The fight for healthcare equity in Washington State
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Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host, Brenda Gazzar.
How would Medicare for all be a form of reparations for the black community? How are communities in the state of Washington fighting for single payer health care? Millennial Sean Cavanaugh, campaign director for Whole Washington, shared his views on these issues and more one year into the coronavirus pandemic.
Welcome to Code WACK!, Sean.
Cavanaugh: Thank you for having me.
Q: So tell us briefly about yourself. Many people who fight for healthcare reform are motivated by an experience. I’m wondering if that’s true for you, or what drew you into the single-payer movement?
Cavanaugh: Hi, I’m Sean Cavanaugh, and I’m a millennial, and I think like most millennials, I got into the single-payer movement during the Bernie 2016 campaign. It seemed really simple to me. At the time, I was poor and I was looking for just some answers to like, man, the world kind of hurt and it kind of just sucked. And so when I first heard Bernie talk about wealth inequality, income inequality and health care disparities, it just clicked for me, and it’s just so simple that you would have everybody pay into one collective pool, cover everybody, expand coverage. And then, because of that, we would be able to increase health outcomes, and it also seemed like the moral thing to do, like, no one should go bankrupt over healthcare costs or die because they can’t see the doctor. That’s just, like, ridiculous and I want to live in a society that takes care of people and it’s not a dog-eat-dog world.
I got more involved in the healthcare movement during the protests in 2020 for George Floyd, Breonna Taylor. I remember listening to a speech, and like what are you doing for the Black community? Are you doing enough? And I just really like stepped back and I was like you know what? I need to be doing something and for me, I think the issue of universal health care is super important to the Black community. We have some of the highest uninsured rates. We have some of the worst health outcomes and just the cost savings that we would get would be part of a reparations that we so long have deserved.
Q: Hmmm, wow, thank you. That’s the first time I’ve heard it described that way as reparations for the Black community. That’s really interesting. Yeah.
Cavanaugh: Yeah.
Q: Thank you. In January, Senate Bill 2054 was introduced in Washington creating the Whole Washington Health Trust. Is this a true single-payer healthcare system, or is it a public option plan? In other words, would everyone be automatically enrolled or could they choose to keep their existing health insurance?
Cavanaugh: So, this is a single-payer bill but of course, it ramps up. So, when it’s first enacted, right, you’d have the choice of opting in for people who are below the federal poverty rate by 200%. They wouldn’t have to pay the premium or pay the health security assessment, just like our paid family and medical leave. There would be a time where we’re collecting money for a bit. And then, because of ERISA, which is a piece of legislation that protects federally protected healthcare programs, like union negotiated contracts, the VA, Tri-Care, those would need waivers to allow those funds — and Medicare, Medicaid — allow those funds to come into our trust, and then covering those people. But everybody’s able to use our trust if they choose to opt in and pay the premium.
Now this isn’t like Cascade Care — and that’s Washington’s public option is Cascade Care — and so, unlike that, we wouldn’t have private insurers handling our plan and we would be able to negotiate with pharmaceutical companies to really drive down costs. We’d be negotiating with providers, hospitals, to come up with fair rates to pay them and then cover everybody.
Q: If people don’t want to opt in right away into the single-payer system, what are their options? How long do they have?
Cavanaugh: So people have until 51% of all Washingtonians and that’s residents so that’s our immigrant communities too — undocumented communities — opt into the plan. At that point, the plan becomes solvent and everybody is then transferred over to our plan. So, again, even after that 51%, that doesn’t include the ERISA protected plans. But, for instance, if you’re part of a union, you can still opt into the program and use it as a secondary health insurance, or you can convince your union and your contractors to shift your benefit package over into the trust, and then you’d be fully implemented.
Q: And what major problems with health insurance in Washington, do you think this health trust would address?
What this would address is that each year, more and more of our state GDP goes towards healthcare costs. So in like 1998, it was 10%. In 2014, it was 14% and then in the next decade, it’s going to rise to 17% and what does this mean for Washingtonians? This means more of our resources are going to private insurance companies rather than funding our schools, protecting and providing services to our vulnerable communities, our homelessness, infrastructure. We just had a bridge break — the West Seattle bridge — and so we’re not able to invest in the public good.
And then for workers, just like the GDP for the state, more and more of their compensation as a total package between their wage, their benefits, more and more of it is going to health insurance. Currently, it’s about a quarter — 25% of people’s benefits — and in the next 10 years it’s going to go up to a third, and everybody knows what that means. That means there are less vacations. People are not being able to own homes. They’re turning into renters. There’s less food on the table and more and more people have to make those tough decisions. Do I pay for my medicine, do I extend it or do I pay my electricity bill?
Q: What about the uninsured population in Washington? How big is it?
Pre-COVID, it was about 6.8% so that’s about half a million people. During the peak of COVID, we had 13% of our population uninsured so that’s well over a million people. It’s back down to 7% but it shows that the folly of employer-based health insurance that if you lose your job, you’ll lose your insurance, and I don’t know if you know your viewers have lost jobs. I believe most people have lost their job at some point in their life. It’s stressful, and then not having health care on top of that. If you need medicine, now you’re doubly stressed because you don’t have a job, you don’t have medicine. Universal health care is about how we want to be treated at all times and (how) we allow other people to be treated. So, by providing that health insurance, we make that promise that we’re going to take care of everybody at all points of their life.
Q: Thank you, Sean Cavanaugh.
Find more Code WACK! episodes on ProgressiveVoices.com and on the PV App. You can also subscribe to Code WACK! wherever you find your podcasts. This podcast is powered by HEAL California, uplifting the voices of those fighting for health care reform around the country. I’m Brenda Gazzar.
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