Pluralistic: Google steers Americans looking for health care into "junk insurance" (25 Nov 2025)


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An old time hospital ward. In the foreground are a pair of stretcher bearers with a patient. The bearers' heads have been replaced with the poop emoji from the cover of 'Enshittification.' The emoji has been tinted in Google's logo colors. The head of the patient has been replaced with the grinning visage of a 1910s newsie.

Google steers Americans looking for health care into "junk insurance" (permalink)

Being "the enshittification guy" means that people expect you to weigh in on every service or platform that has been deliberately worsened to turn a buck. It's an impossible task (and a boring one besides). There's too much of this shit, and it's all so mid – a real "banality of enshittification" situation.

So these days, I really only take note of fractally enshittified things, exponentially enshittified things, omnienshittified things. Things like the fact that Google is sending people searching for health care plans to "junk insurance" that take your money and then pretty much just let you die:

https://pluralistic.net/junk-insurance

"Junk insurance" is a health insurance plan that is designed as a short-term plan that you might use for a couple of days or a week or two, say, if you experience a gap in coverage as you move between two jobs. These plans can exclude coverage for pre-existing conditions and typically exclude niceties like emergency room visits and hospitalization:

https://www.brookings.edu/wp-content/uploads/2020/07/Broader-View_July_2020.pdf

Crucially, these plans to not comply with the Affordable Care Act, which requires comprehensive coverage, and bans exclusions for pre-existing conditions. These plans only exist because of loopholes in the ACA, designed for very small-scale employers or temporary coverage.

The one thing junk insurance does not skimp on is sales and marketing. These plans outbid the rest of the market when it comes to buying Google search ads, meaning that anyone who uses Google to research health insurance will be inundated with ads for these shitty plans. The plans also spend a fortune on "search engine optimization" – basically, gaming the Google algorithm – so that the non-ad Google results for health insurance are also saturated with these garbage plans.

The plans also staff up boiler-rooms full of silver-tongued high-pressure sales staff who pick up on the first ring and hard-sell you on their plans, deliberately misleading you into locking into their garbage plans.

That's right, locking in. While Obamacare is nominally a "market based" healthcare system (because Medicare For All would be communism), you are only allowed to change vendors twice per year, during "open enrollment," these narrow biannual windows in which you get to "vote with your wallet" against a plan that has screwed you over and/or endangered your life.

Which means that if a fast-talking salesdroid from a junk insurance company can trick you into signing up for a garbage plan that will leave you bankrupt and/or dead if you have a major health crisis, you are stuck for at least six months in that trap, and won't escape without first handing over thousands of dollars to that scumbag's boss.

Amazingly enough, these aren't even the worst kinds of garbage health plans that you can buy in America: those would be the religious "health share" programs that sleazy evangelical "entrepreneurs" suck their co-religionists into, which cost the world and leave you high and dry when you or your kids get hurt or sick:

https://armandalegshow.com/episode/is-it-ever-appropriate-to-fudge-a-little/

The fact that there are multiple kinds of scam health insurance in America, in which companies are legally permitted to take your money and then deny you care (even more than the "non-scam" insurance plans do) shows you the problem with turning health into a market. "Caveat emptor" may make sense when you're buying a used blender at a yard-sale. Apply it to the system that's supposed to take care of you if you're diagnosed with cancer, hit by a bus, or develop eclampsia, and it's a literally fatal system.

This is just one of the ways in which the uniparty is so terrible for Americans. The Republicans want to swap out shitty regulated for-profit health insurance with disastrous unregulated for-profit health insurance, and then give you a couple thousand bucks to yolo on a plan that seems OK to you:

https://www.cnbc.com/2025/11/24/republicans-push-obamacare-tax-credit-alternatives-as-deadline-looms.html

This is like letting Fanduel run your country's health system: everyday people are expected to place fifty-way parlay bets on their health, juggling exclusions, co-pays, deductibles, and network coverage in their head. Bet wrong, and you go bankrupt (if you're lucky), or just die (if you're not).

Democrats, meanwhile, want to maintain the (garbage) status quo (because Medicare for All is communism), and they'll shut down the government to make it clear that they want this. But then they'll capitulate, because they want it, but not that badly.

But like I say, America is an Enshittification Nation, and I don't have time or interest for cataloging mere unienshittificatory aspects of life here. To preserve my sanity and discretionary time, I must limit myself to documenting the omnienshittificatory scams that threaten us for every angle at once.

Which brings me back to Google. Without Google, these junk insurance scams would be confined to the margins. They'd have to resort to pyramid selling, or hand-lettered roadside signs, or undisclosed paid plugs in religious/far-right newsletters.

But because Google has utterly succumbed to enshittification, and because Google has an illegal monopoly – a 90% market share – that it maintains by bribing competitors like Apple to stay out of the search market, junk insurance scams can make bank – and ruin Americans' lives wholesale – by either tricking or paying Google to push junk insurance on unsuspecting searchers.

This isn't merely a case of Google losing the SEO and spam wars to shady operators. As we learned in last year's antitrust case (where Google was convicted of operating an illegal search monopoly), Google deliberately worsened its search results, in order to force you search multiple times (and see multiple screens full of ads) as a way to goose search revenue:

https://pluralistic.net/2024/04/24/naming-names/#prabhakar-raghavan

Google didn't just lose that one antitrust case, either. It lost three cases, as three federal judges determined that Google secured and maintains an illegal monopoly that allows it to control the single most important funnel for knowledge and truth for the majority of people on Earth. The company whose mission is to "organize the world's information and make it universally accessible and useful," now serves slop, ads, spam and scams because its customers have nowhere to go, so why bother spending money making search good (especially when there's money to be made from bad search results)?

Google isn't just too big to fail, it's also too big to jail. One of the judges who found Google guilty of maintaining an illegal monopoly decided not to punish them for it, and to allow them to continue bribing Apple to stay out of the search market, because (I'm not making this up), without that $20b+ annual bribe, Apple might not be able to afford to make cool new iPhone features:

https://pluralistic.net/2025/09/03/unpunishing-process/#fucking-shit-goddammit-fuck

Once a company is too big to fail and too big to jail, it becomes too big to care. Google could prevent slop, spam and scams from overrunning its results (and putting its users lives and fortunes at risk), it just *chooses not to:

https://pluralistic.net/2024/04/04/teach-me-how-to-shruggie/#kagi

Google is the internet's absentee landlord. Anyone who can make a buck by scamming you can either pay Google to help, or trick Google into helping, or – as is the case with junk insurance – both:

https://pluralistic.net/2025/07/15/inhuman-gigapede/#coprophagic-ai

America has the world's stupidest health care system, an industry that has grown wildly profitable by charging Americans the highest rates in the rich world, while delivering the worst health outcomes in the rich world, while slashing health workers' pay and eroding their working conditions.

It's omnienshittified, a partnership between the enshittified search giant and the shittiest parts of the totally enshittified health industry.

It's also a reminder of what we stand to gain when we finally smash Google and break it up: disciplining our search industry will make it competitive, regulatable, and force it to side with the public against all kinds of scammers. Junk insurance should be banned, but even if we just end the junk insurance industry's ability to pay the world's only major search engine to help it kill us, that would be a huge step forward.

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Upcoming appearances (permalink)

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Recent appearances (permalink)


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Latest books (permalink)


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Upcoming books (permalink)

  • "Unauthorized Bread": a middle-grades graphic novel adapted from my novella about refugees, toasters and DRM, FirstSecond, 2026

  • "Enshittification, Why Everything Suddenly Got Worse and What to Do About It" (the graphic novel), Firstsecond, 2026

  • "The Memex Method," Farrar, Straus, Giroux, 2026

  • "The Reverse-Centaur's Guide to AI," a short book about being a better AI critic, Farrar, Straus and Giroux, 2026


Colophon (permalink)

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  • A Little Brother short story about DIY insulin PLANNING

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