Stakeholders continue to consider options for improving equity and eliminating disparities in healthcare, and some believe the implementation of a universal healthcare system would help. Experts discussed efforts to address health disparities at the 2024 Michigan State of Reform Health Policy Conference this month.
Michigan Universal Health Care Access Network (MICHUHCAN) Executive Director Marjorie Mitchell said MICHUHCAN’s mission is to help all Americans gain access to affordable healthcare that provides what they need when they need it.
“We’ve done a lot of polling, and the polling—over the years—keeps moving towards the realization that most people want that kind of healthcare system,” Mitchell said. “They want it to cover everyone. And we have been polling people that are primarily conservative. Last year, our poll (of) 1,000 people (saw) over 71 percent (say) they wanted universal healthcare. Ninety percent wanted (healthcare to be) more simple, and 96 percent wanted it to be affordable to everyone; not just some. So we’re moving in the right direction. But we’re not there yet.”
Dr. Caira Boggs—director of Detroit Health Innovations and the Center for Health Equity Practice at Michigan Public Health Institute—moderated the panel, and asked Mitchell what the most common myths she hears about universal healthcare are.
“I often hear myths about it or miseducation about it,” Boggs said. “And people stand on their misbeliefs.”
Mitchell said the most common misconception she hears about universal healthcare is that the U.S. can’t afford it.
“It saves tremendous money,” Mitchell said. “And that has been proven around the world with other countries that have gone in this direction. People also say they’re afraid to lose their doctor for some reason. Even though universal healthcare puts the person first. They have all the choices about (their) doctors and where they go.”
MICHUHCAN, which has been operating since 1990, has seen progress on public opinion regarding universal healthcare in recent years, however.
“It’s beginning to break down. Our polling has been showing that people believe there is plenty of money in the U.S. to do universal healthcare. It just takes talking to people directly, finding out what their concerns are, (and) providing them (with) information. Hopefully we (can) bring people along even further. It’s moving faster the past few years than it had in the first decades after the 1990s. It was really difficult then. It takes talking to people, and we don’t have enough people going out and doing that. We don’t have to totally agree on every policy, but we can keep moving to a union where there is equity.”
— Mitchell
Mitchell discussed pending federal legislation that supports universal healthcare in Sen. Bernie Sanders’ (I-Vermont) Medicare For All Act and Rep. Pramila Jayapal’s (D-Washington) Medicare for All Act.
“They’re very similar,” Mitchell said. “The biggest difference is Jayapal’s includes long-term care. Her bill would fund everything seniors need, (whereas) Sanders’ is mostly community-based care. The Jayapal bill does both.”
Michigan lawmakers are also considering legislation that would implement a statewide universal healthcare system. Rep. Carrie Rheingans’ House Bill 4893 would create a publicly-funded health system that would provide comprehensive services in Michigan.
“It doesn’t have a hearing yet,” Mitchell said. “But we’re hopeful that over the next year or so, we’ll be able to get a hearing. Her bill covers everyone and is based on what your needs are.”
All Michiganders have different health needs, which can vary depending on an individual’s racial or ethnic backgrounds. Brenda Jegede, leader of the Michigan Department of Health & Human Services’ Office of Equity & Minority Health, noted that Public Act 653 requires the department to address health disparities.
“It charges us to let the legislature know how we’re making progress every year. Where do we still need to make strides? We do a survey every year, typically across our department of 15,000-plus employees, to ask them what they’re doing. We also do a lot to support smaller community-based organizations. Those organizations have had contact with our ethnic populations, so we fund them to determine and address their local social determinants of health. We do a lot around equity training.”
— Jegede
Tawana Nettles-Robinson, executive director of Trinity Health Michigan’s Detroit market, said the state’s healthcare workforce needs greater diversity to best serve its many different cultures.
“When we think about workforce development, we have to think about where we place professionals, the services provided, (and) being more thoughtful about how we administer treatment based on awareness of culture,” Nettles-Robinson said. “I can tell you numerous stories where there was a huge disconnect, and a lack of knowledge in how to be connected with the cultures we serve. And it has a tremendous effect on health outcomes.”
Mitchell noted that it is also important to support diversity, equity and inclusion (DEI) programs, considering recent efforts to stymie them in some states. Alabama Gov. Kay Ivey signed a bill limiting the use of public funds for DEI programs there last month.
“Alabama just passed legislation to take DEI out of everything they do,” Mitchell said. “They aren’t going to have language on diversity, equity and inclusion. That is really concerning. You can be able to vote, but if they make it so hard you can’t get to the [polls], your vote isn’t counted. Because you won’t get there to vote. We’re (seeing) efforts across the country that make it harder to vote.”