst product on the market. Medical debt is the number one cause of bankruptcy in the United States. Not bad investments. Not overspending. Not some personal failure of discipline or character. Healthcare. The thing that is supposed to keep you alive is the thing most likely to financially destroy you.
Nobody would accept this anywhere else. In any other context, in any other industry, in any other area of life — if you paid the most and got the least, you would burn the whole thing down and start over. You would demand your money back. You would fire everyone involved. You would never, ever just shrug and say well, I guess that's just how it is.
And yet. Here we are.
The United States spends more on healthcare than any other nation on earth — and we have the outcomes to show for it. Not good outcomes. The worst outcomes among wealthy nations. Higher rates of preventable death. Lower life expectancy. Worse maternal mortality. We are paying for a five-star experience and dying in the parking lot.
Any CEO — any person worth their salt who has ever run anything, anywhere, in any industry — if they walked into a company and saw on the books a program that spent the most money and produced the worst results, you know what they'd do? They wouldn't ask for a task force. They wouldn't commission a study. They'd say that program has got to go. I don't care what it is. I don't care about the details. Whatever that thing is, it's done.
That's where we start. We point at the thing. We agree on what we're looking at. And we stop pretending it's acceptable.
We are not bad at everything
Here's what makes this particularly infuriating. America is not bad at spending money. We are actually very good at it when we decide to be.
Our military? We spend an enormous amount, and we get a product. Pre-Trump, our research institutions were the envy of the entire world. Scientists and scholars came from every corner of the globe to study here, to build here, to discover here. Our entrepreneurial ecosystem generates innovation at a scale nobody else can touch. Silicon Valley. Biotech. Aerospace. We spend big in those arenas, and we get big results.
We can point to those things and say yes, that is expensive, and yes, it is worth it.
Healthcare is the one exception. Healthcare is the embarrassment. It is the one place where we have accepted, generation after generation, that spending the most while getting the absolute least is just somehow the way things are. Where the most vulnerable people — the sick, the elderly, the poor — are left to navigate a system that was never actually designed to help them. A system designed, instead, to profit from them.
This is not a political opinion. This is a business fact. And it is a moral failure.
The universe I grew up in
I know what a functional healthcare system feels like. Not because I studied it. Not because I traveled abroad and experienced another country's model. Because I grew up inside one.
My father served in the military. I grew up on Tricare. And I kid you not — it wasn't until I got to college that I learned health insurance cost money. My now-husband, who was my boyfriend at the time, had to explain it to me. He thought I was out of my mind. I thought he was out of his. We were both completely convinced the other person was living in a different universe.
Because we were.
He was living in the reality that most Americans know — the one where you pay premiums every month, then pay again when you actually go to the doctor, then fight with an insurance company about whether your care is covered. The one where you lie awake after a diagnosis not just scared about your health, but terrified about the bill that's coming. The one where people ration insulin. Where people skip checkups because they can't afford the copay. Where a single ambulance ride can financially devastate a family. Where you do everything right — you work hard, you save, you plan — and one diagnosis wipes it all out.
I was living in the reality that the government quietly built for military families and never bothered to offer anyone else — the one where you just go to the doctor. Where coverage means coverage. Where nobody hands you a bill and tells you that the part that just saved your life was out of network. Where a child gets sick and a parent's first thought is what do we do — not how are we going to pay for this.
I didn't know that second reality was a privilege. I thought it was just how things worked.
It should be how things work. For everyone.
The system already exists
This is the part where the argument gets simple.
Tricare covers nearly 10 million active duty service members, military families, and retirees. It combines military treatment facilities with a broad network of civilian healthcare providers, institutions, pharmacies, and suppliers. It offers comprehensive coverage. Low out-of-pocket costs. Global reach. Robust prescription drug coverage. Specialized programs for different populations and needs.
It is not perfect. No system is perfect. But it works — consistently, reliably, and at a fraction of the cost that most Americans pay for coverage that delivers a fraction of the results.
The government built this. The government funds this. The government runs this. Right now. Today.
And then it tells the rest of America to figure it out on their own.
Let's change the language
For decades, the rallying cry has been Medicare for All. And for decades, that phrase has been systematically destroyed — not by logic, not by evidence, but by money. The private insurance industry has spent billions ensuring that any meaningful alternative to the current system gets buried before it can breathe. They deployed the word socialism like a weapon. They funded the campaigns of anyone willing to protect the status quo. They made people afraid of the very idea of a system that might actually work.
So fine. Let's change the language.
Not Medicare for All.
Tricare for All.
Because this is not a theoretical proposal. This is not a foreign experiment. This is not socialism or a government takeover or any of the other phrases that get deployed to shut the conversation down before it starts. This is taking a system that the United States government already built, already funds, already operates, and already knows how to run — and expanding it to cover every single American citizen.
We are not proposing something new. We are proposing something obvious.
The only question that matters
The barriers to Tricare for All are not logistical. They are not practical. The system exists. The infrastructure exists. The proof of concept exists in the lives of millions of Americans who have used it and never once had to choose between their health and their financial survival.
The barriers are political. Full stop.
The private insurance industry does not want this conversation to happen. The pharmaceutical companies do not want this conversation to happen. The politicians who depend on their money do not want this conversation to happen.
And when you bring any of this up — when you point at the numbers, when you say out loud that this system is broken, when you suggest that maybe Americans deserve better — someone is going to show up and call it socialism. Someone who has made an enormous amount of money off of this broken system is going to look you in the eye and tell you that what you're asking for is un-American.
Here is what I want you to say to that person.
Go fuck yourself.
I mean that with complete sincerity. Because that is exactly what you would say to someone who charged you Maserati prices, handed you a Toyota Corolla, and then showed up at your door to repossess your house because you couldn't cover the difference. You would not engage with that person politely. You would not consider their perspective. You would not worry about whether your response was too harsh or too divisive. You would tell them to go fuck themselves — because they are trying to gaslight you into accepting something that is killing you.
The people defending this system are not confused. They are not misinformed. They are not arguing in good faith about the best way to deliver healthcare to the American people. They are protecting profits. And those profits are coming directly out of your health, your savings, your home, and in too many cases, your life.
So yes. You can send me messages. You can get mad at me. You can unfollow me. You can do all of those things. But what you cannot do — what nobody can do — is make it make sense. You cannot make it make sense to pay Maserati prices and get a Toyota Corolla. You cannot make it make sense that the richest country in the history of the world buries its people in medical debt. You cannot make it make sense that we have a working model — right here, right now, already built and already funded — and we are choosing not to use it.
That is not a policy disagreement. That is a moral obscenity.
Tricare for All is not a radical idea. It is the most American idea possible. Take something that works. Scale it. Stop wasting money and lives on something that doesn't.
We already built the thing. It's time to use it.
And to anyone who wants to tell me otherwise — you know where to find me.