#22 – On Healthcare, The #metoo Movement, And Donald Trump With Joleen Bishop

These videos are about regular people talking about things that divide us immigration race Trump etcetera so there might offend you but I hope they useful like some videos I made about home repairs that helped thousands of people you see I hate do my own home repairs I don’t want to listen to a professional home repair guy who makes.

Easy TV pundits give me the same vibe I don’t want to listen to these people when you see them on TV they’re at work it’s their job.

About this stuff they’re not really interested in learning from each other and fixing the problem the sure don’t ask the questions I would ask so me and my brother who is himself progressive we drove to 22.

Cities and interviewed dozens of people who support progressive causes and I learned this it’s our feelings that divide us feelings driven by personality some of us want to be the innovators the trusting the idealists some of us want to be the managers the cautious the realists and each of us builds a fortress around our feelings that you can’t break through with facts and.

Arguments but maybe we shouldn’t try apparently evolution or God or whatever made us this way for.

A purpose I think that purpose is that we need each other to get the full picture I know works that.

Way with other things but we have to talk to each other if we don’t talk to each other we won’t make.

Progress next we drove to Petaluma where women’s health nurse practitioner Jolene Bishop described the changes that.

Occurred after the Affordable Care Act she’s also someone who experienced firsthand the power differential and intimidation in the workplace that the me2 movement is exposing and we.

Talked about how this related to Donald Trump in the practice I’m in now I work for.

What’s called an FQHC which is a federally qualified health center it’s.

A very good distinction we are a nonprofit public health clinic when I started ACA had not been implemented but when it started implementation what changed was the enormous number of people who came back into the healthcare system so a lot of folks when they don’t have money or the availability other than.

Going to the ER don’t get continuous care they just treated episodic so when a CA came in and people started realizing they had access to primary care to ongoing care if they needed it we are our influx of folks has been tremendous it’s a yeah if you don’t mind yeah with that influx of folks that are getting regular preventive treatment we always hear of the benefits of that yes that’s something you’ve seen.

The direct benefits from yes and and on the federal level we have a lot of benchmarks we have to make and one of the ways that help our reimbursement is keeping people out of the ER and out of the hospital and one.

Of the ways you do that is through a process of certain routine things like diabetes hypertension pap smears so that systems in place so people have access to that and when they come in for these kinds of visits then you can catch up with some of the other things and you you give them.

A place to go that isn’t the emergency room and also gives them empowers them to.

Learn more about taking care of themselves the poor or people who are really struggling don’t always have that they have more intense needs and so their body or their health often often fails.

So that’s that’s what I see as an enormous benefit and it was almost the first year okay great when hospitals became required to to take in people who were.
Indigent and give them care yeah is that something.

That was a big effect on the healthcare not as much as I don’t feel it was now I’m not a hospital administrator and hospitals have a different set of problems and things they have to be concerned about and certainly too many people who are uninsured is one of them there are ways around having to accept people most communities have public health in some way and so there are ways kind of around private hospitals can stay out.

Of giving that particular level of care okay that’s what I wanted to ask you about because I keep thinking okay I know when if you’re in the armed services if you inoculation you know they just line up a hundred.

Guys and they gotta knock you lations there’s some kind of economy’s there yes and I’m ex-military yes I know I know their health systems.

And they have economies of scale correct and it’s quite.

I gotta tell you I if you want a universal health system utilize the structure there are lots of things wrong but the structure in either the VA or a military because that will show you how to do a universal system in a low cop in a much more low-cost way okay so are we doing any.

Of that kind of economies of scale no I think the VA I mean there are a lot of problems in the VA but they certainly try to do that some large.

Public health hospitals and certain clinics do do that you know the push is really to keep people out of the emergency.

When people were being denied care before ACA went into effect there was a lot of discrimination through the insurance company I feel the insurance companies and the drug companies have participated in this enormous problem we have and until some of.

That really gets exposed and talked about and not lobbied and special-interest involved then you won’t see that economy of scale if you had now it’s harder with a universal health system.

It would be easier because then the rules like we deal with we deal with the federal rules a lot they’re all the same so you kind of know what’s expected.

Whereas private private industries private hospitals things like that have their own rules trying to contain cost but sometimes for drug companies or even insurance companies containment of cost is not the priority and so we’ve never really dealt with the cost of drugs in this country there are rules against people trying to get it cheaper in other country things like that.

We’ve not really addressed that and that’s my feeling is they have a very strong khalaby and an investment and they’re protecting that okay okay did I understand correctly that the Affordable Care Act because it’s imposed some kind of like federal standards.

It is doing a type of economies of scale.

Yes it is it pushes it it’s got enough there are enough benchmarks that you have to hit quality.