Health care i have ever had the privilege of hearing. Someone that can combine a masterful analysis of details while keeping a sharp focus on the important principles of why it matters of corporations can make more money. To a very low vaccination rates. Right now the rate is 75 and for context, you want a rate of 95 to achieve herd immunity so theres a big gap right there. Theres two kinds of folks who dont vaccinate. The hard line antivaxers who refuse come hell or high water to let their kids touch those needles but that is the minority. Most folks fall somewhere in the middle omiddle, but ask anything skeptical. They dont want to hurt their kids which is the correct parenting and pulls so the google vaccine good or bad and look at the results and to see what they see, listen to the radio, watch tv and began to wonder whether or not they are a good idea and they choose not to choose but as russia tells us in choosing not to choose is still a choice and the kids ultimately thought they could reach. The doctors were not getting the job done for a couple of reasons. They had a very limited amount of time to see patients. Number two, doctors can be brusque. With the irregularities of concerns in certain patients so they just were not getting the job done. So they turned social workers. Its a prehospital that hired 53 social workers and called them vaccination counselors. These are those that would go to parents after delivery in the Neonatal Unit and say hello, my name is [inaudible] and im your vaccination counselor. Are you thinking of vaccinating your kid and what questions do you have, what can i answer for you. Ultimately whatever choice you make is yours and i respect that but consider me your resource. So what do you think happened . You know what happened. Vaccination rates skyrocketed went from 75 to 87 in hospitals. This is a score of interventions, governmentfunded social workers that meaningfully affects population. Its incredible. This is the future of the Health Policy can be and should be. Effectively denied us by the American Healthcare model. We live in a time of deep alienation with these kind of conspiracy theories often in the world around us and its only this tedious compassion that really makes a difference. Its the kind of work that will never be considered, never championed by blue cross blue shield. Its incomprehensible to the Health Finance model we have now because its not profitable for anybody to invest in so we have these considerations of things that are totally divorced from the model of Health Finance. Thats why i wrote this book. Lets talk about American Healthcare and american finance. Once again, thanks for having me here. This is my first book. Im not much of a writer but i think it is ironclad and i hope you like it if you pick it up. Consider giving you 20 minutes on how medicaid works which is fascinating for a saturday afternoon. Theres a lo a lot of a lot of d health care and a lot of tears and this book but i try to line ilinuxwith little glimmers of h. A better world that we can live free from the betrayal of our own body. They can stand together free and safe and frankly i believe it. I believe we have the tools and resources to build this freedom we just have to demand it. In the opposition to the world we have now a distant natural but created and because it is created either can be changed until it is changed, until we change it if the birthright of continual exploitation. We are pumped for labor and suffer and we are then punished for that suffering and for being sick. Punished for being black or brown, for being pregnant, for being unlucky. The core of all that punishment and suffering there are two little truths. In america, sickness mix you poor and poor ms. Makes you sick so if you permit me for the next halfhour i will talk about that relationship and how it is expressed through our healthcare and Health Finance models. I want to talk about three things. What they have, what we want and what lies beyond. I want to talk about the overwhelming at the numbing brutality of the forprofit health care. I want to talk about the relatively benign structural changes and then i want to talk about a broad vision of a better world, the moral compulsion. Lets start off having some fun with the fundamentals of health policies. First off nobody can afford to pay for the medical costs by themselves. Generally speaking not a lot of folks need it at the same time. Medical costs come from 5 of the population which is someday youll join. What it does come at a cos, thee enough to bury you, so we have the idea of insurance. Insurers pull together to pay off medical costs for those who need it and soak they can spread cost anthe cost and lower it isr person. In the u. S. Insurance companies charge a monthly premium and their job is to make money. Or to many sick people just one person can cost up to a Million Dollars to ensure it is per person and so to compensate it increases premiums but when the premiums go up people cant afford them to drop out. Its sicker and sicker meaning once they get into the higher premiums. Or to find ways to coerce customers until leaving. Maybe it does both. Insurance companies dont lose money when you get sick. Insurance Companies Lose money when you get sick and they used your insurance and there is simply nothing they can do about it because if Insurance Companies were to offer the care people need and where they need it people would buy insurance plans and the insurer would lose money. That is a bad way to run a business. I wonder what is the point of blaming them. Blaming an Insurance Company for seeking profit even though it hurts people is like blaming a rabid dog for running or a scorpion for singing this is just what companies do. Thats why healthcare and insurance doesnt belong in the hands of companies because they cant do the right thing. Instead they turn. And it reduces health to the transaction or Investment Vehicle in sort of a connection or relationship. Mistake in the corporations for healthcare and the people who profit decided to shackle the wellbeing of children to whether or not the parents are lucky enough to find the benevolent employer even if they have a union instead of fighting for better wages every year theyve got to negotiate for more and more expensive insurance, which as we saw in the strikes our children and our families are hostages to our employers. If you demand your fair share of the labor, their bodies on holdd for ransom and so our employers demand mind, body and spirit and use the tools of Health Finance. So that is one side of the coin. Most of her because hospital ceos, pharmaceutical companies, manufacturers, close personal friends keep finding ways to charge more and more for the same services or fees for other services and no private insurer can stop them. Fundamentally the Healthcare Market all prices are fake. They are just really fake. In the u. S. The average inpatient procedure costs 40 more than the exact patient when performed in france. In the u. S. A scan costs five times more than the same machine scanning the same but was stand but its been even closer to home. Sometimes its the same machine and same hospital that has a sevenfold cost based upon arbitrary factors like time of day and prices are fake and medical costs are high. Over the past decade have seen the price of insulin triple up because of the press to produce it but because the manufacturers like making more money and nobody can stop them from charging as much as they can and whenever they want. Think about the relationship between primary care. Its like checkups, basic medications, the kind of familiar intimate healthcare because a Family Doctor or gp. In high volume is low margin and generally primary care is not but now conversely its 2,000 a night from inpatient space so if you were a hospital corporation, it is more to push folks into inpatient care and sort of wasting we are going to break away from this for the longterm commitment of live coverage of the senate as the gavel back into session. Run madam president . The presiding officer the senator from south dakota. Mr. Rounds madam president , i ask unanimous consent that when the senate completes its business today, it adjourn until 10 00 a. M. , wednesday, march 18. Further, that following the prayer and pledge, the morning hour be deemed expired, the journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and morning business be closed. Finally, following leader remarks, the senate be in a period of morning business with senators permitted to speak therein for up to ten minutes each. The presiding officer without objection. Mr. Rounds if there is no further business to come before the senate, i ask that it stand adjourned under the previous order. The presiding officer the the presiding officer the to help those affected by the outbreak. Watch live coverage when the Senate Returns on cspan2. Returning to the programming on booktv. The airlift to watch their bodies turn into timebombs with a heart attack at their jobs and leave their kids behind. Healthcare costhealth care cost afford under the guise of personal responsibility also healthcare ceos and their friends can bring Home Millions and millions of dollars a year. But at the end of the day, costs keep increasing and quality of care stagnates for the most vulnerable among us. Our finance model takes money from the poor and gives it to the wealthy. Its negatively. In 2014, is pushed 20 Million People into poverty or extreme poverty and yet 31 Million People were left uninsured. The american model of health has failed. There are consequences to this failure. Its the most dangerous place to be sick. Which is 60 is clinically preventable. Its the most dangerous place to be gay and to be disabled. Last year across the 4 Million People last year is the fact of 400,000 years. When you look at the data you understand all of this only exists if they were poor because rich people are exempted. Theyve exempted themselves. Men born to the wealthiest get to live 15 years longer than born to the poorest. For the wi one in the gap is ten years. By sustaining the private insurance models we have chosen to let poor people by despair the rich. This is the terrible secret of American Healthcare. This is the fundamental american illness. They are killing us and robbing people for the. We demand something different. A federal universal singlepayer. Singlepayer is a reasonable concept. I can do singlepayer. Here it is. We pull together all the money we currently spend on healthcare to cover in full care for all people. Easy. One sentence. Its called singlepayer. Medicare is costsharing and premiums and deductibles. We demand an improvemen improvet could 90s because of coverage medical, dental, vision, Long Term Care with disabilities to all people in the u. S. Including new orleans at the. Because everybody benefits when its easy. Now delivering care, being a doctor, nurse, home health workers, thats complicated. It hurts all the time and it is a complicated process. Its pretty simple. People ask how can we pay for this . We are spending our money really stupidly. Its required to fund the singlepayer is 3. 9 trillion this year of healthcare between half and two thirds in the Government Spending and the rest is your premiums, deductibles and copayments to the Insurance Companies and the uk to your hospitals. 3. 9 trillion, one third is spent on nothing more than waste. Half of that is like admin costs and high prices. The other is provider like an efficient care. Now take singlepayer, it would cost 10 less from what they are spending right now. Insurance companies are unable to do anything about it. The shovel the cost back upon you. Singlepayer but its peoples medical costs and reallocating ticking everybody longterm. Part of the reason costs are so high is because private intruders have relatively small Customer Base is and cant negotiate. Ensures need more than just the hospitals need insured at once medicare for all ones that singlepayer represents, it basically sets its own price because it is the most powerful negotiator around so these wildly inflated costs get their balloons poppethat theirballoond down to earth on the even field. For the primary care clinics. Most importantly, you return the money to the people who do the work. Take for example, Home Health Aide some folks need their medicine changed, help getting out of bed, physical therapy and they can receive care in their own homes. It is an extra place to be, its where the internet lives, where your friends and family can see you. Disability longterm care at home is by being able to live at home instead of cooped up in the cost of 120 a visit. Everybody benefits. Its more humane and they save money. Everybody benefits except for the home health fears themselves because for this essential service the average is 1. 2 million o with a nationwide average of only 11. Pay fair wages for care that helps everyone. What makes the difference in these health outcomes. Is this luxury hospital suites, millionaires or multimillionai multimillionaire, 40,000dollar data packages, of course not. What makes a real difference is extra Clinical Care or compassionate labor and social work, patient advocates, versus. These are folks that are undervalued and the primary people to make a difference in the population. These were pretty basic ideas. Nobody is investing in longterm health and population health. Nobodys investing in compassionate labor and they never will. Because right now youre private insurer bears the cost of you receiving care while they are insuring it. It keeps you healthy now. Let me put it another way. You are at home, your window break and if the weather gets in, raining or snowing, too hot, too cold. If the local clinic was shut down, youve got to go to the hospital. You have to spend all day dealing with the system, all day dealing with the bus you cant go to work. If you cant go to work, you dont make any money. If you dont make money you cant afford to fix the window that caused the problem in the first place, so the answer isnt to fork over a pile of cash when you go to the hospital when it begins with giving people what they need to fix the windows. There are no private actors in the american model who bear responsibility to fix the responses on their own. They are ones that were created to solve these problems and they are incapable of addressing the foundational problems of healthcare into the windows they are capable of in the past five years. Theyve constructed that justice and cannot follow these problems because existentially they cannot conceive of them as problems in the first place. It should be the actor who pays for the care in the first place because once that singlepayer bears the cost of providing care and the risk of air force to confront the rampant suffering they can use it as a tool for health and justice. If your people are getting sick they dont have a place to live or where they live is unsafe and they would save social housing to bring the healthcare costs down. People are getting sick because they dont have access to healthy food to eat so they get comorbidities like diabetes or failure and then provide them with affordable food options. If people are getting sick because they dont have the Needle Exchange programs, pick up your counseling and rehabilitation is healthcare and there are addiction treatments to Bring Health Care costs down because singlepayer is not the goal. Its only the tool. Because Economic Justice is justice and Environmental Justice is hope justice. Reproductive justice. Regardless of age, gender, race or creed. Its how much a corporation can extract a profit. And utter desolation. And i want to talk about that right now. Over the course of researching this book. Every morning i would wake up, eat a banana. Over and over and over again and its an honor to be trusted like that. The first story takes place in houston. One thing i havent talked about his Mental Health. Its the largest provider of Mental Health services. There is records ireland in chicago its cook county, etc. Its a fine observation. Its held in these cells in the Harris County courthouse. For the Disorderly Conduct what do you do, you have two choices. Weve built the owner you can fight it and looking at more time locked up without your meds and care. People are held in the hospital wing of the person or th prisone prison wing of the hospital. The hospital jail, chiltern hospital. They are the wrong kind of sick operson we delegate your care to private prison. To be black or brown would fall into the intersection. If you are a poor single mother of color for example, you have no right to privacy. If they find too many or if you are a single mother, you can lose your benefits. But if you are disabled and a nurse comes to your home and if you look at this process. You have to make less than 2,000 a year. For the understaffed office to prove that you are employed. They drive people into the hospital were into the streets are ultimately into jail. And so long as we use prison to hide those by the healthcare needs they are inseparable. So, while the idea presence of the largest provider for health care in the u. S. As it is willing to send, its wrong because no prisoner will ever receive the care, support or help they need to handle. And the inevitable return once they get out and remain sick and go back to jail because prisons are not hospitals. They are warehouses for the mentally ill. They are storage units. Another story i want to tell of memphis tennessee. At the turn of the century in memphis, 20 black children died for every thousand live births. Its an incomprehensible number. Its found nowhere else in the first or second where 20 bla