Thank you to all of you. Very happy to be here i miss my chance at the aquarium but i want to talk about healthcare but first i want to talk about canada and anecdote that comes from quebec. As a place of two things extremely punishing the problematic and a very low vaccination rate right now it is 75 percent. You want 95 percent for the herd mentality. Those the anti baxters that have chem trails come hell or high water they will not vaccinate their kids but most fall somewhere in the middle. And then to look at the results and they watch tv but they choose but as rush tells us in choosing not to choose and the kids go unvaccinated but they were not getting the job done because they wanted time to see patients. And with those irregularities so it took three hospitals and 53 social workers and call them vaccination counselors. And then to say hello. And the canadian french canada. So what questions do you have about vaccination cracks and to make that informed choice. So what happens cracks it wasnt a good anecdote but they skyrocketed from 75 percent up at 80 percent and the social workers this is the future of what it can be and should be. And with the shocked and alienation. And with these conspiracy theories. Of the world around us and it is only an profitable and tedious that really makes a difference. With Blue Cross Blue Shield and with that model we have now. And thats for anybody. And those that are totally forced and to say the Health Finance model is unhealthy. It is sick. That is why wrote this book and why i am here to get down with the sickness. I am very disturbed. Lets talk about American Healthcare. Im not much of a writer. And on how medicaid works. Not all happy but with those in American Healthcare so there is a vision free from the crippling fear of our own bodies to have our own flesh and frankly i believe we have the tools and resources we just have to demand it. And to the world that we have now that is not natural but created and because it is created it can be changed. But until it is, until we change it, ours is a birthright of continual exploitation drained of cash and labor and we suffer and then we are punished for we are punished for being sick. We are punished for being hungry and punished for being disabled. Punished for being poor. Punished for being black or brown. Or queer or pregnant or even if youre just a lucky or just being. At the core of that punishment and suffering in america sickness make you poor important is makes you six if you permit me the next half an hour to talk about the relationship of our health care and Health Finance models. What we have and what we want. I want to talk about the overwhelming and brutality of forprofit healthcare i want to talk about the benign structural changes and then i want to talk about the Broader Mission not moral compulsion of healthcare. Does that sound good quicks great. Thank you let start off by having fun with the fundamentals left left this is fun for me. First nobody can afford to pay medical cost for themselves that is extremely expensive but generally speaking not a lot of folks needed at the same time any given year 50 percent come from 5 percent of the population when tragedy comes in when it does the medical cost is enough to bury use we have the idea of insurance. Insurers pool together many to defray the medical cost so the group of people that spread the cost but now in the us we delegate that to Insurance Companies they charge monthly premiums and like any company their job for those are too many sick people even like those with hemophilia to cost 1 million to ensure that per person cost will increase but to compensate they increase the premiums but then people cannot afford them. The sick people and expensive people cant afford to drop out because they need the insurance and thats a death sentence so then it becomes more expensive per person. Or to find ways it drops the coverage maybe it does both usually does both because Insurance Companies dont lose money when you get sick they lose money when you get sick of and use the insurance now suddenly theres nothing they can do about it because of they would offer they care where they need it people would buy insurance plans and use them in the insurer would lose money. Thats a real bad way to run a business. At some point along the line for an Insurance Company seeking profit even though thats like blaming a scorpion for staying this is just what they do. That is why insurers is a belong in the hands of companies because they cannot do the right thing. Instead they turn our health and to commodity this is reduces to a transaction or an Investment Vehicle with a relationship to the person with their body and doctors. That is perverted. And then decided to shackle the wellbeing of children even if the parents have a union instead of fighting for better wages or safety every year they have to negotiate for worse and more expensive insurance which cannot be circumvented as you saw in the uaw. Our children and families and people we love her hostages to our employers have youve ever try to organize against the employers or dare demand your fair share of the fruits of the labor then their bodies are held ransom so in mind and body and spirit. But then it gets worse because the cost of healthcare keeps increasing most Cost Increases occur because hospital ceos are pharmaceutical companies or close personal friends charge more money for the same services fundamentally us Healthcare Market all prices are fake. In the us the average inpatient procedure cost 40 percent more than the exact same for the exact same patient when performed in france. They are just fancy tubes that print money and they cost five times more than the same machine when scanned in australia. Sometimes it is the literal same machine based upon arbitrary factors like time of day or whose paying for it. Prices are fake and medical costs are high because medical prices are high. Over the past decade we have seen the price of insulin triple not because of the new cost to produce it but they like making more money. Think of the relationship between primary care it seems like checkups basic medication to get to your healthy. Dash high volume and low margin now perversely hospitals paid 2000 per night if you are a Hospital Corporation just makes a lot more sense for inpatient care instead of wasting your time in maximizing profit or it makes even more sense to close them down or use the same facilities like johns hopkins. So what does that mean cracks those that have no access to primary care and those are extraordinarily high. C can see those two fundamental and opposing truths to American Healthcare. Is just not profitable for those ours is sick if you are provider it is extremely profitable so looking at American Healthcare who gets to receive healthcare and when or who suffering matters to us is rationed by private profitability. So now the whole scenario scares that the jesus often refusing to pay for claims they dont want to pay if not get ready but thats not enough everybody in america back in the 1970s it is the idea to make consumers which is us a libertarian way to say people pay more than the cost of their own healthcare. True actors of the free markets with those smarter and choices of healthcare thats why deductibles and copays increase every year. This is worship just helps Health Insurance copies pay fewer plans. Because we demand they bear the burden of the Health Care Cost they watch their bodies turn into time bobs and then they have a heart attack at their job in the their kid behind it is under the guise of personal responsibility as healthcare ceos and their friends can bring Home Millions and millions of dollars per year. And gives it to the wealthy it is negatively redistributed. In 2014 it push 20 Million People into poverty or extreme poverty and at best 31 Million People are left uninsured. The american model of health has failed. And there are consequences for this failure. Because among socalled developed countries america is the most dangerous place to be sick is also the most dangerous place to be black it has displays the weight loan the rate of white evidence of the highest mortality rates of which 50 percent of the cases are critically preventable. And the most dangerous place the most dangerous place and to be disabled. And the cost of 4 Million People of 400,000 years. But a funny thing happens if you look at the data more closely you can understand all this danger only exists if you are poor. Because rich people are exempted and have exempted themselves from all these problems. They get to year 15 years longe longer. We have made a choice we have explicitly made a choice by sustaining private insurance models we have chosen to let poor people die from things that spare the rich we have chosen to let poor children die from things rich children do not die from all because the Health Finance model is for the pursuit of private profit and this is more. This is the terrible secret of American Healthcare. This is the fundamental american illness. They are killing us and robbing the corpse to foot the bill. This Ruth Goldberg machine is failing us today and will collapse tomorrow that is incontrovertible. It will collapse. So we demand Something Different to federal universal singlepayer this is a simple concept i could do singlepayer in one sentence. Here it is we pull together all the money we currently spend on healthcare to cover all pit on all care for all people. Easy one sentence it is simple darling because we have one publicly owned and funded insurance. All care for all people is crucial medicare is cost sharing into improve comprehensive coverage mental and longterm care for all people in the us including noncitizens. Because everybody benefits being a doctor or nurse is complicated. And what hurts all the time it is a complicated process. How do we pay for this cracks or spending many really stupid cracks right now america to spend three. 9 trillion on healthcare and with private taxes and Insurance Companies of that one third is spent on nothing more than waste like admin cost like inefficient care. One claims singlepayer would be 10 percent less than what we are spending right now. We could spend 10 percent less to cover all people in full. Those that jacked up corporate profits so they shovel the cost back upon you so there model of health leads you to suffer. Single payer lets us liberate and to reallocate longterm. Part of the reason cost is so high private insurers have relatively small cost per basis and cant not cannot negotiate with big hospitals and insurers need hospitals way more than hospitals insurers. Once it represents 230 Million People it is the most powerful negotiator around. So once the balloon pops they are brought back down to earth. But even before that happens we free up all the money associated with admin cost and profit within the private Insurance Markets this opens up 370 billion per year that is a big chunk of change what you do with it . To build a reopen Community Health centers and most portly return the money of people who do the work take for example home health aide. Person has inpatient care 2000 those have a lower standard of care help with physical therapy and receive care in their own homes. Home is where the internet lives and longterm care at home to take agency over your own life to live at home instead of being cooped up at a cost of 120. With more humane care everybody benefits except for Home Health Aides themselves for the service the average of one. 2 Million Home Health aide is a nationwide average of 11 an hour. So we could allocate this money to the private market to pay fair wages for essential care. Think about that. What makes a real difference . Luxury hospital suites multimillionaire surgeons . 20000dollar data packages . Know. Of course not those are just those that get to build them it is extra Clinical Care social worker Patient Advocates vaccination counselors and nurses these are the folks who are underrecognized and undervalued and those who made a difference in population. These are basic ideas we understand the social forces and the structural ones but in the multi payer private model nobody is investing in Population Health or to pay People Fairly and they never will because right now your private insurer because they will change in the future than they feel pressure that keeps you healthy now or healthier in the future let me put it another way. If your home the window breaks the weather gets in then you could get sick if you get sick or your kid get sick you have to go to the doctor if the clinic is shut down or book solid you have to go to the hospital the hospital as far away if you dont have a car you have to hitch a ride or take the bus. Then you have to spend all god damn day dealing with the bus system then you cant go to work if you cant go to work you dont make any money you cannot afford to fix the window that caused the problem in the first place so the answer isnt to fork over a pile of cash every time you go to the hospital the giving people what they need to fix the god damn window. There are no american model that will fix the problems on their own its only those created by the private Insurance Industry they are incapable of fixing the broken windows of reopening those rural hospitals in texas that have closed they are capable of repairing the tanks in South Carolina they cannot fix this injustice they cannot solve these problems because they cannot compete in the first place. But we can and we do. So it makes perfect sense for those who dont get care for those that pay for it in the first place. Because once the federal actor or singlepayer has the risk and costs of what happens when it is not provided with the suffering of all the people if people are sick because where they live is unsafe then housing is healthcare and that brings healthcare costs down. People are sick because they dont have access to healthy food because of like diabetes or cardiac failure then to provide them with affordable or free food options time space and material to bring costs down. If people are getting sick then rehabilitation is healthcare and with these cost to bring them down because thats not the goal singlepayer Health Justices the goal of a refi for health just as we fight sidebyside because Economic Justice is Health Justice and Environmental Justice reproductive justice those who dont want to reproduce and those who do. Just wages and working conditions for black lives or brown knives and or immigrants or people in prison and all people regardless of age or creed is your permission to healthcare to have your own god damn body to extract a profit and thus we have permitted under desolation. Over the course of researching this book every morning i would wake up, eat a banana drive six hours a give a speech and then talk to people people to tell me the worst things that have happened over and over and over again. It is an honor to be trusted like that but i became a library of human misery. So i will share three stories with you. One long and one short and one medium to conceptualize the movement for health care. The first story takes place in houston for i have not talked about Mental Health you cant talk about the Mental Health in houston without Harris County jail a quote unquote provider of Mental Health services this is the same story of any big city. That is a fine observation but in houston people who are arrested are held in these cells he would not know they exist and that she wore are looking at them and then for those like trespassing or Disorderly Conduct what do you do . So now you have two choices plead guilty and you might get out are looking at more time locked up this is if you are lucky enough to pass some in the middle of a serious episode things get worse and in the county gives you a session of the county psychiatrist or youre in the prison wing of the hospital. This concept of the prison pipeline that comes up is not a pipeline they go in one direction is like a pinball machine these giant invisible flippers bouncy people around from jail to hospital in hospital to jail and at some point there is no functional difference so they become sick this is the wrong kind of sick we delegate your care to private prisons technically its not a crime to be sick its also not a crime to be poor or to be black or brown but in the intersection the rules change if you are single mother of color you have virtually no rights to privacy with section eight housing if they find too many shoes on the shoe rack if youre a single mother or mans shoes you can lose your benefits to be disabled and on medicaid to see if you are still disabled and in some stage of to make less than 2000 a year if you are a medicare recipient then you have to wait in line for an hour to prove that you are employed time you can spend going to work so as long as we use prison with the Health Care Needs healthcare in prison is inseparable so the idea the largest part of healthcare in the us is technically corrupt, it is wron wrong. No prisoner will ever receive the care and support or the help they need and no prisoner will be safe if they get out and remain sick and go back to jail because prison is not hospital they are warehouses for the mentally ill and storage units. That is houston. Another store i want to tell the birth and death in memphis tennessee at the turnofthecentury 20 black children died for every 1000 live births. Twenty black children died for every 1000 live birth that is an incomprehensible number. Nowhere else in the first or second world 20 black children died for every 1000 live births. Why did they die quicks because memphis is home to two Nuclear Wastes disposal sites pushed up against black neighborhoods where do poor babies go when they die quicks . In memphis they go to bb land the potters field for infants they are put to rest in cramped rows in unmarked graves a block and a half from walmart. Or at least they were until recently because in 2014 baby land filled up. Poor black children die in such volume america is poisoning their mothers and homes so effectively we have run out of room to hide our shame and bury their bodies. And finally i want to talk about scott county indiana you might know scott county with a population wide epidemic of hivaids and we understand the cost those that have tamperresistant it does nothing to stop opioid misuse so if you are battling addiction then governor mike pence shut down the Needle Exchange programs they were illegal so therefore they are for criminals why should we spend money on criminal healthcare indiana gutted for places like planned parenthood. If you are battling opioid use disorder now you cant find a clean needle so it is predictable nor people get needle borne diseases like hiv aids and hepatitis c. But thats not where the story ends thats never where it ends these people have families and communities and now hivaids or hep c or in jail these communities have been left behind. Indiana has a very low property tax cap and a School Voucher program so those who dont want to show up so they send their tax dollars elsewhere so they got less and less money and more and more money per capita with families leaving so fewer teachers, less food, no Mental Health or Guidance Counselors so the guy said you could spot a kid going through hell of a mile away a child on board in the world there was nothing he could do to help. There was no funding for vouchers or breakfast or therapy or daycare there were no resources to help the children of the unwanted until scott county saw an increase of child suicide. All these things has a cause they are cyclical they will continue to happen as long as we tolerate the idea the body is a commodity. If they are not valuable if there is no profit in the care of sick people are Homeless People or people battling addiction or disabilities or poor people are pregnant people or trends or women are black or brown people there will always be a private prison system to receive them for profit and servitude continues and death because the organs of the poor that are transplanted disproportionate and sold to the bodies of the wealthy. There was no and to capitalism or any line too far of the commodity on the commodity of the body so i say these awful things not for pornography of the suffering but these are the stakes of the fight for Health Justice. So i want to be explicit. Insurance is not enough. Our goal is not simply insurance by email to patient berkeley was put the people at the front of the line. We must walk together every god damn step of the way and compromise until we all have been liberated. Why is it some have adequate healthcare and others do not why have some have adequate housing or food or income and safety and dignity while others do not while others are compelled to fear their own body along the lines of structural poverty the american body with racial and patry article domination. s when we attack it is exploitation itself. These are problems private insurance cannot fix and that insurance will not fix. This is with the full force of all of americas people to form the shape of our Government Armed with a singlepayer health care model. Upon our throat is a boot it offers relief which we may see to join together to dismantle the lottery only that we are useful to people that make money off our bodies. Freedom to fight back and escape the strictures that bind you and to be safe in the community and your home and your body this is the future of singlepayer because singlepayer is the first counterattack in a war already waged against us. There is good news. We do know what works to stand on the shoulder of the Labor Movement the shoulders of hundreds of thousands of tens of thousands of doctors who have fought the impossible odds and one again after moving for paid sick leave turned over 144,000 people the largest Popular Movement in years if not decades. In maine they turned into a Medicaid Expansion campaign they got all the signatures they needed one day of canvassing in idaho Three Friends bought a camper painted it green and the movement won 60 percent of the vote there was no blue wave there was a massive Popular Movement that turns out if you give people the material they will fight to keep it we build solidarity. I cannot tell you what to do in baltimore but i reckon the job is not to build a singular single Popular Movement but the fight for Health Justice with factories and in the dive bars that spans the country from coast to coast and through these globalizations and only to these massive mobilizations we will win it isnt a radical proposition that people like singlepayer and medicare for all they simply discuss the basic principle of fairness so in closing i offer you my professional opinion. I believe beyond any doubt , that singlepayer is demonstrably found and is feasible a properly ambitious and well structured singlepayer program will do more than any other of this generation to resuscitate the spirit and nourish the moral will of the American People for quite believe it will loosen american Health Finance and our economy. I believe this nation whose labor has created the safety and agency of healthcare it is greater in scope housing and food and income of basic Human Dignity or healthcare and therefore i have to believe singlepayer healthcare is the moral imperative. Singlepayer is our tool. Singlepayer is the weapon. Singlepayer is the first step singlepayer is on its own not the goal. I have seen, and you have seen such suffering i have seen families ripped apart of capitalism and people that i love torn limb from limb while extracting profits and while this is intolerable to me and so i say enough. Not in my name but for those who suffer around us and to cultivate that the machine can and will be destroyed. My friends, singlepayer is moral. Single payer is necessary. Singlepayer is, i swear to yo you, singlepayer is achievable. Solidarity now. Solidarity forever. Thank you very much. [applause] we have time for a couple of questions. Please keep the question short. Im glad you mentioned capitalism. Do support any particular left group . I am the democratic socialists of america but im not too proactive. Any other questions . Under singlepayer what is your vision for rural health access. Right now the lifespan of a rural hospital is to flounder around to be acquired and then be closed down which is pretty poor model to achieve rural health the ideal model with that we have to build more hospitals singlepayer doesnt do that in itself it considers the consequences of not having these hospitals we see programs under medicaid especially in blue states there is a lot of money i think michigan does as well and detroit a Grant Program like that with those regional actors. And to use those systems i presume a lot of that goes to rural hospitals we have to fund these things once i get in the hands of the companies that they are done. Other questions . Under singlepayer what are your thoughts how prices would be set and do you have any concerns providers close down based on the price and what is sustainable for them . Prices are set which is the monopoly for purchasing. I am not concerned about hospitals closing down some micro access hospitals have problems with staying open because thats the patients are uninsured. So with the volunteer care they do they dont get reimbursed and nobody pays into it the average hospital is charging Insurance Companies five times what they get from medicare and that goes into the massive uptick of cost for pharmaceutical companies but the singlepayer but they dont set them so low that the hospitals close we need hospitals is like a tetris game you have to play the knee surgery will not be one dollar but but at the federal level singlepayer is good and the hospitals that do mass quantities of underinsured or uninsured patients then that would be unnecessary to have problems with overbuilding another thing to consider to hire folks to build Insurance Companies doctor spend 60 percent of their time you can get it down to 10 percent to figure out or what other combination of insurance plans that are out there. Thats why the money comes back to overspending from the hospital which is a side benefit of singlepayer. Thats all the time we have got. Thank you for this great talk. [applause] for a lot of younger people today must be difficult for them to fathom what it was like for us to file articles with no computers or internet or email emails. Not even a fax machine and to cover a nominee in the general he has more gizmos than anybody else to make it shows what a different world that was. For example i remember coming back from south dakota that had the famous meeting where mcgovern announced to indicate he would dump angleton this is a story about technology. And then writing separate stories for afternoon papers and i said there were no filing centers or cell phones. And then we have to find a payphone somewhere and you find a payphone. And then you could not get to them. The radio receiver part to use your alligator clips and it was really hard to unscrew the paper. I recall i was being asked. Sure. [laughter] good evening everyone. I am the chairman of the Young Professionals program and we are very happy to welcome for discussion writing a book published recently called stata for ms 13 and el salvadors war of violence it looks like this honestly it is amazing