The following is the text from my third digital town hall, from Tuesday, Sept. 29.
I’m going to open with a story, because our topic tonight is healthcare, and healthcare is personal. Not political, or at least it shouldn’t be political. When we talk about “healthcare,” we’re really talking about you, and how you feel today and tomorrow and ten years from now, about your elderly parents and your young kids, about how all of us have been denied the right to a secure protection of our health because of, yeah, politics.
To the story:
As I rolled through my thirties, I started to notice something odd about my vision. Things just never seemed crisp, and even after getting new glasses, it always seemed that something was just a touch off in my left eye. I asked several optometrists about this, at annual checkups, and everything always measured out fine. More or less, the diagnosis was you’re getting older. So I carried on.
In the summer of 2015, I realized while reading Calvin & Hobbes to my then-6-year-old that I could do a strange trick. By closing my right eye, I could make Calvin’s head disappear. Just, poof, gone. Something wasn’t right.
But, all stories have complications: my employer-sponsored healthcare had recently moved into a high deductible model, for cost-savings measures. And that meant each and every visit had to be paid for out-of-pocket, until we reached what seemed to be a totally distant $3,000 threshold, at which point we’d only have to pay 10% of appointment costs. Many of you know how this works, and you know that we — and you — also pay a not insignificant monthly premium to have this insurance.
So, of course, I waited. Because, I’d been told my vision was fine and I knew a specialist would be expensive. Our monthly family budget is always tight — like most of us — so, sure, if things were fine, y’know? I was just getting older.
That winter, my wife wound up having some expensive tests, and we were close enough to the deductible threshold, that I decided to splurge on my health and see an eye specialist. Within a week or so, I was meeting with a brain surgeon in Pittsburgh, talking about the tumor that had been found on an MRI taken just in case, and how that tumor was growing on the lining of my brain, and was pushing against my optic nerve, and had caused the blind spot that made Calvin’s head disappear when I read to my then-six-year-old.
So in March of 2016, just a couple weeks after that son turned seven, and after our other son turned three, I faced an all-day brain surgery, and a hard multi-month recovery, and six weeks of daily radiation zaps to my brain, permanent side effects, and a perpetual sense of myself as not invincible. Or, as they say in politics and insurance boardrooms, as a person with a pre-existing condition. Who could lose the ability to find health insurance on the open market, if some of what’s happening in Washington continues to happen.
I also became a person who experienced, first-hand, how a medical issue can wreak permanent financial havoc on an American’s pocketbook. That high deductible? Well, we met it in 2016, and the next $3000 deductible, and wound up having to find the cash to pay something like 20% of our annual household salary to cover my treatments. That meant credit card roulette, because I am one of the lucky ones with good enough credit to get new cards on which we could run up balances, and we have what counts as good health insurance these days. Even if, financially, it’s not so good.
If I hadn’t had health insurance, my treatments would have cost about $200,000 out of pocket. And we would be bankrupt. Or I would have rolled the dice and hoped my slow-growing tumor grew slowly enough that I could save up enough money to pay for treatment. Or I would have turned to one of America’s major sources of healthcare funding: a GoFundMe campaign.
Flat out, this is wrong, cruel, ridiculous for a nation as wealthy as the U.S….and completely avoidable.
We know this. We know America is one of the only developed nations without universal, single-payer healthcare. And we know — though sometimes we look away from this — that compared to its peers, the US spends the most on healthcare and ranks at or near the bottom every year in health outcomes.
We pay more. We get less. And this is the system we have refused to fix. When we’ve tried, politicians have crowed about the merits of capitalist competition, and the marketplace, then undermined legislative solutions to a healthcare crisis in America.
One of the main reasons I am running for public office is because of my brain surgery: I want to be part of the solution to this problem, and I have no faith in the politicians we elect over and over, who take buckets of donations from insurance companies, who even have sat on the PA House healthcare committee and done nothing to fix this fixable problem.
An illustrative legislative history: In 2014, Brad Roae voted against Medicaid expansion that would have helped lower-income Pennsylvanians have access to health insurance … and Brad Roae represents Erie and Crawford Counties, where the poverty rate is 13%, higher than the state average, and Brad Roae represents Meadville, which has a poverty rate of 24%, twice the state average. And Brad Roae has voted against Medicaid repeatedly, making it harder for folks to qualify in a district where so many need it.
There has been a proposed solution: in every session for a decade the Healthcare 4 All bill has been submitted, then died in committee. A bill like it would radically, positively transform the healthcare landscape in Pennsylvania.
In the bill:
- Workers would pay 3% of their wages for healthcare. That means 80% of workers across the state would pay less for this healthcare — an even greater percentage would pay less here in NWPA — and the coverage would be superior to what they currently have. The bill offers expanded, high-quality, doctor-choice healthcare, for everybody, and it would not be tied to an employer.
- Employers would pay 10% of their payroll, which would be a direct reduction for most, particularly those who understand the ethical importance of offering coverage for their employees. Many would experience further savings in retiree healthcare costs and Cobra costs.
- Public entities like school districts and county governments would in many cases reduce healthcare costs from 20% of payroll to 10%, saving money for themselves and, get this, for the taxpayer.
- Let me put this in real person dollars. Right now, my family pays more than 7 grand a year for healthcare…between baseline premiums and the deductible we now hit every year (thanks brain tumor!)…and my employer pays about 14. Under this bill, our personal cost would drop to a bit more than $2000…a savings of five thousand dollars. And my employer would save about $7,000. And my coverage would be more comprehensive.
- Here’s another sidelight: no employer is really paying for your healthcare, because those benefits costs really are coming out of your total compensation package. We’ve been trained to feel grateful to employers for giving us healthcare when, in fact, we’re still paying for it, even if we aren’t paying for it directly out of pocket.
So, to recap the high points: 1) Better coverage for less. 2) Lower costs for workers and most employers…plus savings employers enjoy should come back to workers as increased wages. 3) Coverage for everyone, which is the right thing to do. 4) Lower costs for tax-supported entities like school districts…which means a Commonwealth managed healthcare plan would save tax dollars. 5) No one has to stay in a bad job just because it “gives” them healthcare.
So why all the opposition? That is a really good question.
Opposition item #1: Control.
I think a major obstacle to universal healthcare is corporate control. Big corporations don’t want to separate healthcare from employment, because big corporations want to use your life as the incentive to work for them. They don’t want people to quit a job treating them poorly. They don’t want small businesses to be able to compete with larger companies on a level playing field: big companies want to be able t offer “benefits package” that mom&pop enterprises can’t afford, so they can corner their markets. The corporate profit mindset wants to be able to use your health as their competitive advantage.
Because this is the big thing opponents of single-payer healthcare like to roll out: let the market decide! Competition!
Because the competition is about your health. You are the negotiable commodity in that equation. And beyond all else, we should not be viewing the human right to healthcare as a commodity to be bought and sold for someone else’s profit.
A single-payer system is good for small businesses because their employees will have healthcare, and because it would relieve significant payroll cost for those employers currently offering healthcare. Some smaller places can’t even offer it right now, because of the cost of entry, and the manageable 10% would let them do right by their workers, which most employers want to do. Big companies, it seems, would rather pay more for healthcare, because it is the cost of keeping away the competition. Which, again, means you are the commodity.
Opposition item #2: oh, those dang taxes. Taxes bad.
Well, we already pay a massive unrepresented tax in healthcare. We just pay it to health insurance companies, who are not elected. Because, again, if you opt out? You’re rolling the dice with your life. Think about my personal example: yes, our “taxes” would go up $2000. But our costs would reduce by at least $5000. I know it’s counter-intuitive, but sometimes taxes are a way to save money, because taxes are the pooled resources of everybody keeping costs down.
Opposition item #3: Canada.
You’ve heard that one. How awful coverage is for Canadians? I’d wager that most people who say such things don’t actually know many Canadians well enough to talk about their feelings about their healthcare system. I do know a lot of Canadians, as it turns out, and they don’t experience the sort of awful wait times politicians like to pretend exist, and in fact Canadians are pretty proud of their system. Plus, the Canadians I know, many of whom live in places with struggling economies like ours, when they lose jobs — and they do — the one thing they never have to worry about is how they’ll pay for their healthcare.
I think we all see, right now, how necessary healthcare free from employer-sponsorship happens to be: lots of people lost jobs in Pennsylvania due to the combined heath and economic impact of Covid. Unfortunately, because our system is broken, lots of people also lost health coverage.
Opposition item #4: Doctors.
Well, you can still choose your doctor in a plan like Health 4 All Pa. And if you actually talk to doctors about the things that make their work harder? Dealing with insurance companies is at the top of the list. Pre-certifications for procedures. Ridiculous volumes of paperwork because every insurer does it differently. Having to spend half their time on insurance, which leads to job burnout, because you don’t become a doctor to fight with insurance companies. You do it to care for patients.
Another brief story: one of my very best friends in the world left private practice to become the physician at a free clinic in North Carolina. She tells me that one of the largest demographics represented in her clientele is women who have had to break away from bad partners and, in so doing, lost health insurance. Think about that.
How many people are stuck in abusive relationships because they’re stuck in their abusive spouse’s employer-sponsored healthcare? Or how many people leave, then have to worry every day about getting sick. Single-payer insurance gives people the freedom to leave that bad relationship without the additional stress of wondering what happens if they fall ill.
Opposition item #5: Bad faith.
That’s a big one. And we’ve seen it, over and over, politicians who care so much more about corporate profit lines than the people they claim to represent, who demonstrate wanton disregard for public health — whether that’s in denying the reality of Covid or denying the necessity of providing healthcare for everyone. Such opposition reveals the depth of ideological bad faith, that certain strains of politician are so deeply invested in a governance of cruelty and disregard that they can’t even see how compassion is both right and — the kicker — more cost effective.
Because we know a lot of the cost of healthcare — in dollars and human experience — comes from the accumulated effect of people who don’t get it. From people who can’t afford coverage or a specialist visit and, like me, put it off, and the permanent blindspot in their eye gets bigger, or their cancer grows undetected, or their diabetes gets out of control, or their autoimmune disorder goes undiagnosed, on and on.
That costs us all a lot, and we’d be in a better spot if we recognized what almost every other country in the world has: healthcare is good for the economy, for national security, and, c’mon!?, is just the right thing to do.
Now, I’m running for the state house of representatives, so you might be asking yourself, isn’t this a federal issue? I’m going to have to say no, partly because we have seen how intractable the politics are there, and also because we have an opportunity to get ahead of the curve on healthcare here in Pennsylvania. We can be leaders. Our population and economy is big enough — 13 million people, or about the size of Belgium, which has universal healthcare, or three times the size of Norway, which has universal healthcare, or almost four times the size of New Zealand, which has universal healthcare. I think you get the point: we are big enough to do this.
And think of the benefits to our economy and otherwise: well-controlled, lower-cost healthcare would be a draw for companies to come to Pennsylvania. Some of you might start your own business, because you wouldn’t have to worry about exorbitant healthcare costs. Some of you might leave a job that treats you poorly, tell them to stuff it, and not have to worry about healthcare. Some of you could get out of relationships you desperately need to get out of. Some of you might finally be able to afford to start a family, become an artist, afford a home, invent something we don’t even know we need yet.
For us, in a lower income part of the state, how life-changing would it be to have single-payer healthcare? I truly believe this is why opponents to single-payer don’t want it: because it guarantees liberty and freedom for everyone, regardless of wage, race, gender, sexuality, religious belief. And for those of us who live in a part of the state whose economy has been collapsed by industrial abandonment, who are ready to reinvent the region in a better, brighter, more equitable way, to focus on living here, single-payer healthcare could be a game changer.
But again and again, we see how we live in an economy and with representation that seems designed to keep us struggling, so we’ll accept bad deals, and exploitative deals, and turn on each other. And nothing gets better.
I think it can. I think we can be a Commonwealth of care. We can afford it. We must afford it. We deserve to be able to live our lives free of the fear of medical bankruptcy or of getting sick and being unable to pay for care. We owe it to ourselves and to everyone to refuse the same bad, empty deals we keep getting. We owe it to ourselves and to everyone to demand better of our elected officials.
Please consider voting for me, November 3, as that demand.