Hello 14

Dear Readers,

​Book Review 

MARCHING TOWARD COVERAGE, How Women can lead the fight for Universal Healthcare, by Rosemarie Day

Have you ever felt invisible, discriminated against because you couldn’t pay, or worse, suffering without hope? This is how people with no health insurance feel. In America twenty-eight million women, men and children experience this many days. And most are working!       We can FIX this!

Rosemarie Day's first book thoroughly examines the political, operational, and financial costs of universal healthcare, along with the benefits. She explores the relationship between national values and healthcare as a human right in the same way as education, housing, and food. Day advises the US to find a consensus that healthcare is a human right before beginning to discuss the specific details of a universal healthcare program. She asks, "Do we want to make healthcare a right like education? Or keep it as a commodity, like a car?" 

The history of health insurance in the US and other developed countries is reviewed and dispels the myth that other developed countries have only government-owned health systems. Most have a combination of employer-sponsored and public programs. Day proposes that since 49% of US residents are already covered by employer-sponsored health insurance, the combination of private and public coverage would make the most sense for the US. Medicare and Medicaid and other public programs cover 36%. Individual plans cover 6%, which leaves 9%, or twenty-eight million Americans who need health insurance.

The US currently spends $3.65 trillion on healthcare. Day identifies three possible ways to fund universal healthcare: renegotiate pharmaceutical rates, increase tax rates on top earners and reevaluate defense and prison spending. These and other examples are priority spending discussions worth having. 

In a chapter called "Coverage Alone Isn't Enough," Day challenges the reader to consider the components of American lifestyle needed to support quality health. She calls these components social determinants: education, social supports, racism, pollution, and affordable housing. If your life has all of these components, take a minute and think about what life would be without one or two or all of them. 

According to the Department of Labor, women make 80% of the healthcare decisions in the family. They know first-hand the need for healthcare. When the Affordable Care Act was in danger of repeal in 2017, it was women who made 86% of the calls to Congress defending it, specifically they were concerned about losing family coverage for preexisting conditions. Day suggests that women can stand up again to support universal healthcare. 

Day is well-positioned to write a book on universal healthcare coverage. She is CEO of Day Health Care Strategies, former Chief Operating Officer for the MA Medicaid program and founding leader of the MA Health Connector. 

Day drives this book with facts (many facts), passion, and humor. She includes a comprehensive view of health and systems that keep someone healthy. She reminds us that our future depends on women who are "delivering 100% of the population," then goes on to discuss the underinsurance of maternity healthcare. Concerns for families without adequate maternity coverage are consistent with my daughter's experience. She had a $3,000 prenatal and maternity care deductible, which she kept up with paying during her pregnancy. The day her son was born, she was astounded to learn that his $3,000 deductible kicked in. 

Day is a pragmatist. She believes that even in this environment of political division in our country, there is hope that we will do the right thing. After all, the right for women to vote only passed by one "aye" in Tennessee 100 years ago.

Day wrote this book to activate women to stand up for universal healthcare. "Women are an untapped resource of leadership, voices, donations, and very importantly, votes," she said. In the 2016 presidential election over one-third (42 million) of eligible women did not vote. The book includes a Personal Activism Assessment to determine where the reader falls on the activism wave. It starts with being informed, then to showing up, and finally running for office. Not everyone will take the last step, but supporting other women who run is activism!

The bottom line says Day is, "No one's health is truly a right until everyone has access to good, affordable healthcare." When we prioritize the health of our citizens equal to the economy, twenty-eight million uninsured people become more productive contributors.

I highly recommend this book for women and men. The pandemic is magnifying the need for universal healthcare. Together, we can make it a reality. This is still America, dammit! 

By Elizabeth Kilcoyne, April 19, 2020