Marxism Has No Place in U.S. Health Care

Congressional staffers are telling CCHF the phrase Social Determinants of Health (SDOH) is popping up everywhere in federal legislation. Ultimately, SDOH is a Marxist initiative that uses health as rationale to centralize the entire economy. 

The implementation of SDOH comes with the idea that the government can – and will – engage in active surveillance of your life and your health care decisions under the guise of keeping you healthy.

For example, on August 7, 2023, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) proposed a regulation that would continue the government’s ongoing intrusion into the practice of medicine, eroding the privacy and confidentiality rights of Medicare patients.

The proposed rule defines SDOH as follows:

Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. These circumstances or determinants influence an individual’s health status and can contribute to wide health disparities and inequities. ICD–10–CM contains Z-codes that describe a range of issues related—but not limited—to education and literacy, employment, housing, ability to obtain adequate amounts of food or safe drinking water, and occupational exposure to toxic agents, dust, or radiation. 

In a public comment submitted in response to the proposed legislation on September 11, 2023, CCHF submitted that the SDOH initiative is not health care or medical care, and that SDOH should not have any place in Medicare. 

You can also read our public comment, which we have posted on our website, by clicking here.

We detailed several concerns about this intrusive, all-encompassing plan:

  • SDOH initiatives divert increasingly scarce health care dollars from actual treatment of patients.
  • SDOH initiatives rely on intrusive data collection on all areas of an individual’s life, creating extensive profiles on Americans through their medical records.
  • SDOH initiatives ultimately seek to centralize the economy based on the rationale that the government can provide Americans with health and equity, neither of which can be assured or achieved – nor mandated.

The most alarming aspect of this proposal is that most Americans have no idea that, if this proposed regulation passes, information on all aspects of their life will become an open book for the government.

This proposal is a whopping 936 pages long, with 445,104 words in three small columns of print. The language is complicated and difficult for anyone to read, including health care providers. If passed, Medicare patients will be entirely in the dark about the regulations that would impact their access to care or access to the best care for their condition.

CCHF roundly rejects this intrusive proposal and made this clear in its public comment. 

The SDOH drum beat is growing, posing an ever-increasing threat to freedom in and outside the exam room. This past June, CCHF traveled to Washington, D.C. to meet with several lawmakers and staffers on Capitol Hill. A key topic was Social Determinants of Health, and we urged them to perform “search and destroy missions” across all pending federal legislation to prevent the adoption of Marxism into our laws. 


Thank you for standing with us in this critical battle for health freedom!

In liberty,

Twila Brase, RN, PHN
President and Co-founder

September 27, 2023

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