No, Healthcare Is NOT Brat

Until last week, I thought “brat” referred to an obnoxious child. I was vaguely aware of Charli XCX, but I wasn’t aware that earlier this summer she’d dropped a new album with that name, or that the cultural zeitgeist subsequently declared this to be Brat Summer. Then last weekend in the space of a day, Joe Biden dropped out of the Presidential race, Vice President Harris became the presumptive Democratic presidential nominee, and Charli XCX tweeted “kamala IS brat.”

Credit: Charli XCX

V.P. Harris’s campaign exploded. Most of us had kind of been dreading the campaign between two eighty-year-old white guys, and then suddenly we had a mixed heritage woman as a candidate, who even at 59 seemed positively youthful by comparison. And brat to boot!

It’s been hilarious to watch people like Stephen Colbert or Jake Tapper try to explain brat to their viewers. Charli XCX herself described it on TikTok as:

That girl who is a little messy and likes to party, and maybe says dumb things sometimes, who feels herself but then also maybe has a breakdown but parties through it. It’s very honest; it’s very blunt—a little bit volatile, does dumb things, but, like, it’s brat. You’re brat. That’s brat.

It’s been taken much further than that, of course. An article in The Guardian described it: “Because, as we all know by now, brat – inspired by Charli’s most recent album – is more than a name, it’s a lifestyle. It is noughties excess, rave culture. It’s “a pack of cigs, a Bic lighter, a strappy white top with no bra”. It’s quintessentially cool.”  Shirly Li, in The Atlantic, opined: “The essence of “brat” is not defining people as such; it’s being simultaneously provocative and vulnerable.”

But, more to the point, Xochitl Gonzalez, also writing in The Atlantic, made clear how we should think about brat: “If you don’t know what that means, it doesn’t matter.” After all, if you’re not in on the joke, you are the joke.

The Harris campaign is all in on the joke. It fully embraced the appellation, even changing its campaign logo on social media to the easily identifiable lime green of the Brat album cover. The KHive is busy creating memes, posting TikTok clips, and filling the world with coconut emojis (long story). Some have claimed that brat summer is already over, but maybe not so fast.

Whether it is the brat effect or simply a honeymoon period for Ms. Harris, her favorability and enthusiasm ratings have soared, and the Presidential race polls again show a dead heat, after President Biden’s polls had tanked following his disastrous debate performance earlier this month. The simple fact that the Dems have a candidate who can become a cultural meme, in a good way, feels refreshing, especially in a campaign that heretofore had evoked more dread and resignation than enthusiasm.

I wish healthcare was brat.

It’s not brat to sit in your doctor’s waiting room. It’s not brat to be stuck in a telephone queue with your health insurance company. It’s not brat to get a healthcare bill that is confusing at best and terrifying at worst. It’s not brat to not be able to afford your medications, especially knowing that in other countries you’d pay much less for them. It’s not brat that we’re dying younger and have way more chronic illnesses than we once did. It’s really not brat that we’re particularly terrible at safeguarding the health of mothers and babies.  

AI in healthcare should be brat, if we don’t mess it up (and I fear we will). 3D printing of organs and tissues is brat, although it’s not mainstream yet. Nanorobots should be brat, if we can get to where we’ve been promised for years. Genetic therapy should be brat, although so far it seems like another way for pharmaceutical companies to charge us outrageous amounts.  Neural implants could be brat, although I’m worried Elon will Cybertruck it.  

It was pretty brat that we developed a COVID-19 vaccine so early in the pandemic, but not brat at all how it became politicized and, indeed, that people are turning away from vaccines generally. Cancer screenings should be brat, but, as anyone who has had a colonoscopy or mammogram can tell you, they’re not.

Being a doctor once might have been considered kind of brat, but now it just seems like kind of a sucker’s bet: all those years of training, all those debts that ensue from that, and then all the hassles once in practice. Who needs it? No wonder most medical students don’t really want a career that involves treating patients.

Health insurance most definitely is not brat (Oscar Health’s promises not withstanding). ACA made it less terrible, but there’s not too many people posting TikTok videos about how happy they are with their health insurance. It’s not brat at all that so many people remain without coverage, and that GoFundMe is a go-to for people dealing with huge medical bills.

I wish we had a healthcare system that I was excited about. According to a recent Harris poll, more than 70% of American’s feel our healthcare system fails them in some way. A Commonwealth Fund survey found 82% of Americans thought it should be fundamentally changed or completely rebuilt.

No, that’s not brat at all.

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I think of our healthcare system kind of like how I thought about Joe Biden running for President again. Nice guy, done a lot of good, means well, but, gosh, so 20^th century, so frail, and too fragile to count on being there for several more years. I want the brat version, the one that generates enthusiasm, excitement, the one that makes people want to post on social media about how it has helped them, the one that causes people to create memes praising it and the people working in it.

I want the 22^st century healthcare system, or at least a 2050 one, but I want it now. Amaze me, excite me, delight me. That’d be brat.