Healthcare

For the past several years I’ve been experiencing a variety of symptoms ranging from the cognitive: severe deteriorations in my working memory, ability to feel emotions, ability to think, plan, and begin tasks, being extremely irritable, never-ending brain fog, and difficulty speaking and finding words – to the physical: extreme fatigue, G.I. issues, esophageal issues, bone pain, and more. At its lowest point, I was barely human. I could not function, could not feel any emotion good or bad, and basic tasks had become Herculean endeavors. It was an existence devoid of any real meaning, and I would never wish it upon anyone. After several years and nearly a dozen different specialists, I was finally able to find a medical team willing to help treat me. A combination of high-dose prednisone and the chemotherapy drug methotrexate has gotten me to the point where this congressional run is now a reality. After seeing a geneticist, we now believe that a mutation in the COL4A1 gene which produces collagen in the brain is the cause of my symptoms, which you can read more about in the bio section.

Healthcare
Policy List
Essential Articles

I am certainly no stranger to the American healthcare system. Navigating the frustrating labyrinth of health insurance, doctor appointments, prescriptions, MRIs, operations, and genetics testing has been my life for the past 3 years. It has not been easy, and I’ve often felt that I was fighting against a system that didn’t seem particularly interested in whether I lived or died. Too many times I received a concerning result from a brain MRI or a blood test, only for the doctor entrusted with my care to shrug their shoulders and tell me to find someone else.

This issue was not what got me into politics, but it is perhaps the biggest catalyst for why I decided to run. The inefficiency of our system, the lack of equal access to care, and the exploitative practices of some of the most powerful businesses in America are killing people every single day. It should not have taken several years of getting tossed around between nearly a dozen different neurologists to finally get a possible diagnosis or treatment plan. I never felt like I had anyone on my side up until my current care team either. It doesn’t have to be this way either, that’s the most frustrating part.

My illness, with its disabling symptoms, helped put into perspective the urgency of not just this issue, but the fundamental problems of our society as a whole. A healthcare system that is incentivized by the generation of capital rather than the betterment of the health of society suffers from a misalignment of values. There are so many deaths, so much misery, caused not but a lack of resources or even by incompetence (although those are factors), but by a system whose sole priority is to extract money from those who are suffering. It is wrong, plain and simple.

My priority for healthcare is to move from a profit-driven industry to a human-focused service. If healthcare had initially been treated the same way as other essential services such as fire and police departments, I don’t think we would have batted an eye. But the current structure where exploiting the sick is the priority and care is incidental, is bad for everyone – patients like me, doctors, nurses, medical staff, tax-payers, the insured and uninsured alike, and anyone that isn’t a high-end investor or company executive.

The Biggest Healthcare Decision

From a policy perspective, healthcare is by far the most complex. For example, one of the biggest problems is the exploitative practices that insurance companies use to deny people necessary care to maximize profits. Allegedly, Cigna wrongly denied care to hundreds of thousands of patients, without ever considering their claims. UnitedHealthcare (a company with a market cap of almost half a trillion dollars) even utilized AI to deny claims without ever looking at them. Would I vote for increased regulation and enforcement against this practice? Yes. But at the same time, if we implement a single-payer system like Medicare-for-all, where everyone pays into the same system and has equal access to care, there would be no insurance companies to regulate, and everyone would be covered, making that solution moot. Both solutions are better than what we have now, but the first is much easier to make into law than the second.

Staying on health insurance companies, what actual value do they provide? You have massive, massive companies like UnitedHealthcare, Aetna, Elevance Health, Centene, and Cigna that take home hundreds of billions of dollars in revenue every year. How is all that money being made? We pay these companies to only cover part of the cost of healthcare, but their goal as a corporation is to spend as little as possible so they can take our money and give the largest possible handout to their investors. They spread the rest of the cost around to us through an opaque, intentionally confusing system using vague language like “deductibles”, “copays”, and “premiums”. The result of this system is artificially high costs with very poor quality care compared to nations with economies that are a fraction of ours.

These are companies that used to deny or exploit people for having “preexisting conditions”: things like diabetes, pregnancy, or genetic conditions (like mine). They deny claims because they can. Their incentive is to do really immoral things in order to make rich people richer. This conflict, that pits financial gain against the health of society, is the reason why an industry like for-profit health insurance should not exist. Do we want a system where people become rich by denying care to the sick? Why do we need to get permission from a for-profit company to get an MRI or an X-ray when the doctor we just saw said it was necessary? It’s so silly that we live with this every day, and there is so much time, effort, money, and unnecessary pain and anxiety spent on doing something that serves no real purpose other than scamming people. No matter how much you regulate it, this system is always going to incentivize denying people the care they need and making things worse for healthcare workers and patients alike.

There are those that may wonder, how can we just get rid of an entire industry like that? And the first thing I thought of is the fact that this country already did exactly that for an industry far more controversial and popular than insurance: alcohol. The 18th Amendment to the Constitution prohibited the manufacture, sale, and transportation of intoxicating beverages in the United States. American society at that time decided that this industry is harmful, its disruptive, and we’re going to do something about it. They ultimately reversed themselves with the ratification of the 21st Amendment, but the precedent is there for making this kind of change, there’s no reason to keep doing something just because it’s been that way for some time. Anyone that claims that we can’t get rid of insurance companies or that doing so is “not in line with American values” is either lying or is unaware of our history.

So is it single-payer or nothing? I think there is still value in improving the current system even if we end up changing it later. When the Obama-Biden administration and Congressional Democrats passed the ACA in 2010, it saved lives. The Affordable Care Act saved my life. While it may have looked like some minor bureaucratic tweaks and adjustments in the grand scheme of things, those changes really mattered. Without the preexisting condition protection and being able to stay on my parent’s plan until 26, I would not be here. I wasn’t born rich, I couldn’t have paid for everything out-of-pocket, considering how complex my illness is and how long it took to find the cause. At the very least I got a fighting chance, and in some way I’m trying to pay it forward now.

So what’s the strategy? I want to keep pushing for single-payer healthcare, but at the same time there’s a lot we can do to metaphorically clear the runway for when there’s enough support and political will to make it a reality. Cracking down on the worst abuses of the healthcare industry is going to have the broadest support in any Congress, so there is opportunity there even if there isn’t the same appetite for implementing a single-payer system.

Wall-Street Healthcare

A particularly disturbing development in recent years has been the encroachment of private equity firms buying up everything from nursing homes, to traveling nursing agencies, and hospitals. These Wall Street investors take previously nonprofit health providers, and turn them into cash extraction machines. That means firing staff, restricting care, and up charging patients. Once they feel they’ve made enough money, they often shut the operation down. A number of studies have found that after being taken over by private equity firms, nursing homes and senior care facilities experience a significant increase in abuse and patient deaths that cannot be accounted for by other factors. I don’t know how to describe that as anything other than evil, and it must end.

Health Care Workers

Nurses, doctors, medical technicians, and every worker who is a part of the healthcare workplace must be treated with respect, and that means not being overworked, being paid adequately, and given enough autonomy in the workplace. Being denied a full lunch or regular break is not okay. Losing your job so that a Wall Street investor can make a bigger profit is not okay. Not being able to treat a patient and dedicate quality time to helping them because your workplace is far too understaffed is not okay either. One part of the solution is to strengthen the ability to form unions and attain fair contracts, as well as holding healthcare companies accountable for abusing patients and employees. I want to see a large-scale investment in balancing out staffing ratios per patient, that would make life better for everyone. Increasing the amount of practices in a given area will contribute to better workplaces as well by providing medical staff with the option to leave if their employer abuses their labor.

Stopping Health Issues at the Source

Perhaps the greatest and least-focused on aspects of healthcare is the preventable. There are many, many things we can be doing to stop people from getting sick or hurt in the first place. Health is one of the founding principles of this campaign, and a lens by which I view every other policy subject. If we can implement the types of reforms on firearm violence I would like to see implemented, that would prevent thousands of people from ending up in the hospital every year. Empowering the EPA and related agencies to crack down on polluters damaging our air and water will prevent chronic (and potentially deadly) illnesses like asthma and lung cancer. Increasing unionization and funding the Department of Labor will lead to a significant reduction in work-related injuries and hospitalizations.

One of the biggest determinants of health and one of the factors that we have the largest control over, are the foods we eat. And the food system we have is making us sicker, weaker, and causing a staggering amount of premature deaths. And whenever this topic is brought up, too much of the focus is placed upon shaming individuals, instead of taking into account the larger determinants that have led to a collective worsening of our national health. Much of the food we eat has been manufactured to be as addictive as possible, causing a significant spike in obesity and certain types of diabetes. We’re given the illusion of choice when we go to the grocery store, meaning that much of what is presented as competing brands are actually owned by only a handful of companies. It is difficult to find any foods that are not ultra processed and packed full of sugar. If you want to actually be fit and healthy, you have to work against this system. The strategy of telling people to just eat healthier and exercise has not been effective, and it places blame in the wrong area. I want to create an environment where instead of incentivizing a system of obesity, we incentivize health and wellness. We can create a system that works with us to be healthy. That could mean paying farmers to grow more fruits and vegetables, and looking into changing the food industry to move away from unnecessary ultraproccessing. If it is far cheaper and more convenient to eat healthy, I believe that will have a significant impact on reducing obesity and related health problems. I would also like to see increased research into what exactly makes these foods so addictive, in order to figure out the best strategy to counter that.

Nutrition and exercise guidance needs an overhaul as well. Instead of telling people to eat x amount of vegetables a day, giving people easy to make recipes that taste good would be more effective. That should start in schools, teaching children how to cook healthy, delicious meals early on, as well as providing that sort of specific information in primary care visits as well. The current strategy is too vague, and fails to treat the problem with the effort needed to be effective.

Pharmaceuticals

Even a cursory investigation into this industry is enough to make your blood boil. While the work that so many have done to produce lifesaving and lifechanging drugs is awe-inspiring (they certainly have my thanks), the companies that profit off this industry have done some incredibly despicable things.

The most infamous of which involves the maker of oxycontin: Purdue Pharma. Starting in the 90s, Purdue ran a massive marketing campaign to get doctors to overprescribe the opioid painkiller oxycontin to patients. They lied about the addictive properties, profited to the tune of billions, and ultimately caused the deaths of hundreds of thousands (I’ve included a short article on this that is well worth the read). The owners of Purdue Pharma, the Sackler family, withdrew billions of dollars from the company into offshore accounts prior to the lawsuit, and have avoided any direct liability for their actions.

While the opioid epidemic represents the most blatant wrongdoing of Big Pharma, there are a number of strategies used to extract the most amount of money from the sick and dying. For decades, pharmaceutical giants like Johnson and Johnson and AbbVie have abused the U.S. patent system in order to be the sole seller of the drugs they produce. Normally, patents are supposed to expire after twenty years, but these companies take advantage of the legal system and a very weak U.S. patent office in order to hang onto their monopoly for much longer. Without competition, they can charge astronomically higher prices for medications than it takes to produce. That money gets deposited into the hands of wealthy shareholders while people either go without their medication because they can’t afford it, or go heavily into debt to pay for it. That’s a major reason why medical debt is the leading cause of bankruptcy in America.

Up until the Democrats passed the Inflation Reduction Act, the government was not allowed to negotiate prices with pharmaceutical companies, meaning Big Pharma could massively overcharge for their drugs while pocketing billions in tax-payer dollars. I should also note that much of the pharmaceuticals that we have today were funded in large with federal funds. So we pay for these drugs at their inception, pay for pharmaceutical companies to overcharge us, and then pay an additional charge when we pick them up at the pharmacy. It’s exactly as crazy and as much of a scam as it sounds like. The Biden administration and congressional Democrats started to fix this issue when they opened up price negotiations for 10 drugs in 2021. We can expand that to the whole market, like just about every other developed country, if we win this election in November.

Additionally, as a result of the monopolization of certain pharmaceuticals, there are shortages of drugs that never would have otherwise happened. Cancer treatment, ADHD medication, drugs that people need to survive and go about their daily lives are in short supply. I would like to see a public pharmaceutical manufactory that would be tasked with insuring there is a safe supply of drugs that people need to live, something we’re currently lacking.

Improvements to Care

Beyond these structural changes, there are some additional solutions we can implement to make healthcare work better regardless of what system we have:

The exclusion of dental, vision, and mental healthcare from the rest of healthcare coverage needs to end. That means one single coverage for everything health-related.
Expanding public hospitals, clinics, and medical facilities in underserved areas (such as rural communities), and preventing the consolidation of healthcare providers. This includes expanding access to specialists such as ob-gyns.
Increased research to study the effects of Long Covid and provide symptom relief
Studying the effects of currently illegal drugs such as psychedelics to determine use for medical and/or recreational purposes
Increased transparency around health cost “estimates” and investigating significantly inflated costs
Providing more free, public spaces for adults to exercise and play sports
Increased job protections for those caring for ailing family members. People have been fired from their jobs before for things like missing work to take their child to the hospital for cancer treatment. That should not be allowed.
Expanding nursing schools to address shortages, in addition to creating a better workplace for nurses so they feel happy in the profession.
Expanding access to sexual assault nurse examiners, which many hospitals currently lack
Increased diversity in medical staff. There are some diseases, like sickle-cell anemia, that affect one group of people much more than another. Certain doses of certain medications affect men and women differently as well, with potentially deadly results. Having an intuitive understanding of these nuances will reduce deaths and complications, and create a better relationship between patient and health provider.
Creating greater incentives for students to become primary care physicians
Expanding global vaccine distributions to prevent deaths worldwide

One health system issue that really stood out to me during my readings was the alarming rise of maternal mortality rates in the past two decades. The rate is nearly 3x higher than our international peers, and black women are 3x more likely to die from childbirth than white women in the U.S. The statistics are just jaw-dropping. In the Netherlands, there are about 1.2 deaths per 100,000 live births. For black women in the U.S. it’s 55.3! That is a crisis, and it’s heartbreaking. There is a myriad of potential causes to this difference, but a few solutions I would like to see implemented include expanding coverage and training of midwives, an increase in reproductive healthcare centers, and a postpartum support system.

This is by no means a complete evaluation of healthcare, although I have tried to cover as much ground as possible. What is clear to me, is that this system is unsustainable and is in dire need of reform. If we take these steps, it will save lives. It will lower costs, waiting times, and create better environments for health staff and patients alike. It will reduce poverty, misery, and frustration. It may not solve every issue facing the health sector, but these changes are a necessary first step towards ending so much unnecessary pain and despair.

Policy List

Banning private equity firms from buying up healthcare
Creation of a public medication manufactory for the purpose of preventing vital shortages
Single-payer health coverage
Addressing the maternal mortality crisis. (Examining solutions such as the midwife model used by our international peers, an increase in reproductive healthcare centers, and a postpartum support system.)
Ban on direct-to-consumer pharmaceutical advertising
The exclusion of dental, vision, and mental healthcare from the rest of healthcare coverage needs to end. That means one single coverage for everything health-related.
Expanding public hospitals, clinics, and medical facilities in underserved areas (such as rural communities), and preventing the consolidation of healthcare providers. This includes expanding access to specialists such as ob-gyns.
Increased research to study the effects of Long Covid and provide symptom relief
Studying the effects of currently illegal drugs such as psychedelics to determine use for medical and/or recreational purposes
Increased transparency around health cost “estimates” and investigating significantly inflated costs
Providing more free, public spaces for adults to exercise and play sports
Increased job protections for those caring for ailing family members. People have been fired from their jobs before for things like missing work to take their child to the hospital for cancer treatment. That should not be allowed.
Expanding nursing schools to address shortages, in addition to creating a better workplace for nurses so they feel happy in the profession.
Expanding access to sexual assault nurse examiners, which many hospitals currently lack
Increased diversity in medical staff. There are some diseases, like sickle-cell anemia, that affect one group of people much more than another. Certain doses of certain medications affect men and women differently as well, with potentially deadly results. Having an intuitive understanding of these nuances will reduce deaths and complications, and create a better relationship between patient and health provider.
Creating greater incentives for students to become primary care physicians
Expanding global vaccine distributions to prevent deaths worldwide
Increasing the number of mental health professionals
Expansion of pharmaceutical price negotiation