Stan, Clarence, and Barry chat with Dr. Lynn Blewett - Director of the State Health Access Data Assistance Center (SHADAC) and Professor at the University of Minnesota School of Public Health - about access to healthcare and insurance.Dr. Blewett has a long-standing career and experience in public health, health insurance models, health care policy, and access to health care. As the Director of SHADAC, Dr. Blewett supports state efforts to monitor and evaluate programs to increase access and coverage through funding from the Robert Wood Johnson Foundation.Listen along as Dr. Blewett shares their wealth of knowledge on health care accessibility.Join the conversation at healthchatterpodcast.comBrought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.More about their work can be found at http://huemanpartnership.org/
Hello, everybody. Welcome to Health Chatter. Today's topic is a good one, and hopefully it'll be informative for you, the listening audience. It's about access to healthcare and insurance, which kind of go hand in hand. We've got a great guest with us. We'll get to her in a minute. We've got a great crew that always keeps us hopping, Maddy Levine-Wolf, Aaron Collins, Deandra Howard,
Matthew Campbell, Sheridan Nygaard, all do great, great work for us. They do background research. They do the marketing. They do the production for this show. So thank you to all of you guys. You're second to none and greatly, greatly appreciate the work that you do. My co-host for the show is Clarence Jones. Great colleague. He's got great questions.
He comes at it from a different angle than I do. which is always, it's a nice complimentary way of doing a show like this.
But I'm nice when I ask those questions, Stan, right?
Yeah, I know.
Okay, I'm a nice guy. He's always nice. I want our guests to know that I do try to be a very nice guy when I ask these probing questions.
Yeah, yeah, he's good. But from a different angle than I do. We also have a great sponsor, Human Partnership Community Health Organization. in the, actually, is it statewide, Clarence? I forgot if it's statewide. It is statewide.
Yeah, yeah. We've done some work in it as well.
Yeah, you could check them out at humanpartnership.org. We want to thank them for sponsoring us. And also, you can check us out at healthchatterpodcast. All our shows are on there. All our background research is on there if you want to read about it. And also, many of the shows are transcribed as well. So if you're more into reading the show or listening to the show, you have a choice.
So there you go. Today we have a great guest. I've known her for a long, long time. And we were just chatting probably. I've known her about as long as I've known Clarence. Dr. Lynn Blewett. whose research really focuses on healthcare policies. He's at the University of Minnesota in the School of Public Health, focusing on healthcare policy and access.
and she directs the State Health Access Data Assistance Center. And do you call that Shadack? Shadack? Shadack. Shadack, okay. Shadack. Shadack, okay. Her expertise is in healthcare policy, access to care, which we're gonna get into some of these definitions, by the way, so everybody's clear. Looking at disparities,
She's also, I remember we worked together at the State Health Department before she went to the University of Minnesota. Wonderful person, wonderful colleague, and many, many thanks for being on our show today, Glenn. Nice to have you.
Thank you very much.
Yeah, so let's get this thing going here. We're talking about access to healthcare slash health. insurance. So let's maybe start this out by what the heck do we mean by access specifically to health care?
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.
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.
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?
So the insurance then, if I'm reading you right, is kind of the entree to the whole idea of access itself, correct?
Yes.
All right. And then there are issues. around access but we'll get we'll get to that in a second so can you you know that to be honest with you even for those of us who've been in the industry it can be even confusing for us okay because it's like oh my god there's private insurance there's public coverage it's um
doing this stuff yearly, where you have to re-up your insurance or redefine who you're going to have for your insurance, where you get your insurance, whether it's through an employer or on your own. So can you kind of cover that umbrella of all these things, public, private, where you get it, et cetera?
Yeah, and maybe I'll just preface to say that we have one of the more complicated health care systems in the world.
No kidding.
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.
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 let me ask this question. Who typically, let's call it by age, who typically uses health coverage more? Is it fair to say the elderly do? Maybe 65 and older?
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, okay. All right, Clarence, I know you've got some zingers. Here we go.
Well, no, no, I don't have a zinger because I don't want you to give me a bad reputation. You know, you said it from the very beginning, the health care system is very, very complicated, you know, and I come at it from a community perspective. I just recently was invited to be on the board of the Minnesota Community Measurement.
And so we're able to take a look at the gap between systems and FQHCs. How does the community utilize the system that you have? I mean, how can we utilize that in order for us to be able to get or to gain more access to healthcare? Because there is a gap.
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.
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.
Thank you. So you alluded to the fact, and I agree with you wholeheartedly, that our system in the United States is probably the most complicated anywhere in the world. I just think about somebody who wakes up one day and just says, okay, I have to get health insurance. It's just like, whoa, where do I start? So let's back up on one thing. Give me your thoughts about single payer.
In other words, if we're really talking about trying to get rid of confusion and perhaps get rid of confusion and just make it easier overall. Talk to me about single payer.
Well, you know, I like to, I don't like to use the term single payer because it, it polarizes people.
Yeah, well, that's true.
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
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.
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?
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.
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.
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.
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.
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
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.
Yeah, right, right, right. Yeah, Clarence.
So, Lynn, you have been described as an advocate for information access. Tell me, what does that mean?
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.
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.
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.
So let me do a follow-up question with that. As a community member, how do we become engaged in this work? I mean, because for many of us, we are trying to make sure that we have access to insurance for our population. How do we become engaged?
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 I take that as a good reminder as I'm working my way towards retirement, that that's something we could do better at.
So let me go back to this kind of theme that I called, I'll just call it confusion. You know, it's just like, and let me just take one facet of that whole ball of wax here. Yearly, every year, people are required to do open enrollment. Okay. Now what does that do? I mean, you know, in the scheme of things, why do we have to keep going through this year in and year out?
And it, and it provides frankly, angst for a lot of people. It provides confusion. It's, um, can I use for, for instance, when, when you're looking at this yearly update or whatever it is, um, People ask, well, can I still see my same physicians, et cetera? What is it? Why is it that we have to embrace this? I mean, every year we have to go through this.
Well, again, OK, so this is part of the- Well, universal by, excuse me, universal on the other hand, you wouldn't have to worry about that, right? Yeah. It would just continue to happen.
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.
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.
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
It just keeps going on and on. Erin, you have a question for us.
Well, I have something to add on to it. The question you asked about why we do open enrollment every year really stuck with me. And Dr. Blewett, your explanation of why it happens every year was fabulous. And I thought that I could give a little insight as to why it's important. I used to be a overall very healthy person. And so a high deductible health plan is
was an easy choice because I'm not spending thousands of dollars on my health care a year until your health changes overnight and you now have type 1 diabetes and have to spend thousands of dollars on prescriptions. You don't want to have that high deductible health plan anymore.
And so I enjoyed open enrollment in 2018 when I was able to switch my health plan from a high deductible to a lower deductible. because I wasn't going to want to spend five grand out of pocket every year. And now I spend only two grand out of pocket every year. So open enrollment is also great because you don't know how your health is going to change on the flip of a coin.
And that's what happened to me. And that's why open enrollment is good.
That's a good point. Yeah, really a good personal example. Thank you.
Dr. Land, I want to ask this question again. This is not politically loaded, but I want to ask it anyway. A lot of people think they have their two different choices around health care. They think that health care is either a privilege or a right. Do you get into those kind of conversations or have you, you know, where people are just struggling with this issue, you know, because it is so complex.
So is it a privilege or is it a right? And you don't have to answer if you don't want to, but I just want to ask.
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.
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.
Thank you. And if it were a right, then everybody would know it and they would understand clearly that
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.
Yeah. Yeah. Right. No kidding. Yeah.
And this is my personal opinion. I think that a lot of people that are fighting against this are fighting against it until they need it. Until they need it. Exactly. And then all of a sudden it's like, oh, yeah. Then it's like, oh, then they realize that they're just like the rest of us.
Yeah. Things are going to happen at some point in your life.
Exactly. And life does happen.
Life does happen.
So let's play out a scenario here. Let's say I didn't have health insurance. And all of a sudden I'm having chest pain and suffering from a heart attack. What happened? Do I just die in my chair or what happened?
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.
You probably have two heart attacks thinking about the process.
Or where I should go.
Right, right. So really, what happens when people have, frankly, an emergency situation, they're uninsured?
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.
Which is one of the reasons why I asked the question about community engagement, those things, is because we who are involved in community health, we run into this all the time. People running down to the emergency room. They don't know. Well, they know the emergency room. But many times they don't know other resources that they could take just in case.
And then we have with reoccurring visits to the emergency room. And we need to just kind of figure out how we might be able to. And we're not going to be able to address every issue and every person. But I think that we need to know more information about how we can be preemptive or preventive. get in front of some of these issues, uh, because the, the, the, uh, the pathway is there.
We just don't know.
Yeah. You know, we had, um, a colleague of mine, Jeff Louie, and actually a neighbor too. He's a, um, emergency room physician, um, pediatric emergency room physician. And this was really a say, and this, this exists, this problem exists where, um, Kids are admitted to the ER with some kind of medical issue and they are in the foster system or what have you. And guess what?
The ER then lands up being the foster home where the kids are literally living in the ER because there's no place for them to go. All right, so all of these complicated, which then creates an access issue for people who need to get into the ER for actual emergency treatment.
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.
Right.
Yeah, the foster care issue, that's very sad.
It's really, really sad. So, all right, Lynn, you've been studying this a long time. And I can't help but think that a good academic mind can help us to, based on what you've researched, what you know, we know where the past has been. We know where we are now, this kind of state of confusion around access and insurance. What do you perceive?
What do you really think is going to happen going forward based on everything that you've done?
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.
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.
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.
And, you know, people who are not covered changes. You know, one year you can be covered and the next year you're not covered. It's like whatever. You know, I'll tell you, you know, as a public health person for my career, I was happy with the Affordable Care Act. Was it the full enchilada? Absolutely not. But I found myself saying things, at least we've got the train out of the stations.
And to your point, you know, all right, once the train is at the station, at least, you know, along the way, we can see the ups, the downs, the sideways and make changes to an infrastructure that at least we've created. It's better than nothing at this point.
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.
Yeah, yeah.
But we still have 30 million people and we accept that as a country.
Which I don't get. So Clarence, let me ask you something. So you're in the community a lot and you're talking to your colleagues and friends. What are they saying? Are they confused? What's going on out in the community that you're getting kind of wind of?
So I think that there are a couple of different things that I could say. One is that we do have those individuals that they have the private insurance, they have access to care. There are other people that are, they're really confused.
about what's out there uh there are some people that have just decided like you know the system is just a system i'm going to use the emergency room and uh you know it's too complicated for me to kind of figure out and so that's why it it becomes you know uh important for us to know what's really going on i mean it's not like it's not like we can
I mean, people have to make their own choices, but I think part of our work is to give people accurate and appropriate information. That's why I was asking that question before, Lynn, about what's accurate, what's appropriate, and then what's actionable. And a lot of times the information out here is not actionable because it's not understandable.
And so part of the challenge for us, for example, this is so funny because I was going to ask you to define some things for me that I just, you know, these are just definitions. I'm sure you know what they are. Things like, and I've seen this before, like TRICARE, things like CHIP. It took me the longest time to understand the difference between Medicare and Medicaid, even though I'm on Medicare.
You know what I mean? Sometimes I'm like, I'm struggling with this. I mean, people... Sometimes it's not clear. And so that's the answer to your question, Stan, is that it's important for us who are healthcare advocates to really understand where are the resources, where can people go? And we don't. I don't. I mean, some of the stuff I'm struggling with myself.
Yeah.
Go ahead, Lynn.
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.
Yeah, and understand, because there's a whole lot of lists out here. And understand, yeah. And understand. There's no connection between the list and the people.
Yeah, that's a good point.
We got this list, and so that's where you can go, but there is no real interaction or relationship for people to understand the real connection.
What am I applying to? Right.
Exactly. So that's that's that's my piece of that. And I've said this before. I think that Minnesota is a phenomenal place to live. I love I love Minnesota, but it has a huge disparity issue. A lot of that is because people can't make the connections. You know, so, yeah, we have we have advocates. We have we have practitioners, but they don't understand either.
I mean, again, making a general statement.
and i'm not mad at nobody i'm just saying it is what it is that's that's the struggle that's and that's why we're glad to have you here so that we can kind of talk about this and and and know that we're planting seeds is what i call it your seed has been planted your seed we need help okay we need help so here's here's a here's another good one you know when when um
Older Americans, they can apply for Medicare. I've heard from various people that they assume that, okay, once I have Medicare, great. I don't have to worry about anything else. I've got Medicare. Okay. Then all of a sudden there's this other variable called a Medicare supplemental program, right? Or a plan. Okay, so then you're thrust into this craziness again, yearly, by the way.
And what's really interesting about a Medicare supplemental program is on a year-to-year basis, not only do you pick the plan, but you have to identify your risk for yourself. well, do you think you're going to be higher risk now that you're a year, you know, you're 72 instead of 71 or whatever?
Has anything happened in the last year that, you know, should, you know, and then all of a sudden, boom, if you're put into a higher risk, this person pays more. And so it's like, oh, my God, you know, oh, wait, I'm a higher risk. But I don't want to pay more. So put me at a lower risk and I'll just, you know, flip a coin and hopefully everything will be all right.
It's really unfortunate that people have to, in my estimation, have to deal with that.
I agree. I think the Medicare program, I mean, I'm grateful for the Part D. So that's the prescription drug.
Correct. Correct.
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.
Right. I kind of make it analogous to elderly people trying to figure out a mobile phone, you know, yeah, it's just like, Really?
But again, there are a lot of resources. So senior language and there's a lot of resources again, but I take it.
clarence point to heart which is you've got to know they exist and you have to know what to ask for where you have to know what to ask for where to start yeah yeah yeah let me say this real quick lynn yeah go ahead i think the the part of the key is it's uh more intensive training for those navigators to know how to convey information to the community yeah i mean i think
A lot of times we go through these trainings. We go through the 30-minute, 60-minute training. And people think like, well, now you got it. But you don't have it. There has to be some kind of reoccurring knowledge that's given to people. You know, as you talked about the building upon one another, I mean, it's important for people to have additional training because you know how we learn.
We don't do it the first time. A lot of us don't do it the first time. It takes me three or four times to read something before I even get it. You know what I mean? But that's my learning style. But I think that we assume because we gave somebody a 60-minute training or a day's training that they got it, but they don't. They don't. And that's why we keep having all these gaps. That is my opinion.
This is my personal opinion.
So, Lynn, last thoughts. What would you really, you know, when all is said and done, when you're dealing with access and you're dealing with insurance and all these variables that we've talked about in the show today, what do you really want the public to know? I mean, you know, if there's a one-liner or a two-liner or whatever, what is it you know, based on your expertise?
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
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.
Yeah. Yeah. Yeah. Um, So maybe hang in there.
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. The one lighter. Clarence, last thoughts.
I was going to say, Lynn, thank you for chatting with us because that's what this is. This is health chatter and putting up with our probing and those kinds of things. And I really appreciate the fact that, you know, I saw you. I think I saw you writing stuff down and, you know, hopefully we're planting some seeds. But your work is important and your work is important for us.
And we need to know more about your work. and how we as a community can be more supportive of you. Because if we support you, it will give us information and give us access to the services. That's really what it's all about. It's about having access. And that's really what we would like to do with this program is to make sure that people understand that there are people that are working at it.
You are an advocate for access. And that's what we want. We want to be in that place where we can support you or to provide you with additional helpers. Thank you.
And the other thing I'll add to that is this, we invite you back anytime you want, like in your research or your findings, if there is something that, geez, you know, the public really needs to know about this. Here's a method, you know, through Health Chatter that we can get some of that information out. on all the great findings that you're doing and getting in, in the work you do. So.
Yeah.
Thank you.
Okay.
So Lynn, thank you so much for, for being with us today. On one hand, you know, it's happy to be able to talk about it. And on the other hand, it's kind of sad that we aren't further along, but like I said, hang in there. Right.
Hang in there and stay tuned. I'm going to repeat that.
Stay tuned. Yeah, right. To our listening audience, it's been great having you on Health Chatter today. Our next show that we'll be having is on caregiving. And we've had a show on caregiving, but we're going to really focus on caregiver care. burnout, which is really, we're seeing a lot of that, unfortunately, around the country. So stay tuned for that. So again, Lynn, thank you very much.
And to everybody out there in the listening world, keep health chatting away.