America’s Deadliest Con: How Racism Keeps Millions Sick While Helping Healthcare Billionaires Cash In

A shocking new study reveals why millions of Americans vote against their own survival — and why 51 billionaires depend on it…

America has 51 billionaires who made their money from our profit-driven healthcare system, the only one in the developed world. It’s not only obscene that they’re taking so much money from so many of us who have so little; it’s also killing all of us.

We’re among the worst — and most expensive — healthcare systems in the developed world, with Thailand and Ecuador even beating us out.

And the reason it stays that way, according to a shocking new study, is because about half of all white people would rather inflict pain on all of us (including themselves) than allow for a system which may also benefit Black people.

If that sounds irrational, it is. But it’s also completely consistent with a history that includes white communities closing their own schools and swimming pools back in the 1960s when LBJ forced them to allow Black children in.

Sixty-six years ago, on a campaign swing through Tennessee, Lyndon Johnson turned to his press secretary Bill Moyers in a hotel room and explained, with the bluntness of a man who’d grown up watching it work in Texas, why America couldn’t have nice things.

“If you can convince the lowest white man he’s better than the best colored man,” LBJ said, “he won’t notice your picking his pocket. Hell, give him somebody to look down on, and he’ll empty his pockets for you.”

Moyers wrote about it years later in The Washington Post, and the line has been quoted ever since because it explained, in one sentence, the entire arc of “conservative” behavior from Reconstruction to Nixon to Reagan to Trump.

Last week, a pair of political scientists at the University of Delaware put empirical meat on the bones of what Johnson learned the hard way. Sumeyye Mine Iltekin Gocer and Joanne M. Miller, writing in the peer-reviewed journal Research and Politics, surveyed more than 700 white Americans and split them into two groups.

One group was asked whether white Americans were winning or losing politically. The other was asked whether white Americans were winning or losing compared to racial minorities. Both were then asked how they felt about economic redistribution programs like food stamps and Medicaid, the things that put food on tables and keep people from dying of treatable diseases.

The first group’s answers tracked roughly with their income and ideology. The second group, the ones prompted to think about race before answering, turned against redistribution across the board, even programs that would obviously benefit them, even when they themselves were poor.

The mere act of comparing themselves to Black and brown Americans made them willing to sacrifice their own healthcare, their own paycheck, their own kid’s future, as long as people of color were sacrificed too.

That’s the trap. That’s how a country with the largest economy in human history ends up as the only developed nation on Earth without universal healthcare, the only rich country where 600,000 people a year still go bankrupt because somebody in the family got sick, and where, alone among our peer nations, we’ve built an entire group of healthcare billionaires on the simple business model of denying claims and pocketing the difference.

There are now fifty-one of them. Fifty-one Americans whose ten-figure fortunes exist because we refused, decade after decade, to do what every other developed country figured out by the 1970s.

Becker’s Hospital Review crunched the latest Forbes list and counted them up: hospital chain heirs like Thomas Frist Jr. at $41.1 billion, medical-device dynasties like the Cooks and the Strykers, pharma fortunes, insurance fortunes, and a long tail of executives who got fabulously wealthy off the misery of people trying to pay for chemo.

Some who became morbidly rich off healthcare even went into politics like Senator Rick Scott, whose company committed the largest Medicare fraud in American history when he was CEO. Others simply pour millions into buying Republican politicians and judges to maintain the profitable status quo.

These billionaires exist nowhere else in the developed world for a simple reason: no other developed country has set up its healthcare system so that human sickness is a profit center.

From Nixon‘s Southern Strategy to Bush’s Willie Horton ads to Trump’s racist birtherism, scaring White people about Black people has been the go-to position of the GOP since the 1960s. And stopping “socialism” that may benefit Black or Hispanic people is at it’s core.

Canada doesn’t have hospital billionaires. France doesn’t have insurance billionaires. We do, and we have fifty-one of them, and the reason we do is the reason LBJ named in that hotel room.

The people who’d benefit most from a national healthcare system are the people who keep voting against it. Look at the map. Of the ten states that still refuse to expand Medicaid under the Affordable Care Act, seven are former Confederate states with large Black populations.

Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, and Texas have together left billions of federal dollars sitting on the table, billions that would have built rural clinics, kept hospitals open, paid for prenatal care, and saved roughly 1.5 million of their own citizens from going uninsured.

Their Republican legislators won’t take the money, their Republican governors campaign against the money, and their Republican voters keep electing the people who refuse the money, all because that money would also benefit the Black and Hispanic people who live in those states.

And the bodies pile up. Tennessee has the highest maternal mortality rate in the United States, 42.1 deaths per 100,000 live births averaged across 2019 to 2023, with Louisiana and Mississippi right behind.

The Commonwealth Fund found this past summer that Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, and Tennessee all have maternal death rates more than double those of California, Colorado, Massachusetts, and Minnesota.

Mississippi just declared a public health emergency over infant mortality because the state’s babies are dying at the rate of 9.7 per 1,000 live births, nearly double the national average, and for Black babies in Mississippi the rate is 15.2, which would be a national emergency in any country that wasn’t busy looking the other way.

Life expectancy tells the same story in the same racist handwriting. Mississippi sits dead last in the country at around 71 years, followed by West Virginia, Alabama, Louisiana, and Kentucky.

The Princeton economist Angus Deaton, who won the Nobel Prize for his work on poverty, has observed for years that life expectancy in much of Appalachia and the Mississippi Delta is now lower than in Bangladesh or Nepal. White working-class men in the Mississippi Delta and the West Virginia coal country can now expect to live fewer years than men in countries we call “impoverished.”

And the political response from the Republicans? They keep electing racist white politicians to refuse Medicaid expansion, slash food stamps, hand tax cuts to their morbidly rich white men, and triple down on the very cultural grievances that the Delaware study just demonstrated, in laboratory conditions, are the precise mechanism by which they’re being conned.

I grew up in Lansing, Michigan, where in 1956 my father finally got a job at a tool-and-die shop with a union contract and health insurance that covered the whole family without a copay. None of us got rich, but none of us went bankrupt when somebody got sick, either.

The country my dad worked in had marginal income tax rates above 90 percent on the very wealthy, no billionaires to speak of, and a healthcare system that, for everyone covered by a union job or a public employer, looked something like what Canada or Germany has today.

In Michigan, like in most states of that era, hospitals and health insurance companies were required to be non-profits, run for the public good and heavily regulated.

Then Reagan came in, busted the unions, slashed the top rates, deregulated the insurance industry, and let the banksters loose on what had been a largely nonprofit hospital and insurance sector. The fifty-one healthcare billionaires we have today are the direct, foreseeable result of those choices.

I wrote a book about all of it, The Hidden History of American Healthcare, and the math hasn’t changed: every dollar in the bank account of a Frist or a Stryker or a UnitedHealth executive is a dollar that didn’t go to a nurse, a clinic, or a sick kid in Tupelo.

The Delaware study explains why we can’t seem to vote our way out of it. The morbidly rich Republicans who actually benefit from the system know exactly what they’re doing when they fund Fox “News,” Heritage, Turning Point USA, and the entire infrastructure of right-wing media that pumps racial grievance into white American living rooms twenty-four hours a day.

They’re running LBJ’s con at industrial scale. Convince a guy in Tupelo that Medicaid expansion is a handout to Black people in Jackson, and he’ll vote to keep his own daughter uninsured.

Convince a retiree in The Villages that single-payer means giving healthcare to dark-skinned immigrants, and she’ll defend, with every breath she has left, the very system that’s overcharging her for the drugs keeping her alive.

It works because “conservatives” have found it’s a very useful con to make themselves rich and maintain political power, and the fifty-one billionaires it produced are the ones writing the checks to make sure it keeps working.

Every other developed country has figured out that healthcare works better, costs less, and produces longer lives when it’s run as a public good rather than a profit center.

Bernie Sanders, Pramila Jayapal, and Debbie Dingell have a Medicare for All bill sitting in Congress right now, with hundreds of co-sponsors and the active support of National Nurses United and most of the rest of organized labor.

Californians are about to vote on a billionaire wealth tax that would partly fund healthcare and education by clawing back a five-percent slice of accumulated wealth from people who’ll never feel its absence.

The arguments are made, the policies are drafted, the funding mechanisms are costed out. The only thing missing is enough Americans willing to recognize the con LBJ named sixty-six years ago and refuse, just once, to fall for it.

If this article helped you see the con for what it is, please share it as widely as you can, forward it to the in-law who tells you Medicare for All is communism, and consider subscribing to the Hartmann Report so we can keep doing this work.

LBJ laid out the con in a Tennessee hotel room in 1960. The Delaware researchers just confirmed it in 2026.

The only question left is whether we’ll act on what we now know, or whether somebody like me in the next generation will be writing the same article about the seventy-fifth healthcare billionaire and asking the same exhausted question about why we still can’t have what every other developed country built two generations ago.

Louise’s Daily Song: “The Con”

Comments on Monday’s Daily Take:

Did Trump Just Pull Off the Biggest Heist in Modern History?

The $1.8 billion fund is wholly untethered from the law or the ruse of a case Trump filed, and is, in reality, Blanche’s own legal invention to hold open the treasury cookie jar while Trump dug deep.

~ Sabrina Hakes

None of us could filch so much as a candy bar from the check-out line without being observed on camera and hauled off in handcuffs by cops. Those cops and cameras need to be turned around to capture the white wealthy criminals who are thousands of times more larcenous and destructive of the social fabric, yet skate away without jail time, and sometimes not even a fine.

~ Jeffrey Hobbs

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