THIS TIME ON CODE WACK!
What does freedom really mean when, in 2025, health care costs more than $31,000 a year for the average American family? This Independence Day, we’re revisiting a powerful conversation about how single-payer healthcare could slash costs, unleash innovation, and expand access for all. Could it also help revive the American Dream of owning your own business?
Ian Lewis, now with Unite Here Local 2 but at the time of this interview, with National Union of Healthcare Workers, breaks down how our current system burdens small businesses, stifles entrepreneurship—and what a bold reform could change. Could Medicare for All be the key to greater financial security, opportunity, and true independence for millions of Americans?
While Ian ends the interview on an optimistic note, the political context for healthcare reform has changed dramatically since this episode. Funding for public health insurance programs like Medicaid and Medicare are on the chopping block and the threat of privatization is greater than ever.
Keep up with the latest news on health policy reform by subscribing for updates at heal-ca.org/take-action.
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SHOW NOTES
WE DISCUSS
How would switching to single payer affect businesses?
“…with the huge savings that we could realize with single-payer health care, the long-term benefits for all businesses are tremendous…” – Ian Lewis
But what would happen to the people who are working in the insurance industry?
“The kind of jobs that will be eliminated … are mostly the administrative ones, the paper shuffling, the processing of claims … Now, those job losses will be offset some by the creation of a single administrative system, but the simplification, the elimination of claims and adjustment proceedings and appeals and so forth, those kinds of jobs open up the opportunity to train people in, you know, what I see as the jobs of the future, you know, health care…”
“…the economic stimulus that comes with injecting tens and eventually hundreds of billions of dollars more money into the rest of the economy, which is not health care, will unleash real job creation in other industries.” – Ian Lewis
Do you think single payer is actually within reach?*
“I just say I’m more optimistic than I’ve ever been about the promise of transitioning to a single-payer health system…
“This report, it’s very technical. It’s wordy, it’s long and it hasn’t received a lot of coverage, but it lays out a roadmap that if we choose to, we can follow and I really believe that by pointing that way, it provides us hope. That’s the biggest obstacle I see to reform…the lack of hope…
“…there is a moral and fiscal imperative to do this because the consequences of not making this happen are catastrophic.” – Ian Lewis
*Comment:
While Ian ends this interview on an optimistic note, the political context for healthcare reform has changed dramatically since this episode. Funding for public health insurance programs like Medicaid and Medicare are on the chopping block and the threat of privatization is greater than ever.
Keep up with the latest news on health policy reform by subscribing for updates at heal-ca.org/take-action.
Helpful Links
2024 Milliman Medical Index, Milliman
Sick of Healthcare? Healthcare Benefit Update for Employers – What to Watch in 2025, The National Law Review
Health Care Costs Are a Nightmare for Small Businesses—and They’re Going Up in 2025, Inc.
Fundamental health reform like ‘Medicare for All’ would help the labor market, Economic Policy Institute
U.S. businesses are trying to control employee health care costs, WFAE 90.7, Charlotte, N
California Can Save As Much As $500 Billion in Healthcare Costs Over The Next Decade, Healthy California Now
Episode Transcript
Read the full episode transcript.
Biography: Ian Lewis
Ian Lewis is Policy Director for UNITE HERE, a union that represents 300,000 hospitality industry workers across North America. He has previously served as the Research Director for UNITE HERE Local 2 in San Francisco, and for the National Union of Healthcare Workers.
Lewis is a trustee of a multi-employer health benefits fund covering thousands of participants in the San Francisco Bay Area.
Lewis is appointed to the Health Care Affordability Board by the Speaker of the California Assembly, Anthony Rendon, required by The Office of Healthcare Affordability’s enabling statute (SB 184, Chapter 47, Statutes of 2022).
Lewis has been in the labor movement for twenty-five years, much of that time making the best of a broken health care system for low wage workers. Prior to joining the National Union of Healthcare Workers, Lewis was the Research Director for UNITE HERE Local 2 coordinating political and community activities for collective bargaining and legislative efforts.
Lewis’ experience includes bargaining for health benefits in both the US and Canada, administration of not-for-profit health funds, as well as regulatory and legislative strategies. He has been closely involved in legislative efforts to expand transparency of large group health plan pricing, and to advance the work of the Healthy California for All Commission.
Lewis has a bachelor’s degree in Government and Africana studies from Cornell University.
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