What does Anthony Fauci really think about America's health care system?
It depends on the audience
Public health is a public good. We’re all in this together. You heard those phrases a lot during the pandemic, because they’re true. If someone is walking around a city with an untreated disease, they are more likely to spread it to you. If an employee can’t perform at an optimum level at work, because they are suffering from some malady, that individual’s colleagues and organization will suffer. Despite the importance for public health of everyone having access to basic medical care, the United States is alone among rich countries in not having a universal health care system. A 2009 study from Harvard Medical School and Cambridge Medical Alliance found that “nearly 45,000 annual deaths are associated with lack of health insurance.”
The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors, and baseline health,” said lead author Andrew Wilper, M.D., who currently teaches at the University of Washington School of Medicine. “We doctors have many new ways to prevent deaths from hypertension, diabetes, and heart disease — but only if patients can get into our offices and afford their medications.
When Covid-19 arrived, we learned that patients with “hypertension, diabetes, and heart disease” were unsurprisingly more vulnerable to severe disease and death. One might therefore expect former National Institute of Allergy and Infectious Diseases Director Anthony Fauci — the nation’s leading infectious disease expert during the pandemic — to energetically embrace achieving universal health care.
And, when he spoke to the Ambrosetti Forum’s European audience in September 2021, he seemed to do just that.
Fauci told the gathering of Italian and European businesspeople, politicians, and policy big shots that European universal health care systems are “more acceptable, more uniform, and more fair for all,” which he suggested resulted in higher Covid vaccine uptake in Europe than the U.S. (After a complicated start, European vaccine uptake was dramatically outpacing the U.S. by Summer 2021.) He added: “We hope that the United States can also evolve in that direction.”
A year earlier, Fauci had shared similar thoughts with University of Berkeley students: “The short answer to your question is, yes, we do need universal health care.”
Last month, however, when delivering paid remarks to AHIP, the private health insurance trade association formerly known as America’s Health Insurance Plans, Fauci analyzed U.S. health care in a very different way. In front of an audience of private health insurance lobbyists, Fauci heaped praise on the individuals — and their shareholder-owned corporations — responsible for one of the world’s most dysfunctional and lowest performing health care systems.
Fauci, who reportedly charges between $50,000 and $100,000 for speeches, started his talk by thanking the audience of insurance lobbyists and health care marketing companies for being “devoted to making sure that we get good health care in an equitable way.”
In a nutshell, Fauci told U.S. health insurance lobbyists that the for-profit firms they represent are delivering good health care with equity to the American people. While it is possible Fauci was simply unaware of AHIP’s opposition to universal health care, that’s unlikely given the former NIAID director has spent nearly his entire career in Washington, DC. In the past, AHIP has fought against health care systems like those in France and Italy that Fauci praised in September 2021. In July 2021, AHIP sent a letter to Congress blasting even the modest public option proposal that President Joe Biden campaigned on in 2020.
How can his AHIP comments be reconciled with his message to a European audience that we should attempt to “evolve in [the] direction” of more government-oriented French and Italian health systems that cover everyone and deliver better outcomes than AHIP’s private health insurers? What does he really believe?
With millions of the most vulnerable Americans — including many children — currently losing their Medicaid health insurance following the end of the pandemic emergency, the deafening silence of the nation’s most famous doctor is noteworthy. Now that he’s retired from NIAID, Fauci is headed to Georgetown University where he will teach medicine and public policy courses. Perhaps his students can ask him to clarify how he thinks American health care should be financed and delivered.