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Amid a brutal cost-of-living crisis after decades of austerity, popular support for progressive economic policy is the highest it’s been in years. Yet Keir Starmer’s Labour Party refuses to deliver — because it’s afraid of empowering workers.

Labour Party leader Keir Starmer speaking during the British Chambers Commerce Annual Global conference in London on May 17, 2023. (Jordan Pettitt / PA Images via Getty Images)

There can be no denying that, over the last several years, there has emerged a broad economic consensus in favor of a fundamental transformation of the UK economy.

In 2019, a poll from the Institute for Public Policy Research and YouGov found that 60 percent of people wanted the government to introduce significant changes in how the economy is run. In 2020, a poll from Unite and Survation found that 60 percent of people believed that cuts to public services had had a negative impact, while 71 percent believed that taxing the wealthy would be preferable to renewed austerity. In 2022, Ipsos MORI found that 67 percent of people agreed that ordinary working people do not get their fair share of the nation’s wealth.

This represents a shift from previous data. The British Social Attitudes Survey shows that a majority of UK adults favor increasing taxes and spending more ever since 2017, before which point more were in favor of keeping spending the same.

It’s not hard to see why such a consensus had emerged by the 2020s. My generation, which came of age around the financial crisis of 2008, had lived through an era of near-unprecedented crisis and stagnation.

Millennials joined the labor market in the wake of the greatest financial crash since the Great Depression and the worldwide recession that followed it. Graduates born a few years later didn’t have it much better, as they were forced to pay more than £9,000 per year for their university education.

Then came the great stagnation that followed the great recession. In the UK, wages and productivity stagnated for the longest time in more than a century. The Resolution Foundation found during this period that my generation would be the first in the history of modern capitalism likely to be worse off than their parents.

Then came the pandemic. COVID-19 did not only take hundreds of thousands of lives, it forced millions of people to stay trapped in their homes during what should have been their prime years of education or their first years in the labor force. It also forced hundreds of thousands of older people out of the labor market altogether due to the debilitating impact of long COVID.

And then came the cost-of-living crisis. By March 2023, UK workers had lived through fifteen successive months of lower-than-inflation pay increases, meaning households were getting poorer every month.

The Institute for Fiscal Studies recently released the astonishing statistic that wages by 2026 would be over 40 percent lower than what they would have been had precrisis trends continued. In other words, living standards have essentially remained flat in the fifteen years since the financial crisis of 2008. The Resolution Foundation called this period of stagnation “completely unprecedented.”

In this context, it is no longer radical to argue that the UK economy requires deep, structural transformation. With the power to set taxes, levels of public spending, wages in the public sector, and regulation in the private sector, the British state is the only institution capable of enacting such a transformation. It follows that the British electorate is in favor of a radical shift in economic policy.

So why is the Labour Party refusing to provide such a shift?

Keir Starmer is undoubtedly a timid and conservative leader who shies away from the kind of radicalism championed by Jeremy Corbyn and John McDonnell, making him a deeply inappropriate person to have at the helm at this time of unprecedented economic chaos.

Many of his former cheerleaders now recognize this problem — especially after some disappointing local election results — and are encouraging the Labour leader to come up with some interesting economic policy ideas.

But there are reasons to believe that Starmer’s reticence to back radical economic transformation is not simply the result of his cautious character.

The problem with state-led economic transformation is that it encourages people to believe that they have some control over the nature of the economy, rather than the economy having total control over them.

Most people are led to believe that “the economy” is some abstract entity that goes up and down based on psychological patterns and random exogenous shocks. They believe, in other words, that the economy is an external force that controls their lives — not unlike the way ancient societies treated the whims of their gods.

Pleasing “the economy,” like pleasing the ancient gods, often requires some form of sacrifice. This is why David Cameron’s argument that the age of excess had to give way to the age of austerity was so convincing in the postcrisis period. “The economy” had been disturbed, and now it had to be placated.

This ideology is what allows our elites to consistently get away with imposing policies that clearly have a negative impact on the vast majority of people. Without ever providing any evidence, policymakers will state that “the economy” requires tax cuts, or public spending cuts, or deregulation. Experts will nod along and, without the ability to challenge them, most people will simply accept their word as gospel.

And the policies these “experts” promote just so happen to privilege the interests of the already wealthy while eroding the power of the working classes.

But when the government acts to change the nature of the economy, this ideology is flipped on its head. Suddenly, it’s not “the economy” that is in charge of the people, it’s the people who are in charge of the economy.

This is both the meaning of economic populism and the reason for the entrenched bias against any form of progressive state intervention among the British establishment.

The promise of progressive economic policy makes it viable for working-class people to organize in order to demand economic policies that could promote their interests. What’s more, the increase in employment also associated with greater levels of government spending also makes it easier for workers to organize for better pay and conditions.

It’s not hard to see why such a specter would be scary to those who benefit from the status quo. If the state of the economy is something that we can shape with changes to economic policy, then what is to stop people from arguing for significant redistribution from the wealthy to the poor? What is to stop workers from organizing to demand wage increases in line with inflation? What is to stop them from organizing to demand the power to organize production itself?

My instinct is that Starmer simply does not think in such ideological terms. His expert advisers inform him, allegedly objectively, which kinds of policies would be good for “the economy,” and he rigidly adheres to their advice.

But Starmer’s expert advisers, not to mention those who fund him, will be deeply aware of the problems posed by the kind of economic populism that proved so popular during the Corbyn years, and their advice will be expressed accordingly.

For as long as economic policymaking is dominated by “experts” whose views are formed without reference to the needs of ordinary people, the UK’s economic crisis will continue to get worse. What we need is economic democracy — and that’s what terrifies the British establishment.

In Florida, Osceola County Deputy David Crawford has been charged with culpable negligence after videos surfaced of him firing a Taser at a man soaked in gasoline, resulting in a fireball that burned almost three-quarters of his body.

The incident occurred on February 27, 2022, at a Wawa gas station in Orange County. The victim’s lawyer remarked, “They’re supposed to be our protectors, not our ignitors.” He also told The Daily Beast that his client was “cooked alive” by police.

The bodycam footage showed Crawford tackling the suspect, Jean Barretto Baerga, who had reportedly been followed by officers responding to reports of reckless driving.

According to Sheriff Marcos López, on his motorcycle, Baerga had run red lights, ridden on the sidewalk and grass, and gone toward oncoming traffic before arriving at the gas station.

As the suspect lay in a pool of gasoline, Crawford yelled, “Kill the pump! Kill the pump! There’s gas!” At this time, another deputy, Christopher Koffinas, tased Baerga without incident. After this, Crawford was heard saying, “You’re gonna get tased again, dude!” before the Taser ignited an explosion.

State Attorney Monique Worrell stated that Crawford had “recklessly deployed a Taser,” leading to Baerga’s severe burns covering 75% of his body. Baerga’s medical costs are estimated to be around $7 million, and his lawyers plan to recoup this from the sheriff’s office.

Meanwhile, the other deputy involved, Christopher Koffinas, received a 40-hour unpaid suspension for firing his stun gun but is not facing criminal charges. The sheriff’s office stated that it is right to let the criminal justice system determine if Crawford’s actions constituted a criminal act.

The provocative actions of Ukraine and the involvement of NATO in the conflict can lead to a direct clash between Russia and the members of the alliance.

On Wednesday evening, Cameron Robbins, an 18-year-old from Louisiana who had recently graduated from University Laboratory School in Baton Rouge, was on a sunset dinner cruise in the Bahamas with a group of students from local high schools.

Witnesses report that at 9:40 p.m., Robbins, acting on a dare, jumped off the boat into the dark waters near Athol Island and was not seen again, as reported by WAFB.

The vessel, designed in the form of a pirate ship, stayed in the area for several hours to locate Robbins. The Royal Bahamas Defence Force and the US Coast Guard Southeast have been searching for Robbins from the sky.

On Friday night, Lt. Cmdr. Matt Spado, the Coast Guard liaison officer, announced that the search for Robbins has been suspended.

Robbins’ school director, Kevin George, stated that Robbins had attended the school for all 13 years of his education and was a pitcher on the school’s baseball team; his younger sister is currently a junior at the school. George also mentioned that they were all praying for Robbins’ safe return.

On Thursday, the parents of Robbins arrived in the Bahamas, where a prayer service was conducted at the resort where he was residing. Another prayer gathering for Robbins was held on the same day at his past school in Baton Rouge.

Ron DeSantis’s conservatism is by and for internet-addled right-wing media consumers so accustomed to having their eccentricities satiated and pleasure centers stimulated that they’ve become increasingly unmoored from the real world.

Florida governor Ron DeSantis’s Twitter profile page, May 24, 2023. (Scott Olson / Getty Images)

Aside from accidentally generating some schadenfreude, there is no conceivable metric by which Ron DeSantis’s presidential launch this week on Twitter could possibly be deemed a success. If a successful campaign event projects energy and confidence, the DeSantis fiasco had all the majesty of a dysfunctional Zoom meeting, replete with false starts, technical glitches, and unscripted background chatter. And throughout it all, the Florida governor ultimately rallied an audience smaller by orders of magnitude than Buzzfeed once got by blowing up a watermelon or Drake did by playing Fortnite.

It’s worth pondering what the hell DeSantis and his operatives were thinking. A less choppy version of the same event would still have lacked a cheering crowd and likely been absent many of the older, cable news–addicted voters who tend to play such a pivotal role in Republican primaries (they aren’t on Twitter). But notwithstanding these basic practical issues, there’s a deeper insight to be gleaned about the ossified strain of conservatism DeSantis represents in what will almost certainly be his doomed campaign against Donald Trump.

For a fleeting moment after last year’s midterms, Florida’s governor managed to look like he might actually be a viable opponent for the former president. The case for DeSantis, amplified ad nauseam by the Murdoch media and parts of the Republican apparatus eager to ditch Trump, was that he represented a competent and baggage-free version of the same thing. By anointing the governor of Florida — a man whose political style basically consists in serving right-wing activist constituencies an all-you-can-eat buffet of red meat — primary voters were informed that they could have something both more palatable and more electable.

But the promised ascent in the polls never came. Trump’s lead over DeSantis has increased since the beginning of 2023, and nothing has occurred so far to suggest that he will supplant the former president as the standard-bearer of America’s political right. Far from being Trump’s heir or successor, DeSantis now looks more like the second coming of Ted Cruz or Jeb Bush: an establishment figure elevated by the creaking machinery of orthodox movement conservatism who owes his standing to the usual constellation of think tanks, corporate donors, and plutocrat-financed magazines rather than broad populist appeal.

DeSantis-ism is less a harbinger of ideological renewal than a symptom of institutional conservatism’s decadence and exhaustion. Its essence, located in the reactive impulse to lean into whatever freakish cause célèbre is animating the Right’s culture warriors on a given day, ironically mirrors that of the very hyper-woke milieu its zealots claim to detest. It’s an -ism by and predominantly for internet-addled right-wing activists and media consumers so accustomed to having their eccentricities satiated and their pleasure centers stimulated that they’ve become increasingly unmoored from the real world.

Cruel and hateful, to be sure. But it’s also emblematic of a political project whose sense of discipline and purpose has been overpowered by its own machinery — whose activists increasingly speak an abstruse and impenetrable online jargon, strike maximalist poses by default, and obsess over causes that scarcely register outside the reactionary echo chamber. For that reason, it’s perfectly fitting that the DeSantis campaign would think it a great idea to launch itself by partnering with Twitter — a place that, under Elon Musk’s incompetent and reactive leadership, has come to be governed by many of the same impulses.

Whatever continuity Trumpism may have with the right-wing politics that came before it, it clearly represents something other than the old, bowtie-sporting conservatism of the American Enterprise Institute and the National Review. At the level of style, it’s more ambidextrous and rhetorically heterodox, less willing to compromise with institutions, and in many ways inextricable from the idiosyncrasies of Donald Trump himself. Even notwithstanding the poor execution, that DeSantis sought to inaugurate his campaign against Trump in an online medium at all is symbolic of how narrow the appeal of a “Trumpism without Trump” really is on today’s right.

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Last year, the federal government spent $20.5 billion overpaying private insurers for Medicare Advantage plans — and the industry’s aggressive lobbying campaign is kneecapping efforts by lawmakers to stop the scheme.

The government’s inability to crack down on Medicare Advantage overpayments is a product of major lobbying campaigns by the industry. (Bill Clark / CQ Roll Call via Getty Images)

The health insurance behemoth Humana enjoyed a banner 2022. The Louisville, Kentucky–based insurer made $2.8 billion in profits last year, while paying out $448 million in dividends to shareholders and more than $17 million in compensation to its CEO.

The main driver of those earnings? The federal government spent $20.5 billion overpaying Humana and other private insurers for the Medicare Advantage plans they manage on behalf of seniors and people with disabilities. If not for those overpayments, Humana could have suffered a nearly $900 million loss in 2022, according to a Lever analysis.

Humana is the most prominent example of how insurers have built a major cash cow out of systematically overbilling Medicare Advantage, the private Medicare program operated by private interests. These overpayments are symptomatic of a broader profit-driven policy agenda that seeks to completely privatize Medicare, one of the nation’s most popular social programs, and lock program recipients into subpar private insurance plans, even when they get sicker and need the best care possible.

Medicare Advantage plans have higher claim denial rates and more prior authorization restrictions than traditional Medicare plans. Last year, regulators found that nearly one in five payment requests rejected by Medicare Advantage plans in 2018 were wrongfully denied, representing an estimated 1.5 million claims.

And while Biden administration proposals could have helped slow the for-profit takeover by tightening the screws on Medicare Advantage overpayments, insurers recently led a fierce lobbying campaign to dissuade the government from fully cracking down on the practice.

At the root of Medicare Advantage overpayments is “upcoding” by insurers, a scheme by which the companies systematically overbill the public as if their patients are sicker than they really are. Companies have offered bottles of champagne and bonuses to entice doctors to add diagnoses to patients’ records, according to government lawsuits reviewed by the New York Times.

In total, these practices led to $20.5 billion total excess payments to Medicare Advantage insurers in 2022, according to a March report from the Medicare Payments Advisory Commission (MedPAC), a federal body tasked with overseeing Medicare. In the coming years, the overpayment problem could get substantially worse. A November 2021 study suggested that Medicare costs from 2023 to 2031 will be $600 billion higher than if Medicare Advantage beneficiaries were instead enrolled in traditional Medicare.

Because of such overpayments, big insurers like Humana have become highly dependent on Medicare Advantage. Humana, for example, earned more than 80 percent of its revenue from Medicare last year, and now has nearly five million Medicare Advantage customers. Wall Street loves this business model: Humana’s stock has outperformed the S&P 500 by 23 percent over the past five years.

Humana isn’t alone in benefiting from Medicare Advantage overpayments. The other major for-profit insurers — UnitedHealth, Centene, and CVS Health, which owns Aetna, would have seen major hits to their 2022 profits had the government eliminated the overpayments.

UnitedHealth Group would have seen its profits deteriorate by more than one-third, from $14.4 billion to less than $8.8 billion, according to an analysis by the Lever. CVS Health would have seen its profits cut by more than half, from $4.1 billion to $1.9 billion. And Centene would have seen its profits deteriorate by more than one-quarter, from $3.4 billion to $2.4 billion.

Experts say the enormous sums of money going toward overpayments endanger the overall financial stability of Medicare as a whole.

Experts say the enormous sums of money going toward overpayments endanger the overall financial stability of Medicare as a whole.

“It’s threatening the solvency of our Medicare trust fund,” said Ana Malinow, a physician active in pro–Medicare for All groups. “The trust fund is made up of payments that people make throughout their entire working lives. If you are working, you’re paying into Medicare every two weeks with your paycheck. Instead of money going to pay for health care for seniors and people with disabilities, it’s going to UnitedHealth and Humana.”

Cutting back Medicare Advantage overpayments could be transformative for the social program, said David Lipschutz, associate director of the Center for Medicare Advocacy, which lobbies for a robust Medicare system. “These are huge amounts of money that could be directed to shoring up Medicare’s finances,” said Lipschutz. “Or expanding benefits for everyone, not just in Medicare Advantage plans.”

The government’s inability to crack down on Medicare Advantage overpayments is a product of major lobbying campaigns by the industry. Two Biden administration proposals that would have tightened the screws on Medicare Advantage overpayments by enhancing audits and cutting the growth of payments to Medicare Advantage plans were both scaled back in the face of aggressive industry lobbying and TV campaigns.

Instead, while there will likely be some cutbacks, the Medicare Advantage gravy train will continue. The number of people enrolled in Medicare Advantage is set to outpace traditional Medicare for the first time ever this year, with more than thirty million beneficiaries.

Better Medicare Profits

In February, the Centers for Medicare and Medicaid Services (CMS), which oversees Medicare, proposed a rule that would have reined in upcoding abuses by reducing extra payments that insurers receive for certain diagnoses, including diabetes “with complications” and a rare form of malnutrition. But in the face of widespread industry lobbying, the agency settled on a weaker three-year phase-in effort.

Even the original proposed rule might not have been enough to address Medicare Advantage overpayments. MedPAC called the initial proposal “insufficient” in a comment letter, and said that Secretary of Health and Human Services Xavier Becerra had “not taken significant action” in response to MedPAC’s analyses of fraudulent billing in Medicare Advantage.

Another way to crack down on upcoding schemes would be to limit government payments to Medicare Advantage plans, since it would send a message to Medicare Advantage providers that overall program costs are far too high. Last December, CMS did so by proposing increasing payments to Medicare Advantage plans by just 1 percent, compared to the 8.5 percent payment increase it approved last year.

In response, the Better Medicare Alliance, an advocacy group for Medicare Advantage plans, spent at least $13.5 million on ads pressuring the administration to increase the planned rate hike.

The group also spent $570,000 lobbying Congress in the first quarter of this year, nearly double the $330,000 spent in the prior quarter. All told, the four major publicly traded health insurance companies that operate Medicare Advantage plans, as well as the insurance lobby America’s Health Insurance Plans, spent nearly $19 million on federal lobbying in the first quarter of 2023, a 66 percent increase from the prior quarter, according to a Lever analysis of data from OpenSecrets.

The government’s inability to crack down on Medicare Advantage overpayments is a product of major lobbying campaigns by the industry.

That lobbying paid off: instead of a 1 percent increase in payments to Medicare Advantage — which the insurance industry cast as a reduction because the growth rate had slowed dramatically — CMS announced a 3.3 percent payment increase at the end of March.

“The industry’s aggressive lobbying campaign showcases that they clearly want to protect their profit stream,” said Lipschutz. “Their disingenuous campaign tried to paint some very minor payment adjustments as being catastrophic to the Medicare Advantage program. They tried to ‘Medi-scare’ beneficiaries into contacting their elected officials to get CMS to back off — which CMS did to a certain extent.”

While industry analysts have said that this modest rate increase will strain insurers’ prodigious profits, the bond ratings agency Moody’s declared in April that “we believe [Medicare Advantage] will continue to be a growth driver for the industry and will take further market share from traditional Medicare.”

Medicare Advantage payment increases like Joe Biden’s 3.3 percent hike will result in higher dividends to shareholders at the expense of the solvency of traditional Medicare.

The insurance industry also took aim at a recently proposed rule to claw back years of inflated risk adjustment payments, which are made to incentivize Medicare Advantage plans to accept riskier patients.

Initial proposals floated by CMS included retroactive audits of risk adjustment payments going back to 2011. Instead, the final pared-back proposal released in March only included retrospective audits going back to 2018.

Lipschutz said he does give the administration some credit for the audit rule change and the smaller rate hike for Medicare Advantage insurers relative to the prior year.

“On the other hand, it can be seen as far too little too late,” he said, adding that federal policy being so weighted toward Medicare Advantage plans at the expense of traditional Medicare is a “serious imbalance that is long overdue for course correction.”

Privatizing Medicare

Traditional Medicare operates on a fee-for-service basis. This means that doctors and hospitals are paid directly by Medicare for the services they provide. Private plans have operated as part of Medicare since just after the program was launched in 1965, but typically did so on a very limited basis. That changed in 2003, when Congress substantially increased subsidies for plans to enter the market, after intense industry lobbying.

While the traditional Medicare model is not without problems — Medicare only covers 80 percent of expenses, which means that seniors need either Medicaid or a Medigap insurance plan to get full coverage — it has major benefits relative to Medicare Advantage.

The principal benefit of traditional Medicare is that there is not a profit-driven insurer attempting to limit the scope of care that a patient needs.

The principal benefit of traditional Medicare is that there is not a profit-driven insurer attempting to limit the scope of care that a patient needs.

Medicare Advantage “seems like a good idea,” said Ted Doolittle, the State Health Care Advocate for Connecticut. That’s because Medicare Advantage plans often offer expanded benefits like dental, vision, or wellness. They also eliminate the need for a potentially expensive Medigap plan if a senior isn’t eligible for Medicaid coverage.

But then, said Doolittle, “The scholarship shows that when patients get sick, they try to go back to traditional Medicare.”

According to Doolittle, most people who are either Medicaid eligible or who could afford a Medigap plan would balk at signing up for Medicare Advantage plan “if folks had adequate information about the nature of Medicare Advantage versus traditional Medicare, and the higher denial rates and the prior authorizations required for care in Medicare Advantage.”

Doolittle pointed out that there’s a key barrier to patients to getting full medical coverage if they try to switch back to Medicare once they become sick: in most states, Medigap insurers are allowed to discriminate against seniors on the basis of preexisting conditions if they are already enrolled in Medicare Advantage, something that is prohibited when seniors first become eligible for Medicare three months prior turning sixty-five.

This problem is amplified by the rapid growth of Medicare Advantage. In 2010, a little over one-quarter of Medicare beneficiaries were in Medicare Advantage. By 2016, it was still less than one-third. But this year, a majority of Medicare beneficiaries will be on the private plans.

And the exorbitant government costs of Medicare Advantage are not limited to just overpayments related to upcoding. This year, Medicare Advantage plans will receive taxpayer rebates averaging $196 per participant. These rebates have more than doubled since 2018.

The total cost of the rebates could be as high as $75 billion this year, according to analysis by Bill Kadereit, president of the National Retiree Legislative Network.

“The extra $196 is spent on fringe benefits, and only on fringe benefits that go towards Medicare Advantage beneficiaries,” Kadereit said. “The other 30 million people in traditional Medicare get nothing. When Joe Manchin in West Virginia says ‘I like sending money to the Medicare Advantage plans, give them more,’ well, 40 percent of his people in West Virginia are not on Medicare Advantage, so they don’t get a nickel.”

Expanded attention to Medicare Advantage abuses has led some members of Congress to speak up and pressure the Biden administration to rein in the industry, even in the face of aggressive lobbying.

In February, seventy lawmakers, led by Congressional Progressive Caucus chair Pramila Jayapal (D-WA), sent a letter to the Biden administration pointing out that “as enrollment in [Medicare Advantage] grows, spending per beneficiary has grown faster in [Medicare Advantage] than original Medicare, and that spending is being funneled into corporate profits under the guise of operating costs instead of into care for patients.”

That said, there is no voice in Congress advocating for the phasing out of Medicare Advantage and allocating expanded benefits equally to all Medicare beneficiaries, which is by far the most cost-effective option.

And the larger Medicare Advantage becomes, the more politically difficult it will be to rein in, noted Doolittle.

“As Medicare Advantage keeps getting more embedded in Medicare, the situation keeps getting worse,” he said. “It’s gotten up to a real critical mass at this point, which makes it very hard to stop.”

You can subscribe to David Sirota’s investigative journalism project, the Lever, here.