Dr. Lynn Blewett
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So states are really where a lot of the incremental approaches to increasing access are. And so we leverage the federal data to provide states information on health insurance coverage, access to care. We do a lot in social determinants of health. And provide that in a easy, accessible way for people to understand sort of what do we know about our systems of care.
So states are really where a lot of the incremental approaches to increasing access are. And so we leverage the federal data to provide states information on health insurance coverage, access to care. We do a lot in social determinants of health. And provide that in a easy, accessible way for people to understand sort of what do we know about our systems of care.
And so we have a nice, and maybe I'll include that after we're done, you can put it on your resource lists, what we call state health compare, it's a state It's a dashboard that you can look at different measures and compare across states or compare to the national average or get a map. And a lot of researchers use our data.
And so we have a nice, and maybe I'll include that after we're done, you can put it on your resource lists, what we call state health compare, it's a state It's a dashboard that you can look at different measures and compare across states or compare to the national average or get a map. And a lot of researchers use our data.
A lot of state policy people use our data to provide information to policymakers and decision makers. So our kind of motto is we want to inform decisions and discussion. And to do that, provide the best data available and try to be a new, even though I'm an advocate for universal coverage, I try to be an advocate for objective data, good data, reliable data. And that's what we've been known.
A lot of state policy people use our data to provide information to policymakers and decision makers. So our kind of motto is we want to inform decisions and discussion. And to do that, provide the best data available and try to be a new, even though I'm an advocate for universal coverage, I try to be an advocate for objective data, good data, reliable data. And that's what we've been known.
We have a good reputation for that, that people can trust our data to be unbiased and the best available on this topic.
We have a good reputation for that, that people can trust our data to be unbiased and the best available on this topic.
You know, that's a really good question and probably something that the university and my center has done less well. We're really engaged with states and state decision makers and people who run the Medicaid programs. On a community basis, we have done some work with the Blue Cross Blue Shield Foundation to provide... county level information on insurance and coverage.
You know, that's a really good question and probably something that the university and my center has done less well. We're really engaged with states and state decision makers and people who run the Medicaid programs. On a community basis, we have done some work with the Blue Cross Blue Shield Foundation to provide... county level information on insurance and coverage.
And then they've used that with community health workers and navigators. But like when they're in a certain area, they know where the uninsured are and what they look like, what their characteristics are. But, you know, we could certainly do a better job of reaching out to more community groups.
And then they've used that with community health workers and navigators. But like when they're in a certain area, they know where the uninsured are and what they look like, what their characteristics are. But, you know, we could certainly do a better job of reaching out to more community groups.
And I take that as a good reminder as I'm working my way towards retirement, that that's something we could do better at.
And I take that as a good reminder as I'm working my way towards retirement, that that's something we could do better at.
Yeah. So... You know, our capitalistic system that we have in the U.S. is also a foundation of our healthcare system. And part of that is having choice of provider, choice of health insurer, and then having consumers making informed decisions, and then having that market open up every year. And so health plans and providers compete for members.
Yeah. So... You know, our capitalistic system that we have in the U.S. is also a foundation of our healthcare system. And part of that is having choice of provider, choice of health insurer, and then having consumers making informed decisions, and then having that market open up every year. And so health plans and providers compete for members.
So that's part of our, you know, our strategy is to have a private, private public hybrid with some elements of competition rolled in. So that open enrollment allows for that competition. And then as an employer, you know, we have bids and the plans come like they compete to have the university's business. And so that's opened up.
So that's part of our, you know, our strategy is to have a private, private public hybrid with some elements of competition rolled in. So that open enrollment allows for that competition. And then as an employer, you know, we have bids and the plans come like they compete to have the university's business. And so that's opened up.
We have a contract for maybe three to five years and that's opened up every three to five years. But yes, it's a very, and in Medicare, things are changing a lot because of the managed care plans. And so you have to be,
We have a contract for maybe three to five years and that's opened up every three to five years. But yes, it's a very, and in Medicare, things are changing a lot because of the managed care plans. And so you have to be,
you really have to know a lot of information when you go into open enrollment or get help in discerning among the different plans that are, are being offered and what they offer and how they changed from last year. And yeah, it's kind of, but that's the, that's that's this element of competition, which is you have informed consumers and then you have multiple consumers.
you really have to know a lot of information when you go into open enrollment or get help in discerning among the different plans that are, are being offered and what they offer and how they changed from last year. And yeah, it's kind of, but that's the, that's that's this element of competition, which is you have informed consumers and then you have multiple consumers.
supply and that you can make informed choices of the best you know for and again this is sort of the the ideal theory you make you know the best plan high quality plan at a reasonable cost and that's then you have to assume that consumers have all that information which i think the whole thing falls apart because exactly don't have that information or they don't need it's a little bit flawed yeah or even if they had the information they wouldn't understand it
supply and that you can make informed choices of the best you know for and again this is sort of the the ideal theory you make you know the best plan high quality plan at a reasonable cost and that's then you have to assume that consumers have all that information which i think the whole thing falls apart because exactly don't have that information or they don't need it's a little bit flawed yeah or even if they had the information they wouldn't understand it
That's a good point. Yeah, really a good personal example. Thank you.
That's a good point. Yeah, really a good personal example. Thank you.
No, it's such an important question. And, you know, if you. It's in our country, it's not a right. You know, we have 26 million people who are uninsured. And so and so and they struggle to get and people who are insured may be underinsured, which is they still they have a high deductible plan and they can't.
No, it's such an important question. And, you know, if you. It's in our country, it's not a right. You know, we have 26 million people who are uninsured. And so and so and they struggle to get and people who are insured may be underinsured, which is they still they have a high deductible plan and they can't.
So and there's nowhere there's no way there's nowhere in our Constitution, in any legislation where health care is listed as a right. We have the right to. what is it right to what is health and health and wellbeing and happiness or whatever, or the right, but we don't have a technical right to healthcare. Now, president Biden often says it's a right.
So and there's nowhere there's no way there's nowhere in our Constitution, in any legislation where health care is listed as a right. We have the right to. what is it right to what is health and health and wellbeing and happiness or whatever, or the right, but we don't have a technical right to healthcare. Now, president Biden often says it's a right.
But if you go, if you have a legal scholar on here, there would be, there's no right. And until that is something that everybody agrees to, or we have some kind of, you know,
But if you go, if you have a legal scholar on here, there would be, there's no right. And until that is something that everybody agrees to, or we have some kind of, you know,
amendment, which is, you know, it's very frustrating for people who work in the field because if it was a right, we'd have another lever, you know, to get, we'd get those people who are not covered into some kind of system of care.
amendment, which is, you know, it's very frustrating for people who work in the field because if it was a right, we'd have another lever, you know, to get, we'd get those people who are not covered into some kind of system of care.
what it is that they have a right to and you know whether it's universal coverage or whatever it is and you know there's there's a part of our country that just does not like government um public programs per se and so the role expanding the role of government even increment even just incrementally like the affordable care act did it just a tiny
what it is that they have a right to and you know whether it's universal coverage or whatever it is and you know there's there's a part of our country that just does not like government um public programs per se and so the role expanding the role of government even increment even just incrementally like the affordable care act did it just a tiny
you know, input into reducing the uninsured was just, you know, it's just been a huge lift and very controversial, but there's people who's like, I don't care if I'm uninsured. I don't want government public funded program. I want, you know, it's just a very, you have to remind them that their Medicare program is government.
you know, input into reducing the uninsured was just, you know, it's just been a huge lift and very controversial, but there's people who's like, I don't care if I'm uninsured. I don't want government public funded program. I want, you know, it's just a very, you have to remind them that their Medicare program is government.
Yeah. Things are going to happen at some point in your life.
Yeah. Things are going to happen at some point in your life.
Well, if you're suffering a heart attack, You know, this is so terrible. I would, you know, have your loved one take you down to the ER. Once you're in the ER, they have to, there's a law that requires them to assess you. And if you are an emergency patient, If it's emergent, they have to treat you at the hospital. They can't transfer you or say we're not going to treat you.
Well, if you're suffering a heart attack, You know, this is so terrible. I would, you know, have your loved one take you down to the ER. Once you're in the ER, they have to, there's a law that requires them to assess you. And if you are an emergency patient, If it's emergent, they have to treat you at the hospital. They can't transfer you or say we're not going to treat you.
So if your heart attack is imminent, get you down there. Now, I kind of stopped short of saying take an ambulance because I'm thinking the ambulance would probably charge you for that ride. So if you need an ambulance, absolutely go get it.
So if your heart attack is imminent, get you down there. Now, I kind of stopped short of saying take an ambulance because I'm thinking the ambulance would probably charge you for that ride. So if you need an ambulance, absolutely go get it.
They have to get to an ER and then they'd assess whether it's emergent or non-emergent. And if it's not emergent, they can deny you care or send you down to HCMC, which does happen. So if it's non-emergent, you can go, if someone came to me and said, I'm having these heart issues, I'd say go to Westside Clinic or the Northside one. And that's a FQHC and get assessed by a primary care doc there.
They have to get to an ER and then they'd assess whether it's emergent or non-emergent. And if it's not emergent, they can deny you care or send you down to HCMC, which does happen. So if it's non-emergent, you can go, if someone came to me and said, I'm having these heart issues, I'd say go to Westside Clinic or the Northside one. And that's a FQHC and get assessed by a primary care doc there.
And they can help you with a treatment plan and figure out what you need to do.
And they can help you with a treatment plan and figure out what you need to do.
Well, and the ER does become the default for many people because it's open 24-7. It's open on the weekends. It's, you know, it's visit where you know a hospital has one.
Well, and the ER does become the default for many people because it's open 24-7. It's open on the weekends. It's, you know, it's visit where you know a hospital has one.
Yeah, the foster care issue, that's very sad.
Yeah, the foster care issue, that's very sad.
Well, I think... You know, we're kind of, I think the Affordable Care Act was probably the last federal piece of legislation that we're going to have for a long time. And so I think the next iteration or the next incremental changes, I think our healthcare system has, as I've learned over time, it's been, we make changes kind of incrementally.
Well, I think... You know, we're kind of, I think the Affordable Care Act was probably the last federal piece of legislation that we're going to have for a long time. And so I think the next iteration or the next incremental changes, I think our healthcare system has, as I've learned over time, it's been, we make changes kind of incrementally.
And that's, we make progress, but we also complicate the system more. So we build on what exists rather than fixing the problems and then changing them. So one of the reasons everything's so complicated is because you know, we add on to what we already have, but that's just the way it is. So, you know, so we expanded Medicaid. That's part of the Affordable Care Act.
And that's, we make progress, but we also complicate the system more. So we build on what exists rather than fixing the problems and then changing them. So one of the reasons everything's so complicated is because you know, we add on to what we already have, but that's just the way it is. So, you know, so we expanded Medicaid. That's part of the Affordable Care Act.
We established these marketplaces. And now it's like, okay, how can we like just open that up just a little bit more to add more people? You know, so we increase the eligibility levels or we open it up to additional people. So Minnesota just passed, not this year, but the prior legislative session, health insurance coverage, a Medicaid type program for undocumented.
We established these marketplaces. And now it's like, okay, how can we like just open that up just a little bit more to add more people? You know, so we increase the eligibility levels or we open it up to additional people. So Minnesota just passed, not this year, but the prior legislative session, health insurance coverage, a Medicaid type program for undocumented.
So that's, you know, for children and adults. So that's a huge incremental. Now, we don't get any federal money for that. That's a state only. Feds will not pay for undocumented people health care through Medicaid or through the marketplaces. So that's and there's about six or seven states who are doing that now saying these people are here. They're contributing to our economy.
So that's, you know, for children and adults. So that's a huge incremental. Now, we don't get any federal money for that. That's a state only. Feds will not pay for undocumented people health care through Medicaid or through the marketplaces. So that's and there's about six or seven states who are doing that now saying these people are here. They're contributing to our economy.
They're showing up in our ER without any health insurance. We're going to extend a program for them and pay for it. So there will be some premiums. There'll be some cost sharing, but that's, you know, so states are sort of like, where's the pockets?
They're showing up in our ER without any health insurance. We're going to extend a program for them and pay for it. So there will be some premiums. There'll be some cost sharing, but that's, you know, so states are sort of like, where's the pockets?
How can we address these pockets of uninsured and trying to, you know, trying to get those, you know, get those last people who are not covered into some kind of healthcare system.
How can we address these pockets of uninsured and trying to, you know, trying to get those, you know, get those last people who are not covered into some kind of healthcare system.
Well, in 2010, when it was passed, we had 50 million people uninsured. Now we have 30 million. So it reduced the uninsurance bite. It provided coverage for 20 million people, in essence. That's a lot. Yeah. So it's not a... it was a significant impact on our system.
Well, in 2010, when it was passed, we had 50 million people uninsured. Now we have 30 million. So it reduced the uninsurance bite. It provided coverage for 20 million people, in essence. That's a lot. Yeah. So it's not a... it was a significant impact on our system.
But we still have 30 million people and we accept that as a country.
But we still have 30 million people and we accept that as a country.
Well, I was just wondering, so there are... there are grants and support for what we call navigators or enrollment assisters and your community group should know that they exist. And there's a list with phone numbers and they can help, you know, explain the process and help you walk through the application process. And they, you know, that's something, um,
Well, I was just wondering, so there are... there are grants and support for what we call navigators or enrollment assisters and your community group should know that they exist. And there's a list with phone numbers and they can help, you know, explain the process and help you walk through the application process. And they, you know, that's something, um,
that we should make sure the community groups get, because there is- And understand, Lynn.
that we should make sure the community groups get, because there is- And understand, Lynn.
Well, a lot of times people start with health insurance coverage and that this is like the mechanism to get you in to see a doctor if you have health insurance coverage. And then you, so sometimes when people talk about access to care, they're talking about access to health insurance coverage.
Well, a lot of times people start with health insurance coverage and that this is like the mechanism to get you in to see a doctor if you have health insurance coverage. And then you, so sometimes when people talk about access to care, they're talking about access to health insurance coverage.
I agree. I think the Medicare program, I mean, I'm grateful for the Part D. So that's the prescription drug.
I agree. I think the Medicare program, I mean, I'm grateful for the Part D. So that's the prescription drug.
And that's where we spend a lot of time in terms of using survey data and information to understand who's covered and by what type of health insurance and then who's not covered. And that's kind of the vehicle to get access. What you really care about is that people have access to a healthcare provider to get the care that they need.
And that's where we spend a lot of time in terms of using survey data and information to understand who's covered and by what type of health insurance and then who's not covered. And that's kind of the vehicle to get access. What you really care about is that people have access to a healthcare provider to get the care that they need.
You know, it's wonderful, but you have to buy a separate plan. So it's, I've walked my dad through this, it just was almost impossible to sort through all that information and figure out the right thing for him to do.
You know, it's wonderful, but you have to buy a separate plan. So it's, I've walked my dad through this, it just was almost impossible to sort through all that information and figure out the right thing for him to do.
But again, there are a lot of resources. So senior language and there's a lot of resources again, but I take it.
But again, there are a lot of resources. So senior language and there's a lot of resources again, but I take it.
Well, that's a hard one. You know, maybe that, well, maybe that there are, There are people that are working on these issues that healthcare and healthcare financing, insurance access are complicated, but there are people who are devoted and dedicated to continuing to work towards universal coverage. And then students that are coming up in my program in public health are there. I mean, they are...
Well, that's a hard one. You know, maybe that, well, maybe that there are, There are people that are working on these issues that healthcare and healthcare financing, insurance access are complicated, but there are people who are devoted and dedicated to continuing to work towards universal coverage. And then students that are coming up in my program in public health are there. I mean, they are...
they don't want any of this mess. Like they want things to change. And so I'm, I'm a little bit hopeful. I guess I thought we would be further along than we are now in terms of change. And
they don't want any of this mess. Like they want things to change. And so I'm, I'm a little bit hopeful. I guess I thought we would be further along than we are now in terms of change. And
you know, it's, it's, it's the way we do things in this country is incrementally it's complex, but there's also people that are, are, um, advocates and are working on it and you've got to find those networks and, you know, you can participate if you want.
you know, it's, it's, it's the way we do things in this country is incrementally it's complex, but there's also people that are, are, um, advocates and are working on it and you've got to find those networks and, you know, you can participate if you want.
But usually, you know, I would say most people will start like, do you have health insurance coverage and what kind of health insurance coverage? And then who's in your network and who can you, you know, who do you have access to see when you need care?
But usually, you know, I would say most people will start like, do you have health insurance coverage and what kind of health insurance coverage? And then who's in your network and who can you, you know, who do you have access to see when you need care?
Thank you. Thank you for that summary. I think that's really it. And stay tuned. Hang in there and stay tuned. Very good. I couldn't, I couldn't.
Thank you. Thank you for that summary. I think that's really it. And stay tuned. Hang in there and stay tuned. Very good. I couldn't, I couldn't.
Hang in there and stay tuned. I'm going to repeat that.
Hang in there and stay tuned. I'm going to repeat that.
Yeah, and maybe I'll just preface to say that we have one of the more complicated health care systems in the world.
Yeah, and maybe I'll just preface to say that we have one of the more complicated health care systems in the world.
That most, you know, most countries do provide universal access through different mechanisms. But we have kind of a patchwork of insurance and most people in this country don't. get their health insurance, especially under age 65, get their health insurance through their employer. So about 50% of people get coverage through their employer.
That most, you know, most countries do provide universal access through different mechanisms. But we have kind of a patchwork of insurance and most people in this country don't. get their health insurance, especially under age 65, get their health insurance through their employer. So about 50% of people get coverage through their employer.
And then you have your kind of supplemental coverage, which is Medicare, Medicaid. And then for those people who are working, but don't have access to employer sponsored insurance. So that could be like artists or self-employed people, or, you know, people who work on their own. They have access to what's called direct purchase.
And then you have your kind of supplemental coverage, which is Medicare, Medicaid. And then for those people who are working, but don't have access to employer sponsored insurance. So that could be like artists or self-employed people, or, you know, people who work on their own. They have access to what's called direct purchase.
So that's just if you called up Blue Cross Blue Shield and said, I need a health insurance plan, what do you have to offer? So that's kind of the overview. And then, of course, we have the Veterans Administration's Indian Health Service, the military, TRICARE. And those are also important components, but probably less, not as many people. So-
So that's just if you called up Blue Cross Blue Shield and said, I need a health insurance plan, what do you have to offer? So that's kind of the overview. And then, of course, we have the Veterans Administration's Indian Health Service, the military, TRICARE. And those are also important components, but probably less, not as many people. So-
Yes, I would say the elderly and probably the disabled, the elderly and disabled. And many of those people, especially if they're poor, will be on either Medicare or Medicaid if they're poor. And those are where the high cost, high expense people are. And the public does provide public programs for their needs, Medicare and then Medicaid.
Yes, I would say the elderly and probably the disabled, the elderly and disabled. And many of those people, especially if they're poor, will be on either Medicare or Medicaid if they're poor. And those are where the high cost, high expense people are. And the public does provide public programs for their needs, Medicare and then Medicaid.
Yeah. Yeah. Thank you for that question, Clarence. And I I missed one important part of our sort of coverage framework, which is there are about 8% of people across the country, which is, let me just check my number, 26 million who don't have health insurance coverage. And so there is what we call a safety net
Yeah. Yeah. Thank you for that question, Clarence. And I I missed one important part of our sort of coverage framework, which is there are about 8% of people across the country, which is, let me just check my number, 26 million who don't have health insurance coverage. And so there is what we call a safety net
which provides free or low-cost care, and that's through federal and state funding, so federally qualified health centers or community health centers. We have rural immigrant programs, and then like HCMC, the public hospital, which is funded by state and federal grants and financing. And Medicaid does pay for some of those people in those programs, but they're very community-based, local-driven.
which provides free or low-cost care, and that's through federal and state funding, so federally qualified health centers or community health centers. We have rural immigrant programs, and then like HCMC, the public hospital, which is funded by state and federal grants and financing. And Medicaid does pay for some of those people in those programs, but they're very community-based, local-driven.
And if you don't have health insurance, you should be able to find one of those and get either low-cost or no-cost care. Many of them don't provide access to specialist care, but they may be able to help you find somebody who would be willing to take somebody at a discount.
And if you don't have health insurance, you should be able to find one of those and get either low-cost or no-cost care. Many of them don't provide access to specialist care, but they may be able to help you find somebody who would be willing to take somebody at a discount.
Well, you know, I like to, I don't like to use the term single payer because it, it polarizes people.
Well, you know, I like to, I don't like to use the term single payer because it, it polarizes people.
Single payer means, you know, government run, government sponsored health care. And there are some models. So, you know, England has a universal care program with public, funded by public dollars, and most of the health system is publicly supported. But there are also other systems where there's a combination of public and private entities.
Single payer means, you know, government run, government sponsored health care. And there are some models. So, you know, England has a universal care program with public, funded by public dollars, and most of the health system is publicly supported. But there are also other systems where there's a combination of public and private entities.
And so I like to refer to universal care and different ways to get to universal coverage or 100% coverage. There's different ways to get there. And I, you know, I, it's so hard to, I'm 100% supportive of universal coverage. And I think the United States could get there. But
And so I like to refer to universal care and different ways to get to universal coverage or 100% coverage. There's different ways to get there. And I, you know, I, it's so hard to, I'm 100% supportive of universal coverage. And I think the United States could get there. But
in this political environment and for the political environment we've had for many years now, it's just a huge roadblock to get there. So I'm 100% supportive. I was 100% supportive of Bernie Sanders, who was advocating for Medicare for all. I think there's different ways to get there. One thing I do I do kind of come back to is the states that have tried, single payer have done studies.
in this political environment and for the political environment we've had for many years now, it's just a huge roadblock to get there. So I'm 100% supportive. I was 100% supportive of Bernie Sanders, who was advocating for Medicare for all. I think there's different ways to get there. One thing I do I do kind of come back to is the states that have tried, single payer have done studies.
So Vermont was kind of, states have advanced this and Minnesota kind of goes and fits and starts on a model of universal coverage. And Vermont was a state that went kind of ahead of all the other states. And the problem was, is that transferring private funded healthcare services to a public funded system requires an increase in taxes.
So Vermont was kind of, states have advanced this and Minnesota kind of goes and fits and starts on a model of universal coverage. And Vermont was a state that went kind of ahead of all the other states. And the problem was, is that transferring private funded healthcare services to a public funded system requires an increase in taxes.
And so when people see that explicit tax amount that costs are, you know, that would be needed to fund our healthcare system, right now our employers, so 50% of people get their insurance through employers. We call that private insurance, right?
And so when people see that explicit tax amount that costs are, you know, that would be needed to fund our healthcare system, right now our employers, so 50% of people get their insurance through employers. We call that private insurance, right?
But they get a subsidy on that, on what they contribute to. There's a huge subsidy transfer to them, but we don't see it. It's like implicit. So even though we're, you know, it's tax supported in many, many ways, we don't think of it as tax supported. So as soon as you make that explicit and say, okay, private sector, you're not responsible for healthcare anymore.
But they get a subsidy on that, on what they contribute to. There's a huge subsidy transfer to them, but we don't see it. It's like implicit. So even though we're, you know, it's tax supported in many, many ways, we don't think of it as tax supported. So as soon as you make that explicit and say, okay, private sector, you're not responsible for healthcare anymore.
We're going to move it to the public domain. And then we have to raise the taxes. So the employer's maybe, you know, they in Vermont, it was like a 40% increase in employer taxes, because that's how much they contribute. And they get, you know, benefit from contributing to health insurance.
We're going to move it to the public domain. And then we have to raise the taxes. So the employer's maybe, you know, they in Vermont, it was like a 40% increase in employer taxes, because that's how much they contribute. And they get, you know, benefit from contributing to health insurance.
So my, you know, my bottom line is, I don't want to lose that private sector contribution to our health care coverage, which is right now provided through employers. And in some ways, You know, it's not an economist speaking now, but I don't care if it's implicit.
So my, you know, my bottom line is, I don't want to lose that private sector contribution to our health care coverage, which is right now provided through employers. And in some ways, You know, it's not an economist speaking now, but I don't care if it's implicit.
You know, sometimes we have to hide the taxes because we, you know, that is our foundation of our healthcare system is our employer-based healthcare. And it makes it complex and it's all, you know, I can hardly... describe the tax subsidy that they get, but it's really important that the private sector contribute to the cost of the system.
You know, sometimes we have to hide the taxes because we, you know, that is our foundation of our healthcare system is our employer-based healthcare. And it makes it complex and it's all, you know, I can hardly... describe the tax subsidy that they get, but it's really important that the private sector contribute to the cost of the system.
And if we move it into a public domain, then it becomes a political issue and very explicit. And that's, the economists wanna reduce that tax deduction that the employers get to make it explicit, but, um, but then we have to pay for it and we have to vote on paying for it. And so, um, so I guess that's a long winded way of saying I'm supporting universal coverage.
And if we move it into a public domain, then it becomes a political issue and very explicit. And that's, the economists wanna reduce that tax deduction that the employers get to make it explicit, but, um, but then we have to pay for it and we have to vote on paying for it. And so, um, so I guess that's a long winded way of saying I'm supporting universal coverage.
I don't want to lose the employer contribution to our health insurance coverage. And is there a way to get there, um, by, by sustaining that and, um, One answer is Germany. That's how Germany and maybe Austria supports their health insurance is by having employer mandate. Employers have to provide insurance. And then the government subsidizes the low income and people who are not working.
I don't want to lose the employer contribution to our health insurance coverage. And is there a way to get there, um, by, by sustaining that and, um, One answer is Germany. That's how Germany and maybe Austria supports their health insurance is by having employer mandate. Employers have to provide insurance. And then the government subsidizes the low income and people who are not working.
So I think there's a way to get there. There's lots of different models. But I think for our country, you know, it's going to have to be, I don't know, a I don't know what, like a huge, a huge, I don't know what the word is, transformation or a huge shift or a huge outcry. Like it's time. And there are different parts, you know, there have been different moments, like maybe this is it.
So I think there's a way to get there. There's lots of different models. But I think for our country, you know, it's going to have to be, I don't know, a I don't know what, like a huge, a huge, I don't know what the word is, transformation or a huge shift or a huge outcry. Like it's time. And there are different parts, you know, there have been different moments, like maybe this is it.
When there was a time when employers were like, we don't want to pay for healthcare. We don't understand it. It's too costly. The costs keep going up. And if employers start to sort of,
When there was a time when employers were like, we don't want to pay for healthcare. We don't understand it. It's too costly. The costs keep going up. And if employers start to sort of,
bang the drum and you know other people advocates who have been there all the time you know there may be a point where we get some some movement and some outcry like this is and it feels like after COVID and now things are costs are still going up and you know so maybe I don't know
bang the drum and you know other people advocates who have been there all the time you know there may be a point where we get some some movement and some outcry like this is and it feels like after COVID and now things are costs are still going up and you know so maybe I don't know
At the end of my career, I'm thinking, probably not in my... I tell my students, maybe not in my lifetime, but hopefully in your lifetime.
At the end of my career, I'm thinking, probably not in my... I tell my students, maybe not in my lifetime, but hopefully in your lifetime.
Well, you know, we... We leverage all the federal survey. There's about five or six federal surveys that provide information on health insurance coverage. And of course, they measure it all different ways and have different purposes. But we leverage that for mostly for state health policy, because at the federal level, and especially now, Congress, I mean, they don't do anything.
Well, you know, we... We leverage all the federal survey. There's about five or six federal surveys that provide information on health insurance coverage. And of course, they measure it all different ways and have different purposes. But we leverage that for mostly for state health policy, because at the federal level, and especially now, Congress, I mean, they don't do anything.