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universal healthcare
As Mexico Enacts Universal Healthcare, Advocate Says Insurers' 'Stranglehold' Is Moving US in 'Opposite Direction'
Medicare for All advocate Wendell Potter said it's "both inspiring and frustrating" to see other nations advance their public healthcare systems while the US dismantles its own.
Apr 10, 2026
As Mexican President Claudia Sheinbaum moves forward with a plan to enact universal healthcare for her country’s more than 130 million people, a longtime advocate for Medicare for All in the US called the development “both inspiring and frustrating.”
"Inspiring because it shows what is possible," Wendell Potter, a former insurance company communications director who has become a leading critic of the industry, told Common Dreams. "Frustrating because here in the US we are going in the opposite direction."
Earlier this week, Sheinbaum announced a decree that she called "a historic step" for Mexico.
Beginning in 2027, her government plans to unify Mexico's public health institutions into a single Universal Health Service, allowing patients across the country to receive care from the Mexican Social Security Institute (IMSS), the Social Security Institute and Social Services of Workers of the State (ISSSTE), and the IMSS‑Bienestar program, which provides free services to those without employer-provided insurance.
According to TeleSur, universal access would be rolled out gradually, with universal emergency care and continuity of treatment, free of financial constraints, beginning in January. Specialized services such as radiotherapy, laboratory tests, and imaging studies would be phased in later that year, and universal prescription fulfillment and hospitalization would also be added to the program in 2028.
"The goal is that when we leave the government [in 2030], any Mexican man or woman can go to any health institution for treatment for any ailment and be received," Sheinbaum said.
Mexico has expanded its annual healthcare budget in recent years, but Sheinbaum's government hopes that consolidating all of Mexico's health services into a single program will eliminate bureaucratic bloat and create a more cost-effective system that saves money over time.
Potter described the plan as “just another example of countries around the world lapping the US when it comes to healthcare policy.”
While tens of millions more previously uninsured Mexicans have become eligible for free care under the healthcare expansion efforts of Sheinbaum and her predecessor, Andrés Manuel López Obrador, the US under President Donald Trump is in the process of shredding public healthcare programs and subsidies.
Following the One Big Beautiful Bill Act, signed into law by Trump last year, 11.8 million Americans are expected to lose Medicaid and other coverage, and more than 20 million are projected to see higher premiums after insurance subsidies under the Affordable Care Act were allowed to expire.
"Due to the stranglehold Big Insurance has on too many politicians in this country, instead of expanding care and lowering costs, we are simply helping Big Insurance make more and more money," Potter said. "It is totally backwards."
"We must continue to keep Medicare for All as our north star here. But also acknowledge the reality that we need to change so much about our current political environment to make it possible," he said. "And that has to start with breaking up Big Insurance's stranglehold on Washington."
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Trump, Extreme Wealth Concentration, and Our Societal Crisis
The US government simply has not done enough to ensure that the livelihoods of all Americans are protected or improved in this new Gilded Age. What it has done is made sure the rich get richer by the minute and more politically powerful year after year.
Feb 09, 2026
The decline of Keynesian economic theory in the 1970s marked a tipping point in the evolution of capitalism in the United States. Beginning with the Great Depression, Keynesian economic policy facilitated the expansion of social welfare programs to mitigate the social inequities of the nation's economic system. In the last quarter of the 20th century, however, rising political conservatism targeted public expenditures for social services. Cuts in education and health, including reductions in social welfare programs and the weakening of the social safety network for the poor, were then and continue today to be goals of political conservatives. Conservatives, furthermore, argue that cutting taxes for the wealthy and corporations promotes investment, economic growth and job creation; and that smaller government and less regulation of market forces distributes wealth the most equitably. These ideas are variously known as supply-side economics, neoliberal economics or simply “trickle-down theory.” Historically, though, trickle-down theory has failed to benefit American working families. In fact, during the course of the last several decades this market strategy has encouraged vast accumulation of private wealth and accelerated its concentration on both a national and global scale. Tragically, it has had deeply injurious social consequences. The societal crisis America finds itself in today relates directly to extreme concentration of wealth.
Absent effective public regulation of economic activities, government and law protect investors and corporations in their aggressive pursuit of wealth. The distribution of wealth in the U.S. is a primary indicator of who benefits most from the political and legal organization of American society. In the third quarter of 2025, according to Federal Reserve data, the top 1% of Americans held 31.7% of all wealth while the bottom 50% held 2.5% (Federal Reserve 2025). That is the highest concentration of wealth in the post-WWII era (Economic Inequality), greater than almost any other developed country. Another indicator of the government's weak support for workers and their families is the federal minimum wage. It is $7.25/hour. At forty hours per week this represents a monthly income of $1160 and a yearly income of $13,920. In 2025, the federal poverty level for individuals was $15,650 and $32,150 for families of four (Poverty Level). These dismal figures show how dire wages are for many millions of Americans. In real terms (inflation-adjusted) the average wage of American workers peaked 48 years ago in 1978 (Wages Peaked).
If one takes a closer look at wealth concentration and the average American’s opportunity to accrue wealth since the 1970s and 1980s, it offers more evidence of how the last few decades of capitalism's development have denied workers a fair share of the tremendous wealth that has been generated. Indeed, a 2023 Rand Corporation analysis revealed that, since 1975, $79 trillion in wealth had been transferred from the bottom 90% to the top 1%. (Massive Wealth Transfer ). This massive redistribution of wealth continues today. In 2023 alone, $3.9 trillion in wealth was siphoned from working Americans to the richest Americans, enough to give every full-time worker in the bottom 90% a $32,000 raise for the year (2023 Wealth Transfer). When it comes to gaining wealth for the average working American, owning a home is the principal path. Home ownership, however, is completely out of reach for the poor and millions more in today's middle class find it unattainable. The median home price to annual income ratio was 5 in 2025. In other words, the median price of a home was equal to 5 years of salary. The ratio was 3.7 in 1985 when a median-price home was $82,800. Today a median-price home is $416,900. Not only is the distribution of wealth radically unequal, the pathway to increased wealth in home ownership has narrowed dramatically.
The political division and violence in America today stems in large measure from a political system whose policies have encouraged radical disparities in incomes and wealth.
These data amply illustrate the crisis poor and increasingly middle income people in the United States face. The poorest Americans, the bottom 20%, simply do not have enough money to meet their daily needs. Nearly a third of all households lives on less than $50,000 annual income (Household Income). In the richest country in the world 36.8 million Americans live in poverty (Poverty), including 9 million children without adequate access to food, shelter and healthcare (Children). At the same time, the more than 900 billionaires in the U.S. have a collective wealth of $6.9 trillion, their wealth increasing 18% in 2025 alone (Fortune). As reported in Forbes, Elon Musk, the richest man in the world, now has wealth of $778 billion (Elon Musk). It would take the average American worker 16 million years to make that much (Extrapolated).
The US government simply has not done enough to ensure that the livelihoods of all Americans are protected in this new Gilded Age. In fact, the government actually provides 40% more benefits to the wealthy than to the impoverished. In his 2023 book Poverty, By America, Pulitzer Prize-winning author Matthew Desmond draws attention to this fact. From recent government data “compiling spending on social insurance, means-tested programs, tax benefits, and financial aid for higher education,” Desmond calculates that the top 20% of income earners on average receives $35,363 in government benefits and individuals in the bottom 20% receive an average $25,733 (p. 99). This reality is a result of policies, policies that benefit wealthy Americans and corporations at the expense of working people. Public policy, in turn, is shaped by corporate lobbying and political contributions as well as professional research that supports goals of the wealthiest and most influential: smaller government, broad corporate deregulation, limited worker protections, and tax breaks favoring the wealthy over working Americans.
It has not always been this way. Between 1947 and 1979, the period when Keynesian economic theory and policies prevailed, “hourly wages grew 2.2 percent. From 1979 to the present, average growth in hourly wages fell to 0.7 percent per year, only one-third of the average rate in the earlier postwar period” (Economic Policy Institute). In the first three decades after WWII labor unions tripled weekly earnings of manufacturing workers across the nation. Collective bargaining gained “for union workers an unprecedented measure of security against old age, illness and unemployment, and, through contractual protections, greatly strengthening their right to fair treatment at the workplace” (Labor Unions). Significantly, one-third of workers (32.3% in 1959) were unionized in this post-war period (Bureau of Labor Statistics ). By 2024, the percentage of wage and salary workers in unions fell to 9.9 percent (Bureau of Labor Statistics). Concentrated wealth, particularly corporate wealth, and government failure to protect workers dampened wages. Also, in the 1950s the statutory taxes on U.S.corporate and personal wealth were much higher, though the effective tax rate was considerably lower due to corporate tax loopholes and rich taxpayers recategorizing income as derived from investments (Tax Rates). The statutory corporate income tax was over 50 percent (Economic Policy Institute). Today it is 21 percent (Corporate Tax). While it is difficult to determine the percentage of taxes actually paid by wealthy individuals and corporations in the early post-war era, it is clear that the statutory personal and corporate income tax is lower today than it was 70 years ago. Of course, enforcement of steeply progressive taxation would make billions of dollars, even trillions, available to fund social programs that distribute income and wealth more fairly.
The pro-democracy citizenry must organize around a political vision that emphasizes several political projects: a just, progressive taxation system; a guaranteed household income; universal healthcare; quality public education; free preschool education; and scientific and technological initiatives for a sustainable economy.
A society riven by such income and wealth inequality is inherently unstable. The political division and violence in America today stems in large measure from a political system whose policies have encouraged radical disparities in incomes and wealth. The loss of 6.5 million manufacturing jobs since 1979 (1979 and 2025), for example, has been facilitated by trade agreements that enable corporations to chase the cheapest wages throughout the world. Runaway companies have gutted industrial towns without consequence, leaving behind poorer communities of people with limited resources to rebuild their lives and neighborhoods. The federal government, moreover, has done virtually nothing to force corporations to pay reparations for the social disintegration left in their wake. As the coastal regions and large metropolitan centers of the nation were generally integrated into the surging commerce of unbridled globalization, distant rural regions experienced economic stagnation and decline. It is little wonder that an authoritarian political figure that exploits these divisions has risen to the presidency of the United States.
In his seminal book Capital in the Twenty-First Century, French economist Thomas Piketty provides an analysis of capitalism in which he notes that “the history of the distribution of wealth has always been deeply political” (p. 20). Reduction of taxes that favors the wealthy is one political determination reflecting the unstemmed power of concentrated wealth. While this political maneuver undermines a primary income and wealth distributive mechanism (taxation system), it further restricts the resources for funding other re-distributive projects such as social welfare, public education and healthcare. Smaller government and privatization of public services are corollary results.
A principal dynamic factor in the process of wealth accumulation and concentration over the last several decades is the growth of profits as the economic growth rate has slowed down. Put another way, the wealthy are taking a larger and larger slice of diminishing income and wealth production. As the vast inequalities in the distribution of income and wealth deny the provision of basic living necessities to tens of millions and circumscribe opportunity for most Americans, social instability and political division and violence escalate. In response, an authoritarian regime consolidates its power around armed force to repress those protesting its anti-democratic policies. Its armed repression inevitably leads to bloodshed.
The pro-democracy citizenry must organize around a political vision that emphasizes several political projects: a just, progressive taxation system; a guaranteed household income; universal healthcare; quality public education; free preschool education; and scientific and technological initiatives for a sustainable economy. These political goals stand in stark contrast to an authoritarian regime that advances the interests of the one percent. They offer a view of the future that is constructive and inspirational, one that generates broad social justice and appeals to the vast majority of Americans.
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DC Shooting Was Not an Afghan or Immigrant Import—It Was All-American Violence
American violence in its many forms destabilized the alleged killer Rahmanullah Lakanwal.
Dec 07, 2025
I’ve heard very few people say it, but Spencer Ackerman recently said it best: “The most sobering fact about Wednesday’s slayings is that the alleged killer, Rahmanullah Lakanwal, was all too compatible with Western Civilization.” And we have the data to back his claims.
The early findings from investigations into the potential motives of Lakanwal, who allegedly shot two National Guardsmen last month, do not gel well with the MAGA narrative that immigrants are in some way inherently dangerous criminals. Instead, what is coming to light is an all too believable American context: US imperialism-induced trauma, lack of resources, and infrastructure to assist those in need (oh I don’t know, something like Universal Healthcare?), and most likely an all too easily accessed gun, created violent conditions. These are all quite sadly the makings of a very American event. Regardless, the Trump administration is unsurprisingly using this tragedy to justify and expedite an anti-immigrant agenda they already had in motion. Everything they have to say on the matter is pure fiction. It might be tiresome, but we need to continue providing the actual evidence contrary to MAGA’s lies.
I spent the better part of 2025 engaged in a research project with the Afghan community in the state of Vermont. I conducted a large survey, a series of interviews, and a national data analysis aimed at assessing the socioeconomic well-being of Afghans in the state, four years after the US ended its 20-year occupation in Afghanistan, which led to the subsequent fall of Kabul and the largest airlift in US history. Over 200,000 Afghans most closely allied with US operations have since been resettled in communities around the US, including Vermont.
Over the course of 2025, I spent a lot of time working side by side with Afghans, in Afghan homes, in conversations around coffee tables, and at community gathering spaces, getting to know Afghan Vermonters. One can of course never generalize about the "nature" of an entire population; however, in my experience, Afghans were overwhelmingly kind, welcoming, generous, and at the risk of repeating a common trope associated with liberal-American ideology, incredibly hardworking. It feels ridiculous to even have to type these words, but at no point did I feel in danger, like I was amid "criminals," or any other ludicrous claims the Trump administration and their ilk try to place on entire groups of people, just because they have arrived from other countries. The hundreds of Afghans I engaged with always met me with a smile, offered me phenomenal tea and snacks, and were generous with their time, candidly sharing their experiences in the US.
Western civilization created the conditions in which Lakanwal suffered severe mental health issues, and once he was brought to the US, created the conditions in which Lakanwal had likely limited healthcare supports, reportedly dire economic struggles, and it is safe to assume all too easy access to a gun.
Certain uninformed parties might say, “They played you like a fool, those absolute criminals!” So, anecdotal evidence aside, and the fact that I lived to tell the tale of my experiences with these supposed criminals, we also have the data. And the data is vast.
As countless data-rich research projects, reports, policy analyses, and peer-reviewed journal article after peer-reviewed journal article show, immigrants in the US, across the board, unequivocally, are far less likely to commit a crime in the US than US-born persons. For an extensive but non-exhaustive list that just scratches the surface, see this resource I put together during the 2024 election cycle. What this data overwhelmingly show, if we can generalize anything about an entire subset of people like “immigrants” or “Afghans,” is that immigrants in America are overwhelmingly peaceful and law-abiding.
For the sake of countering one more MAGA lie that says immigrants and the services they receive are already too costly to the US taxpayer, let me point to the other endless data sets that show (time and time again) that immigrants from all backgrounds, from undocumented, to refugee, to O-1 visa holder alike, provide far more economic benefits to the US than they receive in governmental aid. Immigrants of all backgrounds, examined from many angles and subsets, pay far more into the US tax system than they receive in governmental expenditures and likewise contribute billions of dollars in spending and labor power into the US economy. Need we keep reminding ourselves that this country, after all, was built by immigrants? Correcting the past tense, this country will forever rely on immigrants in ways mainstream politicians seem to never admit.
The data I analyzed in the above-mentioned research is one more set proving this. Through a nationwide analysis of American Community Surveys, we showed that the recently resettled Afghan population in the United States (2021 and on) is already contributing far more in taxes than the costs associated with their resettlement and other support services (including SNAP, housing vouchers, Medicaid, and so on), a ratio that steadily improves each year of US residence per average Afghan household. What’s more is that Afghan spending power in the US (money left to spend after taxes) reached about $2 billion by 2023 (latest available data).
And the findings of our national data make sense given the results of the community survey we also conducted of a large portion of Afghan Vermonters. We found that Afghans in Vermont are highly employed: 73.6% of adult Afghans are currently employed, compared with the total Vermont employment rate of 65.3%. Because of systemic issues that must be addressed in Vermont and across the country, those employed Afghans tend to be paid far less than US-born workers. But even given this systemic wage discrimination, taxes paid through Afghan incomes provide a net gain to the US tax system, and their remaining earnings provide priceless benefits to their local, state, and national economies. I firmly believe that all humans, regardless of any economic benefit they may provide, deserve equal treatment, rights, and dignity, including freedom of movement to improve their lives, wherever that may be. However, for those who need the economics of it all, the truth is clear and undeniable.
In our report, I discuss the undeniable benefit Afghans have provided for Vermont and the country, explore the ways in which Afghans and New Americans still struggle in our communities, e.g. inherently lower wages than US-born people, and I provide a suggested list of policy solutions to improve Afghan and New American livelihoods here, which includes expanding free industry-specific ESL programs; streamlined credential evaluation and licensing for foreign-trained professionals; expanded access to higher education for English Language Learners; investment in affordable and flexible childcare; improved public transportation; and policy solutions at the national level that promote more streamlined pathways to Lawful Permanent Resident status for Afghans in coordination with family reunification efforts, which includes increased funding for legal aid services, to name a few.
Of course, rather than supporting immigrant communities that are so deeply important to the country, President Donald Trump is taking the opportunity to further attack them for political gain. He is twisting the contexts and conditions of last month’s violence to push his far-right agenda, cutting off services that immigrants depend on, and imposing more draconian immigration bans that smack of the purest white nationalism.
Despite these challenges, refugees and immigrants of all statuses continue to contribute significantly to US society and the economy. As the endless research continues to show, refugees and immigrants of all backgrounds are not dangerous for the country and in fact in many ways keep it running.
So, if new Americans are not the problem as the Trump administration would have us believe, then what is? We come back to Ackerman: American Imperial aggression and a violent socioeconomic landscape is the problem. American violence in its many forms destabilized Lakanwal.
The US government is now treating all Afghans like criminals, when those same individuals in one way or another, for 20 years, aided the US in Afghanistan.
What’s become clear in the early days since this tragedy is that Lakanwal struggled with mental health issues that are unsurprising given what he has gone through. If Ackerman’s math is correct, Lakanwal was recruited into one of the CIA’s now infamous Zero Unit “death squads” at the age of 15. A good portion of Lakanwal’s formative years were spent as a child soldier employed by one of the deadliest armed forces in the world, the United States, in which he likely experienced and committed violence few of us could imagine, all at the command and employ of the US government.
“When he saw blood, bodies, and the wounded, he could not tolerate it, and it put a lot of pressure on his mind,” a friend of Lakanwal told the New York Times.
As Ackerman and others are astute to point out, the long-lasting legacy of imperialism has been known to come home in the form of violence.
And whatever affordable mental health support systems Lakanwal may have had in the US, which could have perhaps mitigated the effects of his trauma, were likely minimal.
Here we find American violence in the form of neoliberal policy. Once Lakanwal was resettled in the US, he was thrust into a harsh socioeconomic climate, where many manage to get by as the above data show, but when those with physical or mental illness falter, there are few services available to support them, particularly as the Trump administration has attempted to slash as much as possible, e.g. SNAP and healthcare subsidies. These forms of violence affect everyone including immigrants and are increasingly American.
American violence rears its head again in its abandonment of those in need.
American violence also rears itself in its refusal to regulate gun control in any meaningful way. The US accounts for 76% of public mass shooting incidents around the world, the vast majority conducted by US citizens. Public shootings are an American problem, not an immigrant or Afghan problem.
Western civilization created the conditions in which Lakanwal suffered severe mental health issues, and once he was brought to the US, created the conditions in which Lakanwal had likely limited healthcare supports, reportedly dire economic struggles, and it is safe to assume all too easy access to a gun.
I firmly believe that all persons should be treated with dignity, equality, and afforded the same rights as anyone else, no matter where they come from. There is, however, a deep and undeniable irony in all this that brings to light the true inhumanity of US immigration and domestic policy. That irony rests on the fact that the US government is now treating all Afghans like criminals, when those same individuals in one way or another, for 20 years, aided the US in Afghanistan (no matter how we feel about the occupation) and are still at great risk if they are sent back. They risk death in the context of a violence made possible by the outcomes of imperial violence turned abandonment. They should have been evacuated. They should be allowed to come to the US. They should be given the resources they need to thrive here. Instead, the Trump administration is using them as a scapegoat to churn forth with its nativist, fascist immigration agenda, while it cuts resources for all "old" and "new" Americans alike. The double-edged sword of the Trump administration’s violent opportunism knows no bounds.
If Western civilization is one that commits acts of violence around the world. If Western civilization is one that places profit and corporate lobbyists over the needs of its population. If Western civilization, in the American context, continues to refuse to regulate access to guns in any meaningful way. Then November 26's shooting was an American problem, not an immigrant problem.
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