Please help me get him a hand and welcome him to the stage. [applause]. This anecdote comes to you from quebec. I know it as a place of two things and extremely punishing seen in a very low measles vaccination rate right now it is 75 percent in the context you want 95 percent to achieve heard humanity on immunity so there is a big gap one hand if you have a hard line anti baxter those that believe they are chem trails for your body come hell or high water those of the minority. Most fall in the middle they dont want to hurt their kids so they google vaccines good or bad and look at the results they listen to the radio and watch tv and they began to wonder if these vaccines are a good idea and they choose not to choose but then you have made a choice and the kids go unvaccinated. These are the folks but doctors were not getting the job done number one they have a limited amount of time to see patients and they can be brusque they can be dicks they see themselves rational they dont want to deal with those squishy patients so they were not getting the job done. But with the social workers 53 social workers call them vaccination counselors those who go to parents right after delivery of the Neonatal Unit and say hello. I have your vaccination counselor. Are you thinking of vaccinating your kids . What questions do you have about vaccinations . What can the answer for you whatever you cheney on choice you make is yours i respect that but consider me a choice on a resource so what happens . You know what happens vaccination rates skyrocket 75 up at 85 percent this is a score of Public Health intervention social workers doing compassionate labor to meaningful effect population its incredible the future of what Health Policy can be and should be a future actively denied us by the American Healthcare system we live in a time of alienation so this kind of self harming conspiracy theories fill the void around us it is from a profitable one that makes the difference this is the kind of work that would never be considered or championed by Blue Cross Blue Shield that is incomprehensible to the Health Finance model we have now because its not profitable for anybody. So these considerations of things that make us healthy are forced from the model of health. Our Health Finance model is deeply unhealthy. It sick. Thats why wrote the book. Thats why i am im here to get down with the sickness. Lets talk about it thanks for having me. Not much of a writer but i hope you like it to i am giving you 20 minutes of how medicaid works which is fascinating but i want to talk about the themes is not all happy but you live in america and you already knew this theres a lot of tears in the book because to envision a better world with a crippling fear of the betrayal of our own body to stand free and frankly i believe in it. We have the tools and resources to build this freedom. You just have to demand it and the composition to the world we have now that is not natural but created by people if it is created it can be changed until we change it. Ours is a birthright of continual exploitation. To be drained of cash and we suffer and then we are punished we are punished for being sick and punished for being hungry and punished for being disabled punished for being poor. Punished for being black. Or brown or queer, pregnant unlucky and just being. At the core of all that punishment and suffering in america sickness makes you poor important this makes you sick so stick with me the next half an hour i will talk about that relationship and how it is expressed through our healthcare and Health Finance models. What we have and what we want want to talk about the overwhelming brutality of forprofit healthcare and the relatively structural changes and then going to talk about our Broader Vision of the compulsion of Health Justice. Sound good . Great. Thank you. Lets start off having fun with the fundamentals of Health Policy. First nobody can pay the cost by itself medical care is extremely expensive but generally speaking not a lot of folks needed at the same time any given year 50 percent comes from 5 percent of the population which someday you will join your day of tragedy comes and when it does the medical cost will be enough to bury you. We have the idea of insurance insurers pull together many for those who need it so now in the us for that to private Insurance Companies that charge to build the risk pool and their job is to make money so they have too many people that use the Insurance Plan or too few Healthy People are too many sick people just like one person with hemophilia could cost 1 million to ensure the per person Cost Increases so to compensate they increase the premiums but then people cannot afford them. Expensive people cant afford to drop out so then its a virtual death sentence so then they get sicker and then leading to higher premiums we want the uneventful risk pool as possible maybe it cuts off access maybe it does both it usually does both because Insurance Companies dont lose money when you get sick they lose money if you get sick and use the Insurance Plan theres nothing they can do about even if they want to because of Insurance Companies offer the care they needed when they needed it at rates they could afford it they would buy them and use them and then the insurer loses money thats a bad way to run a business. At some time along the line blaming the Insurance Company for seeking profit even though it hurts people is like blaming a rabid dog for biting or scorpion for stinging its just what they do thats why healthcare and insurance does not belong in the hands of companies because they cannot do the right thing. Instead they turn our bodies and health into commodities in this commodification of healthcare reduces health to a financial transaction or Investment Vehicle between a person and their body and their doctor and community. The people who profit shackle the wellbeing of children whether or not their parents are enough to find a malevolent employer even if they have a unionist of the better wages of Workplace Safety every year they have to negotiate for worse and more expensive insurance which can be stripped for them as we saw with the uaw strikes children and families are hostages to our employers if you ever try to organize against them or dared to me and your fair share of the fruits of your labor they are held ransom so they use the tools of Health Finance to forge a path. That sucks. But it gets worse the cost of healthcare keeps increasing most occur because hospital ceos, pharmaceutical companie companies, close personal friends keep finding ways to charge more and more money to the same services are rack up fees. Fundamentally Healthcare Market all prices are fake totally fake in the us inpatient procedure cost 40 percent more than the exact same procedure in france or the mri a big fancy tube in the us the mri scan cost five times more than the machine scanning the same stuff in australia sometimes literally in the same machine that has a sevenfold cost variance time of day, which doctors, who pays for that and other horseshit. Over the price of insulin triple not because of the cost to produce it but because insulin manufacturers like making many in nobody can stop them to charge as much as they can whatever they want think about the relationship between primary care like checkups basic medications the familiar healthcare from your Family Doctor or gp high volume of lowmargin generally primary care is not profitable 2000 per night for the inpatient stay so it takes one it makes sense to go to inpatient care is an of wasting your time to minimize your profit to get primary care outside the hospital makes even more sense to buy of the cheap primary care clinics and enclose them down which is what Johns Hopkins does. What does that mean 58 million americans have no access to primary care and go to the emergency room for their healthcare cost and that is extraordinarily high. These are the two fundamental opposing truths one if you are Insurance Company is just not profitable to ensure people who are sick as a provider it is extremely profitable to charge people so the question of who gets to receive healthcare and when or who suffering matters is rationed by profitability. The whole scenario scares the jesus out of everybody involved particularly private insurance they find a way to avoid paying rising cost choosing to pay for plans they dont want to pay but that is not enough. So they got together in the seventies to invent the idea of consumer driven healthcare that you should make consumers pay more for the cost of their own health care turning us into smart shoppers about the healthcare thats why deductibles and copays increase every year to my sheep and more of your own skin into the game. That is horseshit it just helps Insurance Companies because people forced to pay for healthcare costs they cant afford dont seek healthcare. They dont get Preventative Care because we are left to watch their bodies turned into a timebomb. We decided under the guise of personal responsibility. And those that can bring Home Millions and millions of dollars per year but at the end of the day the cost keep increasing in quality of care stagnates through the most vulnerable among us. The Health Finance model takes money from the poor and gives it to the wealthy and in 2014 it push 20 Million People into poverty your extreme poverty and 31 Million People are left uninsured. The american model of health has failed. There are consequences for those failures. Because among the socalled developed countries it is america that is the most dangerous place to be sick. It is the most dangerous place to be black black infants diet twice the right one rate of White America has the highest Maternal Mortality rate of first world country that they are preventable america is the most dangerous place to a child, the most dangerous place to be a woman, the most dangerous place to be gay. The most dangerous place for the older were the most dangerous places to be disabled. Last year it cost 4 Million People board 400,000 years but a funny thing happened when you look at the data more closely you understand this danger that exist when you are poor because rich people are exempted. They have exempted themselves from all these problems and then they can live 15 years longer for a woman the gap is ten years. We have made a choice explicitly made a choice we have chosen to let poor people die and spare the rich and let poor children die from things that rich children do not die from all because the Health Finance model goes to the pursuit of profit and this is war and the terrible secret of American Healthcare and the fundamental american illness. They are killing us and we foot the bill American Healthcare fails us today and will collapse tomorrow it is incontrovertible that will collapse. We demand a federal universal singlepayer i spent 15 minutes private insurance. Is we pull together the money we currently spend on healthcare all care for all people it is called singlepayer because we create one publicly owned and publicly funded insurance medicare is cost sharing to have comprehensive coverage medical or dental or vision for all people in the us including noncitizens. Because everybody benefits to be a doctor and nurse that is complicated the body is a huge bag and it hurts all the time and misery is a complicated process paying for that is Pretty Simple we already pay for it was spending three three. 9 trillion with the premiums the page to your Insurance Companies one third is spent on nothing more than waste half of that the site cost and high a prices like unnecessary and inefficient care. Those singular payer plans would cost 10 percent less than what we stand right now we can spend 10 percent less to cover all people in full but just large healthcare corporations jacket prices and profits and then they cannot do anything about it. So they shoveled the cost back upon you so lets liberate for the longterm. Costs are so high because private insurance has relatively small customer bases and insurers need hospitals way more than hospitals need insurers. Once medicare for all excess singlepayer because it is the most powerful negotiator around the replay on the eve and field looking at admin cost and profits the optimization opens up in a conservative estimate. That is a big chunk of change what you do with that . You can improve everybody standard of living to reopen primary care Clinics CommunityHealth Sister on centers and return the money to the people who do the work. Takehome health a person can receive care in the hospital but first some they need meds changed physical therapy and they can often receive care in their own homes home is where the internet is in friends and family can see you so that longterm care at home instead of being cooped up with an average cost of 120 per visit. Its more humane care and we save money. But for this humane and essential service one. 2 Million Home Health aides are paid an average of 11 per hour we could allocate the money through the private market to pay fair wages for a central care. Think about it. That makes a real difference luxury hospital suites millionaire were billionaire surgeons 40000dollar packages for nerds to look at . Of course not those that get to build the most it makes extra Clinical Care and social work and advocates nurses these are chronically undervalued and make a difference of population these are basic ideas and simple demands. We understand the social forces but to understand the social ones that make people sick in the multi payer private model nobody is investing in population or compassion and they never will because right now your private insurance only bears the cost of you receiving care while they are ensuring they will change and one day go on medicare to make you healthier in the future. So at home and the weather breaks you might get sick or your kid get sick you have to go to the doctor if its booked solid you have to go to the hospital if you dont have a car you have to take the bus and spend all god damn day dealing with the bus system if you can go to work you dont make any money and cannot afford to fix the window that cause the problem in the first place so the answer is to fork over a pile of cash every time you go to the hospital but giving people with they me to one what they need to fix the god damn problem. And they solve the problems created by the private Insurance Industry with the real foundational problems of healthcare they are incapable to fix the broken windows or reopening the hospitals that have closed and those that have ruptured in South Carolina they cannot fix that in justice they cannot solve the problems they cannot conceive of them as problems in the first place. We can and we do. So those who dont get care should be those who get it in the first place once that singlepayer base that bears the cost to provide care and the risks and thats what happens when not provided it can finally be used as a tool. People are getting sick because they dont have a place to live for it is unsafe that housing is healthcare if they are getting sick because they dont have healthy food to eat then they get diabetes then food is healthcare provide with affordable or free Health Food Options to bring those costs down if we dont have access to therapy or counseling then rehabilitation is healthcare because singlepayer although fantastic is not the goal it is the tool Health Justice is the goal when we fight for Health Justice we all fight five sidebyside Environmental Justice is Health Justice reproductive justice for those who dont and those who do. Wages and working conditions black lives in brown lives in trans lives and immigrants and people in prison and all people regardless of age, gender, race or creed is Health Justice. We have inherited our world that permission to receive healthcare and to be safe in your god damn body depends on the rehab permitted in our country under desolation and i want to talk about that right now. Over the course of researching this book every morning and wake up and eat a banana drive six hours in my crv and give a speech and talk to people. They would tell me worse things that happened over and over its an honor but it builds on you i was a library so i want to share a few stories. To contextualize the fight for health care and the movement for Health Justice. The first story takes place in houston. We havent talked about Mental Health. But without talking about Harris County jail the largest provider of Health Services in texas which is the same story of any big cit