Laurel Fitzhugh

Universal Healthcare: We Already Know How to Do This

by

We spend more for fragmented healthcare than comparable countries do for universal care, and get far worse outcomes.

“Medicare for All” is a phrase with a lot of political baggage, so set it aside. What it describes is simpler: extending a system Americans already built to the rest of the population. This piece uses “universal healthcare” from here on, because that’s what it is.

Medicare works. It covers every American over 65, regardless of employment status or health history. It operates with administrative overhead of roughly 2%, compared to 12-15% for private insurers. It negotiates prices, it pays claims, and it has done so for sixty years. We know how to do this because we already do it.

Healthcare doesn’t work like a normal market.

You can’t comparison shop during a cardiac event. You don’t choose when to have a stroke. Every wealthy country that looked honestly at these conditions reached the same conclusion: healthcare cannot be organized around market competition.

The American system has grown around a different goal. The administrative apparatus — prior authorizations, claim denials, billing complexity — exists to protect revenue, not deliver care. The clinical judgment of a trained physician is overruled by a clerk or algorithm with no medical expertise and every financial incentive to deny.

Read more

What Does Medicare for All Mean?

by

The Insurance Pool

Health insurance is a mechanism for pooling risk. Medicare for All is a proposal for extending an existing version of that mechanism to everyone. This piece explains both — how insurance works, where it went wrong, and what “Medicare for All” actually means.

Health insurance is a mechanism for spreading financial risk across a large population so that no single person bears the catastrophic cost of serious illness alone. Everyone pays in, and everyone draws down when needed. Across a lifetime, most people are sometimes healthy, and sometimes need medical care. The function of insurance is to spread the cost of care across users. Insurance functions differently from a normal consumer market.

A productive market system (fair profit for a valuable service) requires something insurance cannot provide: a real exit option. A functioning market depends on customers who can walk away — who can comparison shop, switch providers, or go without. Competition disciplines prices and quality only when exit is possible. Remove the exit and you remove the mechanism that makes markets work.

Read more

Social Democracy Is Not Socialism

by

Social Democracy Is Not Socialism Democrats struggle to make that distinction in the public mind. This piece, published on Substack, examines the difference between social democracy and socialism — two distinct systems that have been deliberately confused for fifty years. It covers the historical record of social democratic governance, how “socialism” became a political weapon, … Read more

Hondurasgate: The Political Plot American Media Isn’t Covering

by

A set of audio recordings is circulating across Latin America right now. They have been forensically authenticated. They document sitting heads of state coordinating a funded disinformation operation targeting elected governments in the region. The operation is being built on American soil.

You probably haven’t heard about it.

Read more

Fifteen States Against Citizens United

by

This article was originally published on Red, Blue & Real, the author’s Substack publication. The version below includes sources and further reading.

Two Doors for Money Into Politics

Money in politics is a classically American conflict. In 2010, business interests gained an entirely new level of legal power. The change was not simply more money. It was a different kind of money, operating under different rules, in quantities that made the previous system look small by comparison.

Two federal court rulings that year dismantled major parts of a century of campaign finance law. One allowed corporations to spend directly on elections. The other created the super PAC system — unlimited independent spending, unlimited contributions, no effective ceiling.

The results reshaped American politics. Outside groups spent roughly $4.5 billion in the 2024 election cycle.5 Super PACs alone raised more than $5 billion.5 Dark money — political spending that does not disclose its original source — reached record levels approaching $1.9 billion.8

Fifteen states have now developed a legal theory intended to close the corporate spending door. The super PAC door is another matter entirely.

Read more

Weakening Unions: The Double-Breasted Trick

by

American workers once held a claim on the full value of their labor — wages, pensions, healthcare, job security. A legal structure called the double-breasted employer was built to take that claim apart from both sides simultaneously. One company, two arms, one owner — and the wage floor suppressed no matter which side wins the contract. This piece documents how the mechanism works, who built it, and why it now operates in an environment designed to make accountability impossible.

Marana: Corporate Interests and Political Support

by

Extractive Capitalism and the Assault on Constitutional Democracy

The Project and the Public’s Concerns

Arizona’s constitution gives residents a direct tool for pushing back against decisions their government makes on their behalf: the referendum. In January 2026, Marana residents used it.

The Marana Town Council voted unanimously to rezone 600 acres of farmland adjacent to the Arizona Veterans’ Memorial Cemetery and a groundwater recharge zone for a data center campus known as Project Blue. The developer is Beale Infrastructure, controlled by Blue Owl Capital, a $295 billion investment firm. The projected scale: 550 to 750 megawatts of continuous power — enough to supply roughly 57,000 homes.

Residents had specific, documented concerns. The energy demand required new generating capacity, the costs of which would be passed to ratepayers. Water usage drew particular concern in a desert community whose aquifers do not replenish on any timeline relevant to human planning. Hundreds of backup generators raised noise and air quality concerns in a largely agricultural landscape. Residents questioned whether the promised $5 billion investment and $145 million in tax revenue over ten years would materialize, or whether the primary beneficiary would be a $295 billion investment firm. Some critics argued the project supports an AI industry that facilitates surveillance and data extraction for private profit.

These are the concerns that drove nearly 6,000 Marana residents to sign referendum petitions in a matter of days. The constitutional tool was available. They used it. The rest of this piece documents what was done to stop them.

Read more

Two Parties, One Machine

by

The Political Machine

The American two-party system requires that you declare a party before you can participate in the voting system. This is the back door to authoritarianism. This is an authoritarian structure.

These days, authoritarianism generally arrives through democratic backsliding — elected leaders gradually take power away from voters and redirect it toward the machine that keeps them in office. The machine is a set of interlocking interests: party infrastructure, donor networks, media systems, and the officials who serve all three. It grows through accumulated small captures of democracy, each one normalized before the next one lands. Voter suppression, manufactured division, and information control are the visible tools. The two-party system is its foundation.

Read more