By KIM BELLARD

Here’s a sentence I never thought I’d have to write: the most interesting discussion in healthcare in the past week has been about Neil Young versus Spotify.  

For those of you who have not been following the controversy, Neil Young gave Spotify an ultimatum: it could have his music or Joe Rogan, but not both.  “I am doing this because Spotify is spreading fake information about vaccines – potentially causing death to those who believe the disinformation being spread by them.”  Spotify chose Rogan.

Mr. Young was not the first to express alarm at some of the Covid “information” promoted on Mr. Rogan’s podcast, The Joe Rogan Experience (JRE); in December, for example, several hundred scientists from around the world issued an open letter to Spotify specifically about JRE, warning:

By allowing the propagation of false and societally harmful assertions, Spotify is enabling its hosted media to damage public trust in scientific research and sow doubt in the credibility of data-driven guidance offered by medical professionals.

Nor is Mr. Young the only artist now boycotting Spotify due to the content on JRE; Joni Mitchell and Nils Lofgren have followed suit.  Notably, though, more current artists like Taylor Swift or Adele have not yet, nor have celebrity podcasters like Meghan Markel and Prince Harry or the Obamas, although the former royal couple have expressed their concerns.

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To put things in context, Mr. Young is risking some 60% of his streaming income, estimated at around $750,000 annually, whereas Mr. Rogan has a $100 million deal with Spotify for his 11 million faithful listeners.  It evidently wasn’t a hard decision.  Spotify lost as much as $4b in market cap last week but seems to have fully recovered. 

Mr. Rogan has issued regrets, of sorts, not really apologizing but sorry if some people were offended.  He’s not anti-vax, he claims, but just wants to get alternative information discussed and debated.  He admits he doesn’t do much research prior to a guest coming on the podcast, claims he doesn’t try to be controversial but hopes to try to offer more balanced discussions. 

Spotify also has issued its own mea culpa, not planning to censor more content but, when it comes to COVID-19 topics, at least directing people to its Covid-19 Hub for “easy access to data-driven facts, up-to-date information as shared by scientists, physicians, academics and public health authorities around the world, as well as links to trusted sources.”  

Show’s over, folks.  Nothing to see here. Move along.

I don’t have a Spotify account.  The only podcast I pay attention to is THCB Gang (which, by the way, you can listen to on Spotify).  I doubt that many people listen to JRE to be educated; more likely, they tune in to be entertained, and, perhaps, to harden existing views that may be out of the “mainstream.”  To be honest, I’m not even that big a Neil Young fan, and the last time I really watched Joe Rogan was on NewsRadio.  But I do think what Mr. Young has done is important.

The COVID-19 anti-vax movement threatens everyone.  We’d still be living with polio and measles if such distrust had existed a few decades ago.  As anyone could have predicted, controversy over requiring vaccines for other diseases is widening, with state legislators already working on bills that could weaken existing requirements, such as for measles.  “Measles is like a jam jar full of wasps that is raging to get out,” Professor Liam Smeeth of the London School of Hygiene and Tropical Medicine warned CNBC. “The minute vaccine coverage drops, measles will reappear. So that is a worry, that that [Covid anti-vax sentiment] and that dent in confidence is seeping across into other vaccines. That is a real worry.”

The scientists who signed the open letter to Spotify opened themselves up to criticism, but Mr. Young put his income at risk.  It’s not like his music isn’t available elsewhere, but a loss of $750,000 annually would get most people’s attention.  He was already critical of Spotify for what he perceived as issues with sound quality, so perhaps there are other motives here, but I’ll choose to believe that he’s willing to take the loss of income “in solidarity with the frontline healthcare workers who risk their lives every day to help others.”

Bravo.

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In my opinion, though, this is even broader than COVID misinformation, and we shouldn’t be relying on musicians for moral leadership in healthcare.  People working in healthcare need to be willing to walk away from some of their income when they see things that are wrong.

In the midst of incredible bravery and sacrifice by frontline healthcare workers throughout the pandemic, there are some physicians who have spread misinformation and promoted remedies that are at best useless and at worst harmful.  Where are the healthcare workers who resign rather than be associated with them?  Where are the medical boards who believe that such practitioners are still deserving of their medical license?

And, let’s be clear, there are physicians who do such things outside of COVID.  They do surgeries that aren’t necessary, they promote cures that aren’t, they treat conditions they don’t really have qualifications for.  Unless something particular egregious happens, we allow it, because once physicians get a license, it’s awfully hard to take it back.  Doctors don’t like to criticize, much less penalize, other doctors.

Similarly, there are hospitals that sue patients for unpaid bills, even when those bills are based on charges that no one really ever expects to have to be paid in full.  There are hospitals who contracted with, say, emergency room practices or anesthesiology groups who, they knew, would be issuing “surprise” bills to patients (at least, before the No Surprise Act). The medical staff can claim, oh, we didn’t know about these practices, but, yeah, they probably did, or at least choose to look away.  

There are people – physicians and others – working in health insurances companies that deny treatments for critically ill patients, or make them jump through needless loops that they don’t have time or energy for.  Who in those companies is fighting for those patients, risking how much?

There are way too many situations when people in healthcare should be pulling Neil Youngs and walking away — noisily.  

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It takes courage to speak up about injustices and dangerous practices.  When someone puts their income at stake in doing so, all the more.  Healthcare has a lot of things that need to be spoken up about and stood up against.  If not now, when, and if not us, who?

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamented Tincture.io, and now regular THCB contributor.