Opinion: For-profit healthcare is killing us. It’s past time for a BadgerCare expansion and a public option.

Opinion: For-profit healthcare is killing us. It’s past time for a BadgerCare expansion and a public option.

By Dr. Pamela Guthman

November 15, 2023

Wisconsin is one of only 10 states yet to accept federal funds to provide more families with consistent, affordable healthcare coverage.

When I first started working as a rural public health nurse, 40 years ago, I’d get calls from folks saying things like: “Could you check on my neighbor, Margaret? She’s elderly and I haven’t seen her at the mailbox in a couple of days.” So, I’d stop by and see Margaret. We’d chat and I’d check her medications, see if she had food in the fridge, make sure she was eating. Maybe I’d call her family and say, “I’m a little bit worried about your aunt. Why don’t you check in on her? I’ll stop by next week and have a cup of coffee with her, too.” 

Can you imagine how nice it would be to have a nurse available to check on you or your long-distance loved one? Back then if you had a new baby, a nurse would come by to make sure mom and baby had the support they needed. Health care was neighborly. A holistic approach to health was part of community life. Plus, when the county nurse stopped by, you  didn’t have to brace yourself for a surprise bill. 

In my lifetime, I’ve seen this neighborly, community-focused healthcare system destroyed. It’s been stripped of funding and privatized so that greedy corporations can get rich by denying care or price-gouging on prescription drugs. Healthcare industry lobbyists have worked hard to shift government focus away from prevention. Now the focus is on treating disease, which is often more profitable. Why pay community health nurses to keep people well when you could sell them a costly pill every day, instead?

Our government’s refusal to invest in prevention-focused public healthcare is enriching corporations while killing working-age Americans and forcing millions into debt. When you really peel apart the onion, you start looking at discrimination based upon race, power, wealth, and geography. You start looking at the effects of institutional racism and the socio-economic pieces, as the data shows that Black Milwaukeeans die 13 years younger than their white neighbors. Think about that. That’s 13 family Thanksgivings. Thirteen beautiful Wisconsin summers—stolen because we have chosen to prioritize corporate profits, rather than people’s health. 

The healthcare crisis is especially bad here in Wisconsin because our Legislature has refused to expand our successful BadgerCare Medicaid program. This means thousands of hard working but low-wage workers have no coverage, some of whom are health aides who work with our seniors. Let me tell you, when you’re in that bed and you can’t turn yourself and you can’t toilet yourself, that home health aide is going to become one of the most important and most beloved people in your life. But that person who is providing you care may not have access to health care themselves. It’s no wonder there’s a shortage of workers in this field. 

If elder care is important to you, if you’ve wondered who is going to take care of your dad or grandma, get on the phone to your legislator and talk to them about expanding BadgerCare so low-wage workers can get covered. The deal is a no-brainer. The federal government will help us to do it and—as happened in the 40 other states that have already expanded their Medicaid programs—we’ll start seeing better health outcomes, including fewer overdose deaths that plague rural and urban families alike. 

But BadgerCare expansion is just a start. The next step is to take some of the power back from the healthcare industry that has so much toxic influence over public policy.  Bills like the BadgerCare Public Option—in the Legislature right now—are how we change course and get our legislators on record about whether they support us, or the healthcare industry. 

The public option “supersizes” BadgerCare. It would ensure that a family of four earning under $60,000 could get quality coverage they could afford. Most of the families I see in my current work—I took a job as school nurse in rural Wisconsin—would qualify based on income. Steady insurance without a lot of paperwork would be a game-changer for the families I see, who are so busy and dealing with so much. 

Small businesses and towns could choose to offer BadgerCare for their employees, too. Their employees would have coverage from a plan with a business model that isn’t based on denying care. Self-employed folks who use the Affordable Care Act marketplace could get it too. And as BadgerCare enrollment grows, it will have more power to negotiate and set prices. This bill is the first step of getting back on the right track toward restoring public investment in healthcare and the ability to choose which health care provider and system that we want. 

If “we the people” were to choose a healthcare system, would it look like the one we have now? Or would it look more like the one we used to have? We know the holistic, prevention-focused population health model is similar to systems in other countries that spend less on healthcare than we do (but they get better health results with longer, quality life expectancy and fewer chronic diseases). We know what we need to do. We must come together and hold our government accountable to doing it. Our lives depend on it and, perhaps most importantly, so do the lives of innocent kids, who need a healthy start so that they can have a chance at a healthy life. 


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