Uncared For: Bonus Episode - Your Health is at Stake This Election

Host: Soojin Pak
Guest: Julie Rovner, Chief Washington Correspondent for KFF Health News
Release Date: October 25, 2024

1. Introduction to Healthcare in the 2024 Election

In this special bonus episode of Uncared For, host Soojin Pak engages in a comprehensive discussion with Julie Rovner, a seasoned health policy journalist with 38 years of experience covering healthcare and Capitol Hill. The conversation focuses on the critical healthcare issues at stake in the upcoming 2024 election, emphasizing the complexity and urgency of the nation's healthcare system challenges.

2. The Imperative of Public Engagement in Healthcare Reform

Key Insight:
Julie Rovner underscores the necessity of public involvement to address the broken healthcare system.

“We're not gonna be able to fix the healthcare system unless more people plug into the problems.”
[02:13]

Rovner emphasizes that while widespread dissatisfaction with the healthcare system exists, meaningful reform requires collective effort and active participation from the public.

3. Reproductive Health: The Forefront Issue in the Election

Highlighting Abortion and Beyond:
Rovner identifies reproductive health, particularly abortion rights, as the paramount electoral issue this cycle.

“Reproductive health care is affecting the health of everyone, not just pregnant people.”
[04:59]

She explains the broader implications of abortion legislation, including the reluctance of healthcare providers to practice in restrictive states, leading to shortages and care deserts. Additionally, debates around IVF and fertility treatments are poised to influence voter decisions.

Impact of Candidate Outcomes:

• If Trump is Re-elected:

  • Potential rollback of abortion rights using executive powers.
  • Possible rescinding of the abortion pill's approval by the FDA.
  • Elimination of Planned Parenthood funding, exacerbating healthcare access issues.

• If Harris is Re-elected:

  • Limited ability to restore abortion rights without congressional action.
  • Potential barriers due to the Senate's filibuster rules.

“Vice President Harris has as much to do with who's in and what the administration happens in terms of the regulatory agenda and what the courts will have to say about that.”
[23:28]

4. Long-Term Care and Medicare Expansion

Proposal by Vice President Harris:
Harris has proposed expanding Medicare to cover long-term care costs, addressing the needs of the "Sandwich Generation" who balance raising families and caring for aging parents.

“Long term care is so expensive it's impossible to make it self-supporting.”
[14:27]

Challenges and Historical Context:
Rovner traces the longstanding issues with long-term care funding, highlighting past legislative attempts and the collapse of the private long-term care insurance market.

Current Public Opinion:
While there's support for expanding Medicare, especially among those directly affected, there is significant debate over funding sources and the role of government versus private sector involvement.

5. Addressing Medical Debt: A Pervasive Issue

Julie Rovner’s "Bill of the Month":
A recurring segment where Rovner dissects outrageous medical bills to highlight systemic issues.

“Never pay the first bill. It’s hard to imagine anything in society where when you get a bill, you shouldn't pay it.”
[18:51]

Notable Stories:

• A teacher in Texas facing a $110,000 bill after a heart attack due to out-of-network charges.
• A teenager's $7,000 surgery bill because the procedure lacked a coding classification.

Election Impact on Medical Debt:
Policies aimed at curbing medical debt include:

• Preventing medical debt from appearing on credit reports.
• Encouraging hospitals to forgive debts in exchange for higher Medicaid payments.

6. Comparing Health Policy Promises of Presidential Candidates

Vice President Harris:
Brings experience from the Biden administration with specific policy proposals, such as Medicare expansion. However, her ability to enact significant changes is tied to broader administrative and legislative dynamics.

Donald Trump:
Offers vague healthcare plans with limited specifics. His previous presidency was marked by traditional Republican approaches favoring private over government involvement, but his current stance remains unpredictable.

“Vice President Harris has the record of the Biden administration to run on and knows about health care... Former President Trump doesn't really talk about health care in any kind of specifics.”
[23:28]

7. Current Trends and the Possibility of Change

Unique Nature of the 2024 Campaign:
Rovner notes the unusual dynamics of the current election, where one candidate has a clear healthcare record and policies, while the other offers minimal specifics, creating an unprecedented uncertainty in healthcare policy outcomes.

“We know where she's coming from, that she's a lot like Biden... We have no idea what Donald Trump would do on healthcare if he was elected.”
[25:16]

Hope for the Future:
Despite recurring challenges, Rovner remains cautiously optimistic, believing that persistent efforts and new approaches can eventually lead to effective healthcare solutions.

“Other countries have figured this out. I assume that we can too.”
[27:05]

8. Conclusion: The Critical Role of Voting

Soojin Pak wraps up the discussion by reiterating the high stakes of the election for American healthcare, urging listeners to participate actively by voting to influence the future direction of the healthcare system.

“When it comes to your health and the health of your friends and family, a lot is riding on this election. So make sure you go out and vote.”
[27:16]

Produced by Lemonada Media and The Commonwealth Fund

Uncared For is dedicated to exploring and advocating for improvements in the American healthcare system. For more insights and updates, follow Uncared For across all podcast platforms and social media channels.