Challenging the Healthcare Status Quo with Rosemarie Day, CEO at Day Health Strategies was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.
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Saul Marquez:
Welcome back to the Outcomes Rocket, Saul Marquez is here and today I have the pleasure of ringing back onto the podcast Rosemarie Day. She is an outstanding leader in health care and helped lead the launch of health reform in Massachusetts in 2006, which became the model for the Affordable Care Act. She’s been working on health reform ever since and is passionate about universal health care and women’s health issues. She is the founder and CEO of Day Health Strategies, a successful, mission driven women owned consulting firm that’s celebrating its 10th anniversary. She’s also a mother, a breast cancer survivor and an activist. She’s the author of the book Marching toward Coverage How Women Can Lead the Fight for Universal Health Care. And it’s a pleasure to have her here on the podcast again. If you hadn’t had a chance to listen to the original interview with Rosemarie, it’s Episode 209. Make sure you go listen to that or listen to it after this one. I think you’ll you’ll get a lot of inspiration. But in that podcast, she promised she would reach out when the when the book was written. And so here we are, Rosemarie. Such a pleasure to have you back on the podcast then. And congratulations on this big milestone.
Rosemarie Day:
Thank you so much, Saul. I’m really happy that I live to see the day that’s getting past that milestone and that it wasn’t a milestone.
Saul Marquez:
Well, you know, you you delivered. And as with everything else in your career, what you do in health policy and and what you do for your clients and your employees and really the community at large, you deliver. And so kudos for that. And so in today’s episode, we’re going to dive into what the book is about and also what that means to all of us listening. So, Rosemary, you know, tell us a little bit about the inspiration for writing, marching toward coverage. And, you know, once once you give us a little insight on there, we could dive into the details.
Awesome. Well, you know, the inspiration really goes back to my roots in starting the whole health reform, the operational aspects that actually worked in Massachusetts and became the model for the Affordable Care Act.
And and that was an amazing thing to get to do at that point in my career, was an honor to be asked. And it was a tremendous amount of work. But to see it, to see it go into operation and to get Massachusetts to an uninsured rate of about two percent, which is pretty close to universal coverage. And then to have that become the model for the country was just incredibly gratifying. Up until the fact that we had an election in 2016, that was one at the federal level by candidates from Donald Trump on down who were making it their number one priority to repeal the Affordable Care Act. And I sat here saying, wait a minute. We started this as a bipartisan endeavor. We had Governor Romney representing Republicans and business interests and then a Democratic legislature in Massachusetts that listened to all the advocates. And we came together and found something that we thought would work in our economy and in for our citizens in this state. And I thought that that bill ought to translate nationally, and it did in some places. But the national situation just became so fraught politically. And so I wanted to try and have a chance to explain to people why this made so much sense for the US as a as a starting point. And that was part of the inspiration. So there was the having birthed this thing and delivered, as you say, here in Massachusetts, and then see its potential for the country and wanting to try and realize more of that potential.
And I never one who wants to stay in the negative. So I was also inspired very much by the women’s march in 2017, the first one in Washington, D.C., in which I participated and saw the power of peaceful protest, where you’re putting forward a positive agenda. How many people can rally around that and say this is what we want? And I think a lot of women who came to that march had never seen themselves as activist. So I kind of put that together along with, you know, all of my lived experience of women, a preponderance of caregiving responsibilities and health care on the home front and so many things like that putting that together. This kind of the aha that this could be the book. And I then went further. I didn’t want to just say, let’s defend the Affordable Care Act. I wanted to explain, like, how do we get to a vision for 2020 and a future where we might actually truly get to universal health. So I’ll I’ll leave it there. But there were multiple sources of inspiration that got us all kind of came together in that perfect storm, including my own health event in 2017. So, yeah, it just kind of became this thing I felt that I had to do.
Now, I think it’s you know, it’s both very personal, but also something that is aimed at service.
And, you know, the really, as you mentioned, bipartisan efforts to figure something out kind of fell apart and you felt something inside of you pulling you toward we’ve got to do something about this.
And so that’s inspiring. You know, and it’s a it’s a big undertaking. And nevertheless, you’re not shying away. Tell us a little bit more about some of the concepts in the book.
You know, I’d love to take a sneak peek here on this podcast.
And in the end, you know, if everyone is is engaged and you feel like you wanna learn more. The opportunity to either pick up a copy or get one on audible or wherever you do audiobooks, it’s available.
So looking forward to using today. Yeah. Or it is an opportunity for us to dive in. So, you know, universal coverage is is is a loaded word here. And so I’d love Rose-Marie, if you can take that and give us your frame of universal coverage in the U.S..
So I think what. Yeah, absolutely. And, you know, many terms that we use end up getting kind of loaded. And I think that happened with Medicare for all, which I think was, you know, a great you know, the goal of of making health care a Right.. I very much share. But the means to get to that goal is something that I I thought the proposal that candidate Sanders and now Senator Sanders had was just a bridge too far for most of the country. And and I and I felt that kind of in my bones from all the work I’d done over the past, you know, 15 years and implementing health reform first in a state that, you know, is already more on the liberal side than not, gets coded as a blue state and seeing the limits of of what was acceptable in this state. And then all the work I’ve done across the country and in purple states, red states, you name it, I’ve been there. So knowing kind of what I’ve been through with the implementation of the Affordable Care Act. I felt like, OK, you know, we’ve got to find something that is digestible for for our country in order for it to happen. And I wanted to see what what could that be? What how could we get there and put forward to the readers, you know, some ideas that they could wrap their minds around and get beyond saying, well, you know, it’s England’s model, you know, or nothing. And and, in fact, there are so many models in other countries that have universal health care that would be more applicable to. So I devote a chapter to some examples of that and say why? I think, you know, that we could bring that here and and be successful. So I try to find that path. It’s frankly pragmatic from both both political and economic sense.
Yeah. And, you know, taking that approach is is is critical. Right. Because the economic piece is vital. It’s a it’s a vital part of the way that we get it done. Right. So so talk to us a little bit about how you see the ideal means to the end of, you know, getting to a universal coverage.
So I, I talk about I love the model, the continuum. And there’s a can, you know, in how you think about a healthcare system. You can be, you know, way into the private sector side at one end of a continuum or kind of all government at the other end. And I think the U.S. has got to be somewhere in the middle there.
And and as I say, there are other countries that have found more of that middle ground where you leave the private sector to do a bunch of things, because I think that in our country, we really like having the choices that the private sector brings and the innovation, that kind of thing. But you also have to bring government in, you know, as we do for the Medicare program to set the standards and guardrails and to and to level the playing field to make something truly universal and accessible to all. So it’s a combo of keeping private sector for what it’s good at and involving government for what it’s good at.
And putting that together and I don’t want to give it all away, but I think that’s better that there are some great thinkers who do this thinking in D.C. who have like put a lot of this together and I, you know, have put different paths. Forward and you don’t actually have to prescribe one path. And I think that’s what I wanted readers to be excited about, is that you? I actually have to know every single detail. We’re not all going to be health care policy wonks, and some people find that really intimidating. So it’s like that’s not the starting point. The starting point does go back to like the signs. I saw it in March and a chance like health care is a human right. And so what does that really mean? Well, simply put. Think about something like K through 12 education in this country. We have bipartisan agreement that K through 12 education is a right for every child and nobody’s debating that or trying to pull that apart. Now, I’ll admit. Of course, there are tremendous inequities in the system, but there’s no one saying let’s just cut off kindergarten and first grade or let’s just graduate people at eighth grade. We’re kind of done.
We have we have a consensus that there is this universal education. And I really think we need that same frame of mind for health care.
Yeah, that’s a that’s a good parallel and one that, you know, because it’s been in place so long, we don’t we don’t really challenger or think of applying to other areas like health care. And so, as we, you know, are in the Colvard era. It’s been challenging. And you know how we cover costs and, you know, the the hurt that a lot of, you know, providers are going through right now. And, you know, who owns what. You know, this is always a challenge for for us as a country. What other things would you want to add there? As far as what the book covers as solutions to some of the challenges we have today?
Well, I. I’m glad you bring up the covered tandem. I because I think that while I felt there was an urgency to this cause already, given the number of uninsured people was already inching back up to 30 million, and that’s now grown tremendously because of the pandemic. The official numbers aren’t out yet, but I think we can easily add another probably 10 million people, if not more. When all is said and done to the number of uninsured, the uninsured and underinsured people who technically have insurance but can’t afford the out-of-pocket costs, can’t afford deductible. So they’re really skimpily insured. That’s also become a really big problem. And with a pandemic where you start to realize how interconnected we all are, how our health, you know, isn’t just an individualistic thing. It is connected to what other people are doing and the fact that, you know, to get past this pandemic, we’re going to need to have a vaccine and people need to have access to that vaccine. But, you know, in the in the near term, people need access to testing. They need access to treatment. And they’re still kind of a gotcha culture around, even if we say, well, we’re going to cover that treatment. People may not fully have gotten that message because they know that if they show up in a yard, they tend to get a big bill. So we don’t have this culture of coverage. And I think the pandemic shows very acutely that that needs to change. And I’m inspired I went back to the book and did a lot of looking at, you know, the messages in the in the civil rights era and the campaigns then that were inspiring to people and say, you know what? What can we take from then to be motivated today? And if you’ll indulge me, I’d love to read this, a very short quote from Dr. Martin Luther King, which I think is really timely.
Yeah, please. He wrote and I put this in the book he wrote about interdependence. In his letter from a Birmingham jail in 1963. And it starts with this. He says, injustice anywhere is a threat to justice everywhere. We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly affects all indirectly. Anyone who lives inside the United States can never be considered an outsider anywhere within its bounds.
That’s I think those words are so, you know, he’s only powerful. But when you think about today and the moment, the moment that we are in, which is a extremely difficult and challenging time, I, I think this quote takes on even more meaning.
Yeah, that’s that’s a good one, Rosemary. And, you know, we have a responsibility to do what’s best for our people and how we do it matters.
And, you know, today, I, I, I just I always find myself saying that, Rosemary. Psych today, because I covered, but the reality is it’s true. And, you know, I think that how we handle this pandemic from, you know, virtual map medicine perspective, it’s going to change the front door to health care, how we handle this pandemic with regard to how we pay for things and who gets covered. If we miss the lesson, we’re gonna we’re gonna be in big trouble. But we need to we need to answer the call. Right. I feel like you’re answering the call with an option, because if we don’t answer the call, there’s there’s gonna be a big mess here. And so I appreciate it.
Absolutely.
Yeah. And so. All right. So, so powerful quote. And I just kind of envisioned MLK in his cell writing than the time that he was writing it. And guess what? We’re all in our hour quarantine, you know. And so, you know what’s happening with with with health care is going to be a direct result of our thoughts and our actions. So what do you what’s the call here? Rosemary, you know, what’s the call, the action that you have for the listeners, obviously, to learn more.
But, you know, what is the vision to make it better and to get more coverage for more people?
So I. I really believe in the fundamentals of our democracy. And I’ve come to see that we’re not going to arrive at universal health care. You know, out of some kind of sense of corporate goodwill. And it’s not going to happen with politicians just automatically the hue and cry for this has to come from the people and the people have to push the politicians as as they did when the Affordable Care Act looked like it was going to be repealed and then it wasn’t. And in fact, during the congressional midterm elections in 2018, we saw that health care became like the number one issue that people were voting on. And that was in part to continue to protect the ACA and people with preexisting conditions. That was a driving force in the sentiments in that election. So that’s really interesting example of how I in my view, democracy was working to say, OK, the common values here are that we maintain coverage for people, the coverage gains we’ve gotten, we don’t want to lose. So I’d like to build upon that and go further. And I go back to that K through 12 education example. We agree as a society that we should be a Right. because we are trying to create citizens who are educated enough to be able to be functioning citizens.
Well, I would argue the health care piece is just as important for that know fundamentals of being a good citizen. You can’t function if you don’t have your health. And so, again, I find it very analogous to the call to action is that I wanted people to not shy away from this topic to set to get beyond the size of health care is a right and say, what does that mean and what would it take to make it so and to rally people to the cause. And I, I look to women to lead, frankly, because they already have to lead in the homefront. And I want them to see that the personal is political. And you may not love the idea of getting political. You may not think of yourself as an activist, but there are ways in which you can step up and step up your activism, even if that doesn’t mean going out and marching or what have you. But it’s looking at things differently. So I give people the encouragement and the tools in the book to do that, as well as on my Web site at Rosebury Day dot com. And I’m just I want to inform people about the issues in a very accessible way and then inspire them to act on it.
I think doesn’t get any clearer than that. And, you know, for all of you listening, I mean, you’re hearing from a health leader, a cancer survivor, an author, Right., somebody that and that’s that’s committed to making health care accessible for all. If you got some inspiration out of our discussion today, certainly take Rosemary up on listening or reading her book. It is and is going to be a really an extraordinary way for you to figure out what you could personally do to to stand up for yourself and obviously your family in today’s health care environment.
You know, can be a lot better. So Rosemary, can’t thank you enough for first spending some time with us today to give us a sneak peek on the book and certainly looking forward to reconnecting with you when when I take a read of it. And so I thank you very much. You know, it’s always, always great to connect with you.
Thank you so much. It’s really a pleasure. And thank you to your listeners.
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