Ep. 2: Busting Trump’s Health Care Myths

Following the rollout of Bernie's new Medicare for All bill, Briahna takes on the many myths that critics use to attack universal healthcare. Campaign staffers share their own healthcare ordeals. And Dr. Heather Gautney, a senior policy advisor with the campaign, argues that, while Medicare for All might not be a “silver bullet” for every problem in the US healthcare system, it is an absolutely necessary first step.

Transcript

Eileen Garcia: [00:00:00] When I left home for college, literally the same August that I left for college, we got a notice from the healthcare plan that my premium was being increased three hundred percent. And suddenly we were thrown in a whirlwind where I was trying to figure out how to apply for Medicaid again because I went out of state for school. My parents could not afford to put me on their insurance from their employer. We just could not afford it. Again, my dad makes a thousand dollars over the threshold.

[00:00:17] Cut to News: [00:00:17] Why can’t the free market work?

[00:00:27] Briahna Joy Gray: [00:00:27] This is Hear the Bern, a podcast about the people, ideas, and politics that are driving the Bernie Sanders 2020 campaign and the movement to secure a dignified life for everyone living in this country. My name is Briahna Joy Gray, coming to you from Bernie’s campaign headquarters in Washington, DC.

[00:00:48] To be honest, when I sent out an office-wide Slack message to see if anyone had any interest in sharing their health insurance stories with me, I didn’t expect to get much of a response. The staff, at least those who are active on Slack, tend to skew young, and young people tend to skew healthy and insured. Especially since the Affordable Care Act allows folks to stay on their parents’ insurance until age 26.

[00:01:13] But the thing about private health insurance is that, even when it’s working, it’s often not working well. Forty-three percent of adults with health insurance are struggling to afford their deductibles. About a third can’t afford their premiums. Medical bills are the number one cause of bankruptcy, and nearly half of those who get cancer exhaust their entire life savings in two years. Tens of millions of people are skipping or delaying the treatment they need, and tens of thousands die each year because they can’t get care. The conversations I had with my co-workers about this reflected that reality.

[00:01:49] So we’re all here today to talk about how much we love our insurers, right? No?

[00:01:55] Julia Griffin: [00:01:55] Not exactly.

[00:01:56] Briahna Joy Gray: [00:01:56] That’s Eileen Garcia, head of Spanish translations at the Bernie 2020 campaign, and Julia Griffin, a graphic design associate here.

[00:02:04] But I hear this all the time when I’m watching TV, pundits get on and they ask people questions about what are you going to do about the fact that Americans love their insurance companies?

[00:02:15] Cut to News: [00:02:15] Now, do you worry that that is going to be politically unpalatable to Americans, many of whom have private insurance that they like and they’re comfortable with. Is that going to be too big a change too fast?

[00:02:27] Julia Griffin: [00:02:27] Like are they talking to normal people? Like I don’t know who says that.

[00:02:31] Briahna Joy Gray: [00:02:31] So what have your experiences been like if they haven’t been a love story between you and Blue Cross Blue Shield.

[00:02:38] Julia Griffin: [00:02:38] So I am 23. So, I’m still covered luckily under my father’s insurance. And he luckily has like a really great job and great benefits and we have Blue Cross Blue Shield. I can go to any doctor. It’s fine. Relatively low co-pays. But I got sick this past January. January 1 you get a new deductible. My dad is thrifty, so we have a high deductible. And since I was the one racking it up, I was on paying for it. I got to spend Christmas in the emergency room, and I had multiple emergency room visits, and they had to do all these weird tests on me, and I just kept getting socked with bill after bill after bill. I had just graduated from college, and I had like no money.

[00:03:32] Briahna Joy Gray: [00:03:32] That’s Julia. Not only did she find herself paying thousands of dollars out of pocket due to her father’s thriftiness, she also felt that doctors insufficiently credited her pain both because she’s plus-sized and because she’s a woman.

[00:03:46] Julia Griffin: [00:03:46] The tests they were running, because I am a plus-sized woman, they all assumed, you know, you just have gallbladder issues because you’re fat, and they just focused entirely on my gallbladder. Like the first ER trip I had, the doctor was male. I was in extreme pain. Like I woke my boyfriend up, and he had to drive me to the emergency room in the middle of the night on Christmas. And the guy was like, you should just be taking Advil. Like I don’t know what’s wrong with you. There’s nothing showing up on the scans. You should just go home.

[00:04:19] And I’m like, I come from a family where we push through pain. Women, we are used to pushing through pain. But like when it does get to the point where we are, okay, we’re going to the emergency room in the middle of the night, like I’m not just someone out looking for drugs. Like I need help.

[00:04:36] Briahna Joy Gray: [00:04:36] And Eileen? She seems to have experienced every flaw of our very flawed system, from high deductibles, to being kicked off Medicaid, to having to ration her insulin. Well, I’ll let her tell it.

[00:04:51] Eileen Garcia: [00:04:51] When I was a year old, I was diagnosed with type 1 diabetes, which for people who don’t know type 1 is the autoimmune version of diabetes. So, the beta cells in my pancreas attack themselves. And my pancreas no longer produces insulin. So, I need insulin in order to survive. That’s a hormone that your body is supposed to naturally produce, without which you can’t convert glucose into energy, and you will die.

[00:05:16] When I was diagnosed, I was fortunate enough that my family was eligible for Medicaid, and for a good portion of my childhood that was how I got coverage. But when I was about 8 years old, suddenly my dad made a thousand dollars over the Medicaid threshold. So, I was transferred to KidCare of Florida and, while expensive, we were, you know, cutting where we had to cut and making ends meet because I need insulin. You know, that’s a non-negotiable drug. When I turned 18, I was then kicked off of KidCare, and so we were in a scramble trying to find insurance because they gave me a month’s notice that I was no longer going to have insurance.

[00:06:01] And thankfully that was in 2016 to 2017. So, Obamacare was a thing. Thank God. My parents went to an Obamacare center, and we were enrolled in an Obamacare plan, and that literally saved my life. It was with an affordable premium, a very low deductible. So, it was exactly what we needed.

[00:06:22] But when I left home for college, literally the same August that I left for college, we got a notice from the healthcare plan that my premium was being increased three hundred percent. And suddenly we were thrown in a whirlwind where I was trying to figure out how to apply for Medicaid again because I went out of state for school. My parents could not afford to put me on their insurance from their employer. We just could not afford it. Again, my dad makes a thousand dollars over the threshold. We can’t afford that.

[00:06:58] And it took about two months for me to get the Medicaid process figured out, during which I completely ran out of my insulin pump supplies and had to be transferred to multiple daily injections in an emergency because I was going to run out of insulin.

[00:07:17] Medicaid is great and I hate complaining about it because it saved my life when I needed it. But it has very strict rules about the kinds of medications you can get and how much of that medication you can get. And so, I was using literal inch and a half long needles to give my injections that were causing huge bruises all over my body. And I was fighting with the doctor, fighting with the insurance to get them to cover different needles. Kept getting denied. So eventually I started rationing my injections and trying to spread them out because it was so painful.

[00:07:55] Thankfully, now through school, I had to take out student loans, but partially to cover the health insurance provided by my school.

[00:08:04] At least with this private insurance, I’m able to get needles that are comfortable for me to use so that I’m not rationing my injections. I had to change the type of insulin that I was using. I used to use a fast-acting insulin called NovoLog. My insurance made me…technically their preferred insulin is Admelog, which is very new to the market. So, I was hesitant to use it, and so I went with their tier two insulin, which is Humalog, and it hasn’t been too great. It’s supposed to be a seamless transition, but it hasn’t been very seamless so far. I’ve noticed I’ve had to use about double the amount of Humalog than I was using of NovoLog. But trying to make it work, you know?

[00:08:55] Briahna Joy Gray: [00:08:55] You’re making me want to leave this podcast recording studio and grab a banner and start protesting in the street, but we’re like already at the Bernie Sanders headquarters. We’re already on it!

[00:09:05] Already on it indeed. The day after we recorded the interview with Eileen and Julia, Bernie Sanders announced his new Medicare for All bill.

[00:09:14] Bernie Sanders: [00:09:14] Healthcare is a human right, not a privilege. It is not a radical idea to say that in the United States every American who goes to a doctor should be able to afford the prescription drugs he or she needs.

[00:09:40] Briahna Joy Gray: [00:09:40] It’s aimed at addressing all of the issues raised by both Julia and Eileen’s stories. It would decouple healthcare access from employment and give everyone, everyone, healthcare coverage, preventing the situation wherein Eileen had to ration the insulin she needs to stay alive. It would eliminate out-of-pocket costs, including the high deductibles experienced by Julia, who found herself paying thousands of dollars for tests. And it would get rid of premiums, making it so that no one ever has to experience a sudden hike, like the three hundred percent rise Eileen experienced just as she started college.

[00:10:17] Bernie Sanders plan understands that there’s a better way, as evidenced by the fact that every other major country in the world has some form of universal healthcare.

[00:10:26] Bernie Sanders: [00:10:26] We are going to end the international embarrassment of the United States of America, our great country, being the only major nation on Earth not to guarantee healthcare to all as a right. That is going to end.

[00:10:46] Briahna Joy Gray: [00:10:46] Healthcare matters. So, I wasn’t surprised to discover that my co-workers’ experiences with our healthcare system almost uniformly informed their choice to commit themselves to the Bernie 2020 campaign.

[00:10:58] Georgia Parke: [00:10:58] For me, this is probably one of the biggest reasons that I support Bernie, why I believe in Bernie, why I want him to be the president, is because we just have to have universal healthcare that is free at the point of service with no co-pays and no deductibles. And that’s Bernie’s Medicare for All plan. And that is not the case with any other proposals that are currently out there. It just it has to be Medicare for All.

[00:11:27] Briahna Joy Gray: [00:11:27] Georgia, a senior social media strategist, is a childhood cancer survivor. Diagnosed with stage 4 neuroblastoma at the age of five, she was able to get excellent care because her family had good insurance. She was able to get follow-up treatment, like the hearing aids she needed as a result of the chemotherapy. But she saw that others weren’t so lucky and believes that everyone deserves the care she received, regardless of how much wealth their family has.

[00:11:54] Georgia Parke: [00:11:54] It’s true, the US has some of the best doctors in the world. It has some of the best medical innovation. We have, you know, just incredible treatment options available for people here, but the problem is that for literally millions of people they can’t get to that through no fault of their own, just because of the circumstances they were born in, because of the circumstances they’re currently in. They can’t afford that.

[00:12:19] So I went through a lot of treatment. I went through multiple rounds of chemotherapy. I did a stem cell transplant. I had surgeries. And all of that I was able to get because I had insurance. So, my belief in Medicare for All doesn’t necessarily stem from the problems that I’ve personally experienced with the current system, but because I’ve experienced what we are capable of. And that’s the reason I’m here recording this podcast right now, working for Bernie to be the president of the United States, is because I was able to get that treatment. And I don’t believe that any person is more or less deserving of having access to that and getting the same kind of care that I was able to get. So that’s why I think, if we are going to reach our full potential as a country, we have to make sure everyone has that chance, and that’s why we need Medicare for All.

[00:13:09] Briahna Joy Gray: [00:13:09] This simple moral claim, that just because you have less money doesn’t mean you should be more likely to die or live in pain, seems so obvious, so undeniably true. Maybe that’s why it’s a norm in every other similarly situated country in the world.

[00:13:26] Nathan Ober: [00:13:26] I spent a year abroad living in Denmark and as a resident studying there, I was granted access to the healthcare system. And so, you know, as soon as I arrived in the country, I was given a small card. It’s about the size of like a library card. You just carry it around in your wallet.

[00:13:44] Briahna Joy Gray: [00:13:44] That’s Nathan Ober, who works on the campaign scheduling and advance team.

[00:13:48] Is this your card?

[00:13:49] Nathan Ober: [00:13:49] Yeah, so if you flip it over, so it’s just like a credit card strip. So, there’s this little kiosk in the office. And so, you just walk in and you swipe the card and that’s it.

[00:14:00] There’s no co-pays at the time of visit. There’s no billing department that you have to fight with on the phone or in person. No mysterious bills show up in the mail. It’s as simple as swiping a card and seeing a doctor for free whenever you need to.

[00:14:20] Briahna Joy Gray: [00:14:20] So no long wait lines, no death panels?

[00:14:23] Nathan Ober: [00:14:23] No, I mean like yeah, the waiting in line is I think a total myth, and that was not my experience at all. Whenever I needed care, I could get that care. As soon as I needed it without any hassle.

[00:14:35] Briahna Joy Gray: [00:14:35] Long lines and wait times are far from the only myths you commonly hear bandied about when Medicare for All comes up. And it’s no surprise why. The principal difference between single-payer Medicare for All and the more moderate options backed by certain other candidates is that single payer gets rid of the private insurance companies who are acting as a middle man. This is where the savings come in. This is how you cut administrative waste. Millions being spent on advertising and the billions in profit that go to companies like Aetna, whose CEO alone made fifty-nine million dollars in 2017. Not to mention all the money these companies spend lobbying politicians in Washington. Is it any surprise that Bernie’s plan has detractors?

[00:15:18] Bernie Sanders: [00:15:18] Let me tell you exactly what this debate is about. It’s not a healthcare debate because the current system is dysfunctional, and no one can defend spending twice as much per capita on a healthcare system, which doesn’t cover tens of millions of people. What this is a struggle about is the power of the insurance companies and the drug companies who make billions of dollars in profit. They love the current system.

[00:15:42] Briahna Joy Gray: [00:15:42] Private insurance and pharmaceutical companies have been throwing millions at thwarting universal healthcare for years. And now that it’s overwhelmingly popular among Americans, they’re doing anything they can to make us settle for less.

[00:15:55] In one of the most entertaining and cathartic news segments I’ve heard in a long time, Dr. Adam Gaffney, an instructor in medicine at Harvard Med School, schooled six Fox News pundits, who threw every myth in the book at him.

[00:16:08] Cut to News: [00:16:08] The cost would be extraordinary, would it it not? How you going to get a million doctors to take a pay cut? The hospitals go out of business, the doctors all just no longer work because they’re not getting paid. I mean, then where are you going for care? How can you guarantee that our quality of healthcare won’t go down the way it has gone down in Great Britain as a result of their socialized system? Why can’t the free market work? A true free market in healthcare is something no nation, no civilized nation, would ever accept. You’d have people literally dying on the street because they couldn’t afford the care.

[00:16:41] Briahna Joy Gray: [00:16:41] but we don’t need a Harvard Med School degree to do just as good a job.

[00:16:45] So for this week’s praxis segment, where we put ideas to action, let’s play healthcare red herring: how to spot them, how to beat them, and how to convince your mother/father/sister/brother/cousin/best friend/partner/boss that healthcare is a human right.

[00:17:00] Helpfully, Trump Press Secretary Sarah Huckabee Sanders, no relation, summarized the empty arguments against Medicare for All in a statement released the day of Bernie’s Medicare for All bill.

[00:17:11] The statement claims, and I quote, self-proclaimed socialist Senator Bernie Sanders is proposing a total government takeover of healthcare that would actually hurt seniors, eliminate private health insurance for a hundred and eighty million Americans, and cripple our economy and future generations with unprecedented debt.

[00:17:29] Okay, one sentence, four healthcare corrections. Let’s do this.

[00:17:34] First, I’d like to point out that the total government takeover is simply moving from private insurance, which people hate because, you know, it regularly kills and bankrupts people, to public Insurance like Medicare, which people generally love. And you don’t have to take my word for it.

[00:17:50] Look at the stats. Sixty nine percent of Americans rate their health care coverage as excellent or good. That’s excluding, of course, the twelve percent of Americans who have no healthcare at all. But when you break out the group over 65, the group of Americans who are eligible for Medicare, that number jumps from 69 to 88 percent approval.

[00:18:12] This segueways into my second correction. The fear-mongering about how Sanders wants to quote eliminate private health insurance is a total deflection. You hear this one, unfortunately, from folks on both sides of the aisle. This false equivalence between Sanders, who wants to replace private insurance with universal single-payer coverage, i.e. something better, and Trump, who wants to strip insurance for millions of Americans without providing any alternative. Americans rightly fear losing their insurance because, so far, that can mean anything from background stress to a total disaster. But under Medicare for All that would no longer be the case.

[00:18:50] The thing is, the people who are truly invested in maintaining private health insurance are the ones making money hand over fist by charging us high premiums, ridiculous deductibles, and astronomical copays. If anyone tries this with you, you should point out that people love their doctors, not their insurance companies.

[00:19:09] Third, Bernie’s plan wouldn’t hurt seniors. It would expand the benefits they already get under Medicare to include vision, hearing aids, and dental services.

[00:19:20] And fourth, Medicare for All wouldn’t cripple our economy. Medicare for All costs two trillion dollars less than what we currently pay for a system that doesn’t even adequately insure us all. Remember, under Medicare for All, all of those hefty premiums and deductibles and co-pays would simply go away. Between that and reduced administrative costs, the average American will have more money in their pocket at the end of the month, not less. As Bernie says we can’t afford not to switch away from our current system.

[00:19:53] Let’s run through some other common attacks. They say Medicare for All will result in hospital closures. We say, if anything, the opposite is true. US hospitals and rural areas are already closing at an alarming rate, 72 of them between 2010 and 2016, according to the North Carolina Rural Health Research Program. The result is that there are now large stretches of this country that are virtual medical deserts. Why? Because providing medical care in those areas wasn’t sufficiently profitable.

[00:20:25] They say we’ll have fewer doctors. We say Medicare for All doesn’t mean that we’ll need to cut doctors’ salaries. Again, the savings come from much lower administrative and drug costs. Plus, doctors will no longer need to spend so much of their time arguing with private insurers. Trust us, plenty of people will still want to become doctors.

[00:00:00] They say quality of care will suffer. We say quality of care is already suffering. We have the worst health outcomes among major economies. American women today are fifty percent more likely to die in childbirth then our mothers, and life expectancies are actually declining. This in the richest country in the world.

[00:00:19] This is not radical stuff. Many other countries, including our neighbor to the north, have adopted systems very similar to what Sanders is proposing. We’re not reinventing the wheel here. The only good reason to oppose Medicare for All is if your name is Mark Bertolini. That’s Aetna’s CEO. Mark, if you’re listening to this, what can I say? I’m sure you’ll get by with your seventy-six million net worth.

[00:00:43] Perhaps the biggest red herring involves this notion of choice.

[00:00:48] Cut to News: [00:00:48] The fact of the matter is that under Medicare for All your choice of health coverage disappears. What happens is you wind up eliminating choice. Your only choice is the plan that the government offers. Government-run healthcare takes medical decisions away from patients, that means you, and puts them in the hands of bureaucrats.

[00:01:09] Briahna Joy Gray: [00:01:09] But the only choice being protected is the choice of insurance companies not to extend coverage to you. You don’t have choice when you can’t afford the treatments your doctor prescribes. You don’t have a choice when you’re a stay-at-home parent and you lose insurance because your partner dies. Think about it. You have to work to get health insurance, but being sick means you can’t work. It doesn’t make any sense. No one would choose this kind of a system. And we don’t have to put up with it.

[00:01:50] We’ve been talking about Medicare for All in fairly general terms up until this point, but the reality is that not everyone is equally affected by the flaws in our healthcare system. Hispanics are the most under-insured population in this country. About one out of every three non-elderly Hispanics are uninsured. The number is one in four for black Americans. So, I talked to Dr. Heather Gautney, a senior policy advisor for the Bernie Sanders campaign, about how the Bernie Sanders Medicare for All bill really does help us all.

[00:02:27] So Dr. Gautney, you wrote an article earlier this year in Jacobin where you argued that health insurance and racial justice efforts go hand-in-hand. When I read that I remember thinking about the Black Lives Matter platform, which actually includes universal healthcare as one of its important prongs. Can you talk a little bit more about the relationship between racial justice and health access?

[00:02:49] Heather Gautney: [00:02:49] Sure, the impetus for writing that article was I had a fascinating conversation with a reparations advocate, and she’s for Medicare for All not because it’s a silver bullet for addressing racial disparities in healthcare, but because it’s an absolutely necessary first step. And part of the reason is because black and Latino populations are the absolute least likely to be insured and most likely to be underinsured.

[00:03:23] I started to look at what was out there. There wasn’t a lot in terms of legitimizing Medicare for All by looking at it through a racial lens, but there was a study that I found on the VA, and it was in particular about cardiovascular patients at the VA, and they had concluded that because, you know, the Veterans Administration is like a quasi-single-payer institution, that some black patients actually did better than their white counterparts. So, I thought, well, you know, that’s actually an argument for Medicare for All. There were other studies out there on the Medicare system, and certainly there are racial disparities in Medicare that Medicare for All would not address. They exist in that system, and likely Medicare for All would have to be more targeted toward point of contact discrimination, but the disparities reduced after people entered into the Medicare system.

[00:04:21] And then there’s an intersection between race, class, and gender, the coverage of reproductive health and maternity health. Black women are 243 times more likely to die from pregnancy related or childbirth related complications, and that is…

[00:04:47] Briahna Joy Gray: [00:04:47] That’s out of control.

[00:04:48] Heather Gautney: [00:04:48] Yeah, staggering, and the highest in women’s health. And I did not know this until today…Erica Garner was one of our beloved surrogates in 2016. It was suspected that this was the cause of her death. These kind of disparities, Medicare for All would improve access to those services, and that’s part of the reason why this is the high mortality rate because of lack of access to services.

[00:05:17] There’s also the dimension, and this is in the bill, of home and community-based care, which is largely women’s work. And that has to do of course with job discrimination and also gender relationships between men and women.

[00:05:34] Briahna Joy Gray: [00:05:34] Cultural norms, yadda yadda, yeah.

[00:05:35] Heather Gautney: [00:05:35] Exactly. Yeah, and I have personal experience with this because my mother, who recently passed away, her husband had Parkinson’s disease. And my mother was 75. He was 80, and he wasn’t eligible for more than an hour like every other day of home care. So, she was in a position of having to care for him. Parkinson’s disease is a serious disease. Elderly people fall. They break bones. They can’t shower. His hands had tremors. So, there was a lot of really basic things that he couldn’t do that she had to help him with. And she was essentially alone. She lived in a rural community in Maine. There was not a lot of people around to kind of pick up the slack.

[00:06:23] As soon as she kind of stepped away from his care – his family kind of stepped in and our family stepped in – she became very ill, and it was just clear to us that she had not been able to take care of herself because of the stress and the exertion associated with caring for him.

[00:06:40] Briahna Joy Gray: [00:06:40] I think that’s a really powerful point, the extent to which because women play an outsized role in home care, and in the same way that Medicare for All disproportionately benefits blacks and Latinos, women another historically marginalized group that are going to end up being disproportionately benefited by the provisions of the Medicare for All bill, which offer more support for home care.

[00:07:05] Your story resonates with me also because something very similar was happening recently with my own grandparents. My grandfather had a stroke about a decade ago and had been bedridden ever since. My grandmother was a registered nurse who hasn’t worked in years because she suffered an injury moving a patient, a back injury moving a patient from a gurney to a bed. Now she’s in a position where she was having to help my grandfather move around. She already can’t help people around, obviously, that’s how she incurred her injury in the first place. But she’s in these tense situations with him where there’s an emergency. He has to get up and go to the bathroom. There’s not home health aides available, and it’s exacerbated her own condition. And after he passed, now her own health is declining as well. And it’s this vicious cycle.

[00:07:48] So I also wanted to ask you a little bit about an article that you mentioned when we were chit-chatting yesterday that was written by Vann Newkirk in the Atlantic last year that highlighted the ways in which the fight for healthcare in this country has been linked to the fight for civil rights.

[00:08:07] Heather Gautney: [00:08:07] There was a bill that was about discrimination and hospitals. It was like a labor-oriented bill.

[00:08:15] Briahna Joy Gray: [00:08:15] Yeah. The NAACP sued a segregated hospital over segregation, and what the court finally ended up holding is that any institution that receives federal funds couldn’t abide by separate but equal. And what that ended up doing, once we got Medicare and Medicaid in the mid-1960s – the first case was a 1963 case – and by 1965 when we got Medicare and Medicaid, and all of the hospitals in the country basically started receiving public funding, that basically meant all of the hospitals in the country had to desegregate.

[00:08:49] There is this interesting way where there’s this coupling of this fight for equality and a fight for healthcare that stretches back to the Civil Rights era and probably before that. One of the first points you made was that, sure, every inequity in healthcare is not going to be resolved by Medicare for All, but in the same way that it’s a fallacy to say, will breaking up the banks cure racism? No. I mean, we should still break up the banks, right? There are of course racial disparities in how the financial crisis hurt people, right. Black people lost forty percent of their net wealth, of our net wealth in the crisis. In the same way, there’s this way in which just because the Medicare for All bill doesn’t do it all, we need to keep talking about how to supplement it and how to deal with point of access discrimination etcetera. It is such a crucial foundational backbone aspect to getting substantive equality across racial and other historically marginalized groups that those who would seek to marginalize it by pointing to the fact that it doesn’t do it all are really doing a disservice to the groups that they’re trying to help.

[00:09:57] Heather Gautney: [00:09:57] One of the things that I think people forget in the Civil Rights Movement. There were figures like A. Philip Randolph, who had the freedom budget. And if you look at the freedom budget, it is pretty identical to what Senator Sanders is proposing. I think Randolph used to use the language of the common man, which is very similar to the Senator’s project.

[00:10:22] But this was in the context of the fight, the struggle for civil rights, and of course that’s around the same time that King arrives at having to confront poverty and getting interested in labor issues. And this is I think where economic and racial justice sort of blend. And then they kind of separated away, apart from each other. So, I see this moment as a time when that relationship is being once again recognized and addressed.

[00:10:53] Briahna Joy Gray: [00:10:53] It might surprise people to hear this quote, but it shouldn’t from Dr. Martin Luther King. He said of all the inequalities that exist, the injustice in healthcare is the most shocking and inhuman.

[00:11:05] Heather Gautney: [00:11:05] Yeah. Yep, that’s a great, famous, important quote to remember. The other thing I wanted to say with regard to what you were talking about in terms of what Medicare for All doesn’t do. I was speaking with one of the Senator Sanders’ health staffers, and she made that same point. I mean she’s got her hands right in there, and I mean helped build this bill out. Really got into the weeds on it. And she said but we’re still going to have to figure out ways of doing targeted repairing of what’s happened in certain communities. And if we can’t get this baseline of Medicare for All, then we’re not going to be able to solve the bigger problems within the healthcare system.

[00:11:50] Briahna Joy Gray: [00:11:50] This is like an ongoing preoccupation for me. Anybody who follows me on Twitter and knows how online I am has heard me make this argument. But it’s like the piece of that question that’s like, well will this cure racism, that project is an undeniably important project, but it’s also perhaps the most difficult to pin down. How do you on a policy level cure racism? So, it’s not that I’m not interested in that piece. Will breaking up the banks cure racism, will Medicare for All cure racism? The answer is no. And it’s not that I don’t deeply care about the fact that racism is a persistent and ongoing ill. It’s that, in light of an absence of workable ways from a political perspective to change the hearts and minds of people, to ignore the constructive, substantive, structural ways that you can start to change outcomes seems to be perverse.

[00:12:47] Heather Gautney: [00:12:47] Yeah, the way I kind of think about it is like the institutions that foster integration have been completely defunded. Public education is a place – I mean, and not New York City now, because public schools are the most segregated schools in the country, and we are pre-Brown versus Board of Education.

[00:13:07] But if this system is working and properly funded, these are places where people learn from each other, right, and get used to seeing each other and living with each other and also learning history and different versions of history. And when you defund those institutions and you allow people to live separately, then you’re kind of not dealing with the core of the cultural level. Unions are another thing. Unions are places where often, you know, unions can be diverse institutions, and to state the obvious, in steep decline. They barely exist anymore.

[00:13:44] That’s the other thing I really like about what Senator Sanders’ program does is it’s about reinvesting in the public sphere and trying to reinvest in the institutions that can actually solve some of these problems. Or not solve, but at least mitigate them. And then you don’t have – the likelihood of fake news and all the racist stuff that Trump says falls on deaf ears because people know better. But you have a weak education system. And don’t get me wrong. I don’t think education is the silver bullet either on this, but certainly if you degrade it, you’re really stuck.

[00:14:20] Briahna Joy Gray: [00:14:20] I really appreciate you coming to talk to me and working so hard on all of these amazing policies that are making structural changes that are getting us a little bit closer day by day, a lot closer quite frankly, to genuine equality. Thank you.

[00:14:32] Heather Gautney: [00:14:32] Yeah, absolutely.

[00:14:39] Briahna Joy Gray: [00:14:39] That’s it for this week’s show. A big thank you to those of you who sent in comments about our first episode to [email protected] You had some great suggestions that we will be rolling out in coming episodes, including episode transcripts available at berniesanders.com. Keep those ratings and reviews coming in on Apple Podcasts or wherever you get your podcasts. Till next week.