Dr Potter, a plastic surgeon who performs breast reconstruction surgeries at her private practice in Texas, is mostly on TikTok, where she went viral and got major media exposure following a video she made in 2025 about how an insurance company (UnitedHealth Group) called her during surgery to question the necessity of a patient’s hospital stay. This video resulted in a threatening letter from UnitedHealth and more media coverage about how the company has bullied its critics over the years.

Potter has around 405,000 TikTok followers and focuses on patient advocacy and the everyday challenges of dealing with insurance companies that encroach on clinical care decisions she makes. She was also involved in a coalition of patients and advocacy groups who fought against billing code changes for breast reconstruction surgery in recent years. In interviews, Potter has said she believes in the power of social media to bring about change, especially in the realm of patient care, and her TikTok feed features patient stories, often of women with breast cancer who have struggled to get appropriate care.

Dr Potter recently appeared on the New York Times podcast Divided, in which she had a discussion with Dr Troyen Brennan, a former health insurance executive, about whether “insurance companies prioritize profit over patient care.” The conversation, unfortunately, ended up reinforcing the idea that the main problem in health care is the delivery of too much care (“inappropriate care”); that the job of for-profit health insurance companies is to police such waste, fraud, and abuse; and that these companies can do so objectively and effectively. Relevant information — such as company profits, CEO salaries, care denial rates — didn’t come up.

To be fair, Potter pushed back on some of this in a TikTok video recorded after the podcast. Referring to the number of times Dr Brennan invoked “unnecessary care,” she said, “That does not ring true to me. There’s not enough care getting to people.” But even then, Medicare for All was not brought up once in the discussion — a curious omission in light of the fact that M4A would solve a number of the problems created by for-profit health insurance, including high administrative costs, high costs at the point of care, and under- and uninsurance of millions of people.

Both Doctor Mike and Dr Potter recognize that American health care has serious problems and that health insurance companies are causing harm to their patients and people all over the country. Dr Potter has gone as far as comparing insurance companies to “the mob” in terms of how doctors have to “pay a tax to the Godfather” in order to practice medicine. She has relayed how one of her patients once told her that insurance was “cruel and unpredictable” and “frightening” because of how many hurdles they had put her through just for her to get breast cancer care.

At the same time, both doctors tend to express an apologetic, polite deference to corporations and the health care system as it is currently structured. In his June 2025 podcast discussion with Dr Potter, Doctor Mike said that he didn’t want viewers to get the idea that “all insurers are bad” or that “the insurance industry is evil.” Potter responded: “Insurance is really important. . . .  I just want it to work well for patients and providers. It’s not that we want to throw it out, right?”

These doctors seem to believe that we have a well-intentioned health care system and that the system is simply not functioning as well as it could be. But this isn’t true. The purpose of a commodified health care system is profit, period. These doctors’ deference to the system is what I suspect leads them to propose the kinds of tired market reforms that we might recognize from right-libertarian think tank fellows or Reagan-era Republicans. Let’s go through some of their ideas to see why they are wrong.

The idea here is that the health care system can remain structurally intact so long as it is brought into “balance.” They cite this idea of “balance” in several different ways. For instance, Dr Potter says that the ACA gave too much power to insurance companies and hospitals and took away power from physicians. She thinks that needs to be reversed — doctors need to be able to own hospitals, she says, something that the ACA effectively barred in most cases.

Dr Potter also notes that the system is out of balance with respect to patient care versus profit. The industry needs a “painful” “reset,” she told Doctor Mike last year. Dr Potter’s goal is for the insurance companies’ “fiduciary responsibility to shareholders” — a phrase she uses often — to be balanced “in the middle somewhere” with doctors’ responsibility to patients. She doesn’t say what any of this would look like though.

Doctor Mike has made similar points. In the same interview from last year, while discussing the aftermath of Potter’s viral video with her, Doctor Mike said that since both UnitedHealth and Dr Potter are “passionate about patient care,” why couldn’t they come to a compromise (as opposed to the aggressive approach UnitedHealth took)? Later in the interview, Doctor Mike said that insurance “needs to be a tool that is used appropriately and in balance.” He also brought up administrative burdens being out of balance. Prior authorizations have “gotten out of control,” he said on another 2025 episode of his podcast. Again, it’s unclear how many prior authorizations would constitute a “balance.”

This all reminds me of when Hillary Clinton once said that capitalism had simply “run amok” and that we needed to “save capitalism from itself.” This seems to be the idea with health insurance and health care: that we can save a predatory health care system by restoring it to some “balanced state.” But how would we know when we’ve achieved balance? What metrics would we use?

Right now, tens of thousands of people die every year due to our failure to enact Medicare for All. So, presumably, at least that many deaths are considered acceptable for us to continue the current system. Beyond that, how many people should die or get fragmented care or otherwise be harmed in order for us to know we have balance? Was the system ever, in fact, balanced? The doctors don’t ever really explain any of this, which is what makes “balance” such a bullshit idea.

Dr Potter is correct when she says that insurance companies have a “fiduciary responsibility to maximize profits for their shareholders.” What’s difficult to understand is her belief that this can be “balanced” while meeting patient needs. Doctors and insurance companies “have to meet in the middle somewhere,” she claimed in an interview with Doctor Mike. The fallacy is thinking you can “balance” profit with people’s health. As Dr Mark Vonnegut, a pediatrician for over forty years, argued in his 2022 book The Heart of Caring: in health care, you can serve people or money but not both.

Dr Potter in particular likes to emphasize the importance of competition. “I’m someone who really believes in competition and in the market. Those are values that are really dear to me. I think what we need is more competition in the market,” she said in an interview with Current Affairs in 2025. The idea is that allowing a bunch of companies in a space to compete against each other will allow the best ones to rise to the top and the bad ones to fall away.

One way this competition could play out is with employer-sponsored plans. On a Meidas Health podcast episode in 2025, Potter suggested that employers looking to purchase health insurance plans for their employees should not contract with the “bad actors” and instead choose the good ones. Okay. But what actually makes a health insurance company “good”? Merely a lower claim denial rate than some current rate? Cheaper copays? Better peer-to-peers? What is the ultimate goal here? Something merely less bad or marginally better than what we have now? And how would this work exactly? There are just too many unanswered questions to take this idea seriously.

The other problem with competition is that it sounds good in theory but doesn’t reliably get us the outcomes we want. The idea that we’re going to let a thousand companies bloom and let the consumers sort it out unfortunately doesn’t lead to better products or lower prices. In one example from Texas, the proliferation of energy companies under an allegedly “competitive” (and deregulated) market has actually led to increased prices, sketchy firms that price gouge during natural disasters, and a failure of the power grid to meet demand at critical times.

In an example directly from health care, the ACA exchange itself was supposed to spur “competition” in the insurance plan market and thus bring better plans and better care. But what has the exchange gotten us? As Nathan J. Robinson argued in 2022, the ACA marketplace exchange functions less like a rational consumer marketplace and more like a bewildering scam. The site uses opaque charts to supposedly allow the consumer to make a comparison of different insurance plans based on a dizzying number of factors (copays, deductibles, networks, and so on). But it’s impossible to make a rational decision with the information provided on the exchange website.

As Robinson notes: “HealthCare.gov has put out information that is indefensibly confusing.” His experience with the ObamaCare exchange left him convinced that its labyrinthine design was not only a waste of people’s time but cruel — a system defined by inefficiency and profound information asymmetries between insurers and consumers. As he put it, “People are being gaslit into thinking that they’re just too stupid to work out the answer to the puzzle of which insurance is best, when in fact they couldn’t choose correctly no matter how smart they were.”

It’s also important to understand that capitalist firms don’t seek competition. They tend toward monopoly and consolidation so that they can eliminate the competition. Interestingly, both Doctor Mike and Dr Potter acknowledge this when they discuss “vertical consolidation” in health care and the opaque way large firms (for example, those with pharmacy benefit managers) move money around while extracting huge profits. Yet we are still supposed to believe that the solution to all of this is . . . more competition.

If the health care market must be constantly regulated in order to counteract firm’s own incentives, it seems very much like competition is not the right organizing principle for health care in the first place. While breaking up “big medicine” is something we definitely need to do, the presence of competition in the market will not be enough to get us to universal health care, which is what we need.

Even within the exchange itself, companies will simply drop out when the profits aren’t there and, importantly, when government subsidies fall out of favor politically. Cigna, for instance, has recently decided to drop out of the marketplace in 2027. As the Wall Street Journal reports, this is just “the latest sign of turmoil in a business that has been hit hard by the loss of federal subsidies. Cigna will be the second major health insurer to leave the rapidly shrinking ACA market, after CVS Health’s Aetna stopped offering plans at the start of this year.”

Some might argue that underperforming companies leaving the market is good — competition working as intended. But the “shrinking” of the “politically sensitive” ACA market does not seem to be the result of consumers disciplining these companies, which is the whole idea behind competition in the first place. And there’s no reason for us to believe that the remaining companies in the marketplace will somehow make their products any better than the indecipherable, unaffordable plans on offer now. The instability of the marketplace also shows how ineffective it is as a way to ensure people have health care. People need health care, not a market for health care where companies can just back out whenever it suits their bottom line.

The issue of cost-cutting is a big one for Doctor Mike. For instance, in a nearly ninety-minute conversation he had with former Centers for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure about “America’s insurance crisis,” he brought up the issue of reducing costs multiple times in multiple contexts. But Doctor Mike seems to be focusing on the wrong kinds of cost.

The purpose of a health care system is not to be low-cost per se. It’s to provide high-quality health care for the citizenry. Strictly speaking, cost is not the primary issue for a system designed to take care of people. We are a wealthy nation, and we should want to spend money on life-sustaining programs such as health care — as opposed to, say, wasting money on bombs and war. Problems arise when we have to deal with the costs of things that do not meaningfully contribute to patient care and that do not have to exist, such as corporate profits and administrative overhead. We already know that government insurance runs on far less administrative overhead than private insurance.

When Brooks-LaSure observed that the country’s health insurance system was “complicated” and proceeded to explain government insurance and private insurance, Doctor Mike did not once bring up a simpler single-payer system. Medicare for All would cost less than the current system in part by cutting out the exorbitant administrative overhead of private insurance. The financing for M4A is also straightforward. We can afford it because we’re already paying for it.

Both Doctor Mike and Dr Potter agree that transparency (in costs and other factors) will be good for patients because they can shop around and find the best insurance plan for themselves. This is essentially a variation of the competition argument: it imagines that well-informed consumers will reward the best insurers and punish the worst. Doctor Mike has also talked about transparency around insurance corporations themselves, such as companies’ prior authorization and denial rates. In an interview with another medical doctor influencer, Pamela Mehta, Dr Potter agreed with the characterization of health insurance as essentially a “coupon” and the idea that people need to know the value of their coupon.

All of this may sound sensible. But, again, these ideas rest on the belief that the system can be made more transparent. Perhaps it can (but as we’ve seen with the ACA exchange, reading these plans is like reading hieroglyphics). But the question remains: Why should people have to die or be harmed — for lack of M4A — while we try to find out? Knowing the price of something doesn’t make it any more affordable. Having greater clarity about the bad choices on offer doesn’t make those choices any better. If anything, it may cause people to opt-out altogether, which is something that insurance companies probably don’t want since they are eager to take a customer’s money. Ultimately, “transparency” arguments start to feel like a substitute for doing the more ethical thing of giving everyone access to health care. Making the predatory terms of health insurance plans easier to read is like making a payday loan contract easier to read.

Such so-called transparency efforts, in any case, are already underway in the industry, as Wendell Potter, a former Cigna and Humana executive turned whistleblower, explained recently. The Trump administration has given the major insurers a chance to police themselves in the aftermath of the public’s reaction to the Thompson killing. Cigna has just come out with a “transparency report” that Potter analyzed. The company claims to have put into place practices that have reduced prior authorization volume by 15 percent. But, as Potter explains, the company has not made changes to any insurance plan coverage policies. It simply standardized a prior authorization form. In other words, it made a cosmetic change, not a change in “Cigna’s criteria for approval or denial.”

And since the company won’t make its claims data public, there’s no way for anyone to verify whether there has been any meaningful impact on what sorts of claims are being denied. Potter calls this entire effort a “sophisticated” strategy to “get ahead” of possible regulatory consequences for the insurance industry’s practices. In this sense, voluntary transparency is nothing more than a cover for the industry to keep doing what it does: denying care.

Finally, the idea of transparency for the purpose of the consumer being able to shop around is impractical when it comes to health care. In her interview with Doctor Mike, Brooks-LaSure mentioned that health care isn’t exactly a commodity like other things on the market. It’s a public good. And, as she explained, because health care is a complicated issue, a person in need of treatment who’s dependent on a doctor’s expert opinion isn’t in the same position as a person looking to buy a car. If we keep treating health care as a commodity defined by insurance plans — which are financial products — we lose focus on what people actually need: health care.

Dr Potter, speaking on the Meidas Health podcast last year, proposed what she calls “direct care.” Basically, your employer will now act as your insurance company. What this means is that employers that purchase health insurance for their workers would instead contract directly with doctors or networks of doctors to pay for care.

There are many problems with this proposal. First, why is a company CEO going to be any better at dictating your health care than a health insurance CEO? American workplaces are far too antidemocratic for this to be a good idea. And there’s no reason we should keep health care tied to our employers. The beauty of M4A is that it frees health care from employment, allowing people to change jobs freely without losing care. Furthermore, what about all the people who lack jobs or can’t work? Or whose employers do not sponsor health care coverage? This plan would leave tens of millions uninsured, or dependent on uneven employer coverage, and is therefore unacceptable.

Doctor Mike and Dr Potter make it clear that they do see a role for the government to “step in” when things get out of hand. Dr Potter has called for “penalties that have teeth” for the bad behavior of insurance companies. In the Current Affairs interview, she said: “I really do feel like it’s time for the government to step in, in the same way that when a company that makes airplanes makes a plane that hurts people, the FAA steps in and says, okay, enough’s enough.”

Of course, what Dr Potter is describing is reactive: The FAA stepping in after people have already been hurt by an airplane manufacturer or the government responding after prior authorizations or other practices spiral “out of control.” Does the government ever get to have a proactive role? What if we created a system where people weren’t getting hurt in the first place?

In the same interview where she talked about direct care, Dr Potter also said that markets could improve the situation faster and better than the government. But what could be simpler and easier than changing the Medicare eligibility age to zero? Everyone would be covered. This sounds a lot easier than endlessly layering reactive regulations onto a system that continually produces the same crises.

Doctors, who are among the highest-paid workers in American society, can be a fairly conservative bunch. While partisan affiliation may vary based on specialty, historically doctors have put up significant opposition to universal single-payer systems such as those in Canada, the UK, and even here in the United States (for a long time, the American Medical Association fought against single-payer, although there may now be some movement in the other direction on this issue). Part of the pushback is due to fear of “socialized medicine.” But remember, Medicare for All is not socialized medicine; it’s socialized payment. Care would still be delivered through private facilities as it is now.

But beyond fearmongering over a government takeover of health care, doctors themselves do have a conflict of interest here. If we were to do it Dr Potter’s way and go back to the days when doctors were mostly individual practitioners — most doctors nowadays are employees of corporations — doctors would still have to deal with the fact that “you eat what you kill,” as the saying goes.

The profit motive facing private practitioners may differ from insurance companies, but it is still very real. As a doctor who worked as a general pediatrician for six years myself, I don’t think we should try to go back to the days of doctors being independent practitioners. The goal here isn’t to make doctors entrepreneurs again; it’s to give everyone health care. And the best way to do that is to start with Medicare for All and eventually create a national health system.

Not only does our current health care system leave around twenty-seven million people uninsured, care is increasingly unaffordable even for people who have insurance. Rising health care costs constitute a massive burden on Americans and are a major contributor to the current cost-of-living crisis.

One recent survey by West Health-Gallup Center on Healthcare in America found that one in three Americans have to cut back on essentials in order to pay for health care. The ACA, despite implementing some important and useful provisions that enabled more people to get insurance, has failed to rein in the costs of health care for ordinary people.

Prices for some ACA marketplace exchange plan purchasers have skyrocketed this year after Congress decided to end enhanced subsidies for the plans last year. Some 9 percent of ACA enrollees have decided to go uninsured due to the costs. Medical expenses are a leading cause of bankruptcy in the country, not to mention the stress of dealing with the nightmarishly opaque copays, deductibles, networks, bills, and so on. Medicare for All, a socialized payment system, would end this toxicity once and for all.

In a recent TikTok video, Dr Potter herself said, “The answer cannot be that if you see injustice, you act with injustice. The answer has to be that if you see injustice, you fix the problem.” Well, what would be an injustice is to enact more market tweaks to the system while continuing to deprive people of universal coverage. Medicare for All is exactly what we need to fix the problem of insurance injustice in this country, and anything less is unacceptable.