Politics is shaping the face of health care in a radically different way than before. It’s not political partisanship or polarization – not red versus blue, left versus right, or even government versus market. It’s something deeper and more disorienting. Americans no longer share a common story about what health care is.
For some, it’s a moral right. For others, it’s a marketplace. And for many, it’s a personal ecosystem of wellness, faith, and autonomy. The debate over insurance or regulation may dominate headlines, but beneath it lies a far deeper divide: competing epistemologies — different ways of knowing, trusting, and defining health itself.
That’s what we uncovered when we built PRISM, a segmentation model mapping how Americans think about health care and the forces shaping it. What emerged wasn’t a simple red-blue split, but a mosaic of cultures and moral vocabularies that reveal how identity shapes trust. We uncovered sixteen unique groups – ten among Republicans and six among Democrats.
Republicans:
- On one end are the Radical Futurists — those who see gene therapies, AI, and data as the next frontier of human flourishing. To them, technology isn’t threatening; it’s emancipatory.
- On the other side of the map sit the Medical Freedom Libertarians, for whom the same tools embody control.
- Where Futurists see algorithms as liberators, Libertarians see them as gatekeepers — yet another system telling individuals what’s best for their bodies. One’s faith is in the machine; the other’s is in autonomy.
Democrats:
- A similar tension plays out on the Left. Health Abundance Democrats — the entrepreneurs and reformers of the center — believe that start-ups, AI, and data transparency can democratize care faster than bureaucracy ever could.
- In contrast, Universal Care Progressives argue that only the public guarantee of care — Medicare for All — can safeguard dignity and justice.
- One prizes innovation as the equalizer; the other sees equality as the precondition for innovation.
This is where health tech and other industries face their greatest test. The next wave of digital health adoption won’t be won on features or user experience — it will be won on trust alignment. People don’t evaluate innovation in a vacuum; they interpret it through moral frameworks. A wearable isn’t just a device — it’s a statement about whether you believe data belongs to the individual or to the system. AI in diagnostics isn’t just about efficiency — it’s about who gets to define what “better care” means.
Our data suggest that technology succeeds not when it sidesteps politics, but when it speaks to these underlying belief systems — when it bridges the “abundance” optimism of technologists with the “protectionist” instincts of skeptics.
Health care has always been about biology. But its future will hinge on anthropology — on understanding the diverse human logics of trust, authority, and care that technology must live within.
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Bryan Dumont leads the Health Analytics & Insights Group at Reservoir Communications Group, where he developed the PRISM initiative, a research platform mapping how Americans’ cultural worldviews shape their engagement with health, technology, and reform.
