Fighting for America’s Health: Debra Ness, President and CEO of the National Partnership for Women and Families

Debra Ness

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Mark Masselli: This is Conversations on Health Care I’m Mark Masselli.

Margaret Flinter: I’m Margaret Flinter.

Mark Masselli: Well Margaret interesting development and omit the opioid crisis the US
Surgeon General Dr. Jerome Adams has issued a national advisory to the nation that all
people who are close to someone at risk for overdose be equipped with a ready dos e of
Naloxone, the highly effective antidote to overdoses. It’s an interesting idea in the wake
of the opioid crisis which shows no sign of slowing down.

Margaret Flinter: Well Mark it’s an absolutely pragmatic idea. The responsibility for this
has fal len on first on first responders both the police and of course the EMTs or call to
the scene of an overdose. Communities are overrun with the opioid crisis, budgets are
being tapped out just from stockpiling the Naloxone which is also known as Narcan and
perhaps most importantly there can be lag time between a 911 call placed by a family
member, a friend or a loved one or even a bystander and the Naloxone being
administered in time. Having friends or family members nearby who are equipped and
trained to a dminister the antidote has save lives and would save more lives if we
followed the surgeon general’s recommendation.

Mark Masselli: Margaret it’s a terrible tragedy that roughly a 115 people are dying by
overdose every day in this country. The surgeon ge neral noted that while policy makers
are working to put better strategies in place to address the overall crisis, this will save
lives in the short run.

Margaret Flinter: Mark this conversation reminds me of a former guest on t he show Dr.
Leana Wen, remem ber?

Mark Masselli: Oh yes.

Margaret Flinter: Baltimore’s health commissioner. She issued a standing prescription
all of the region’s pharmacies for anybody who wanted to obtain the Naloxone. They’ve
actually had to start rationing the antidote in thei r city which is just unconscionable in
midst of this public health crisis.

Mark Masselli: The amount of money being spend on rehab for those struggling with
addition has gone up noticeably in the past year. Insurers have been reluctant to
approve paying in for rehab and other mental health services, so this is a positive
change.

Margaret Flinter: Speaking of insurance coverage Mark the administration cut this past
year’s open enrollment period in half and spent very little money marking the Affordable

Debra Ness

Ca re Act. According to the latest numbers, about 400,000 fewer Americans signed up
for health coverage and that is of great concern to us as well as to our guest today.
Debra Ness is the President of the National Partnership for Women and Families, and
her organization was instrumental and helping to craft a number of key elements of the
Affordable Care Act. We’re very interested to hear her thoughts on the current state of
health reform in the United States.

Mark Masselli: We’re also interested in listen ing into Lori Robertson who stops by,
she’s the managing editor of FactCheck.org. No matter what the topic you can hear all
of our shows by going to chcradio.com.

Margaret Flinter: As always of course if you have comments please email us at
[email protected] or find us on Facebook or Twitter because we love to hear from
you. We’ll get to our interview with Debra Ness of the National Partnership for Women
and Families in just a moment.

Mark Masselli: First here is our producer Marianne O’Hare with this week’s headline
news.

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Marianne O’Hare: I’m Marianne O’Hare with these health care headlines. What is the
most concerning topic of the minds of American voters? In the HuffPost YouGov poll of
a thousand US adults. Health care topped all other subjects as primary concerns for
those planning to vote in the upcoming election. According to the poll 30% of those poll
listed health care as their number one concern gun legislation and immigration received
about 2 5% each. Democratic pollsters have been gazing Americans reaction to the
merit attempts by the GOP leadership to undo the Affordable Car Act which has actually
steadily gained in popularity among Americans over the past several years.

Meanwhile, according to a Kaiser Family Foundation poll most Americans who
purchase insurance coverage on the exchanges say health coverage and the peace of
mind from being covered are the primary reasons why they purchase coverage not
because of the individual mandate that r equired all Americans to have coverage or pay
a penalty. A majority of those poll however are worried about what will happen to their
health coverage as they watch repeated attempts to undermine the law.

Meanwhile, Virginia appears poised to enact Medicai d expansion in that state which
could lead to health coverage for some 400,000 poor and working poor residence in that
state, enough republican voters in the state have switched away from the party line to
endorse the measure. Two republican state senator s have said they will vote in favor of
Medicaid expansion, if approved Virginia will become the 34 state to expand Medicaid
under the Affordable Care Act. Health care spending meanwhile does continue to be a

Debra Ness

cause for concern for all health consumers and state governments. California is
launching a measure a bill that would give the state power to set health care cause
across the board for hospital pricing to doctor’s visit. They are expecting a significant
pushback and powerful battle from the hospital and medical lobbies. I’m Marianne
O’Hare with these health care headlines.

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Mark Masselli: We’re speaking today with Debra Ness President of the National
Partnership for Women and Families, nonprofit, nonpartisan advocacy group dedicated
to promot ing fairness in the workplace and access to quality health care for all. Prior to
that Ms. Ness served as Executive Vice President of the National Partnership. Ms.
Ness served on the Executive Committees at the Leadership Conference on Civil and
Human Ri ghts and is a member of the Board of Directors at the National Committee for
Quality Assurance NCQA. She earned her undergraduate degree in psychology and
sociology from Drew University and her master’s of science from Columbia University
School of Social Work. Debra welcome to Conversations on Health Care.

Debra Ness: Thank you for having me.
th
Mark Masselli: We just mark the 50 anniversary of the assassination of Dr. Martin
Luther King Jr. who said that of all of the forms of inequality injustice health care is the
most shocking inhumane. For nearly 50 years your organization has been advocating
for policies that eliminate heal th disparities and really focused it on women and children.
You’ve been a major force behind many important policy initiatives that have advance
the cause of health equality in this country. I wonder if you could highlight some of the
most important heal th care issues women have faced in what role the National
Partnership for Women and Families played in addressing some these issues.

Debra Ness: Well I’ll start by really reinforcing what Dr. King said, it’s unconscionable to
think about people not gettin g basic health care they need in a country like the United
States of America. When I think about the progress that we’ve made particularly from a
women’s lens there are quite a number of really important steps we’ve taken, Supreme
Court decisions like Roe v. Wade giving women the ability to have autonomy over their
reproductive health and destiny. Most women understand how important access to
contraception and family planning services, access to safe legal abortion services if
needed, it affects your educ ation, it affects your ability to be in the work place. I think
about Medicare and Medicaid as two extraordinarily important programs in ensuring that
the people in this country get health care regardless of income. If we didn’t have
Medicare in place, w hen you think about how many people struggle to make ends meet
when they retire. If you had to add the complete cause of health care to that so many
more people would be living in poverty particularly women.

Debra Ness

Medicaid is an enormous part of our health care and that it is responsible for paying for
more than half of the births in this country. It also paid for the – it’s the primary funder of
family planning services for women in this country, and it also covers the other end of
the spectrum. It’s the prim ary source for paying for nursing home care. Talking about
the progress we’ve made, the Affordable Care Act the ACA that too was an
extraordinary breakthrough for this country. It expanded c overage for millions of
people, and it also expanded Medicaid fo r millions, and it became an important way of
lowering what was really a pretty shameful uninsured rate in this country. We’re fighting
still, sometimes to hold on to what we’ve already gotten as much as we’v e gained in the
way of coverage, one of the thi ngs that we’re painfully aware of is the extent to which
we have real disparities in how people get health care is how they fair with that health
care across gender and across race and ethnicity and socioeconomic lines.

We know that in the United States bl ack women are three to four times more likely to
die from a pregnancy related complication than white women. We know there are huge
gender disparities, so women in pain are much more likely to get sedative while men
are much more likely to get actually pa in medication. In the last year we have spent an
enormous amount of time fighting the legislative repeal of the Affordable Care Act which
would have taken coverage for millions of people. We are still fighting to protect the
ACA but the administration th at we have now is using all sorts of regulatory ways to
actually undermine that coverage, and they couldn’t get where they wanted to go on
outright repeal of the law. Instead they’re doing what we would refer to as regulatory
sabotage. We have a huge amo unt of work to do, health care is an extraordinarily
important piece of the puzzle that goes into women being able to achieve equity and all
families being able to achieve economic security in this country.

Margaret Flinter: Well Debra it seems like we’v e made progress on the policy side, we
also made a lot of progress just on the science side. We would say we have far safe
way far more effective methods of contraception, safer ways of getting them to women.
Without the Affordable Care Act and some of t he changes that came along that people
aren’t always so mindful of like the equal treatment of women in terms of the cost of
health insurance. The inability to exclude people for preexisting conditions, these are
big things that I’m not sure the public st ill realizes how much of a gained this
represented for women. I wonder if you could speak about those two issues
specifically.

Debra Ness: Within our by definition pretty disadvantaged by the fact that they are both
the primary users of health care becau se of their reproductive health systems and
because they live longer they use more services than men, they tend to be more prone
to certain chronic diseases. Prior to the ACA they were automatically charged more for
the health care coverage that they need ed. Just by virtue of being a women you are
automatically charged more for an insurance plan than men were. That became illegal

Debra Ness

under the ACA, another thing that happened under the ACA is that there was no longer
the possibility of plans capping your cov erage at a certain amount. Imagine if you’re a
woman with cancer and you get pretty far into your treatment, now you’re supposed to
have chemo or radiation and your plan tells you that sorry you’ve now exhausted your
benefits and you’re out of luck. Pree xisting conditions hit women particularly hard, they
were including in that definition of preexisting conditions things like Cesarean infection.
If you had a C - section you are considered somebody who had a preexisting condition.
If you had been the victi m of domestic violence, they were considering that a preexisting
condition. Another thing that the ACA did was that if you have a health plan you have to
cover certain basic benefits, certain categories of coverage, and that was really
specifically import ant to woman because one of the things that health plans would often
leave out of their coverage especially on the individual market was maternity care.

In the individual market if a woman wanted a plan with maternity care usually they were
priced so high they were unaffordable or they had things lik e a 17,000 dollar deductible
before you even got any reimbursement, so it made maternity coverage out of reach.
All of those were important gains we’ve made through the ACA, and it really meant that
when you ar e getting coverage you are going to get meaningful coverage. The ACA
has a provision and it say but you cannot discriminate against people based on their
gender but also based on their race or ethnicity or sexual identity or disability. That was
going on , and it’s one of the reasons why we’re working so hard to preserved protection
in the ACA.

Mark Masselli: We’re speaking today with Debra Ness President of the National
Partnership for Women and Families a nonprofit, nonpartisan advocacy group dedicated
to promoting fairness in the workplace and access to quality health care for all. You
have been working hard on so many fronts and I was amaze to know that the
organization was a key player in the passage of the HITECH Act. Over this past 10
years there’ s been this incredible transition from paper records to electronic health
records and I’m wondering if you could talk to our listeners about the role you played
and continue to play as we watch the health industry move into the digital age.

Debra Ness: We have been involved in that as a policy advocate, we formed a coalition
of many consumer groups to work with us on this issue. We had a lot of influence as
the HITECH Act was rolled out and helping to shape the policies and focus of that law.
We believed it was really important for the medical world to come into the modern age,
there is no other industry where we’re still doing things on paper. In fact health care has
advanced so much and gotten so complicated, it’s very dangerous to be doing
everything on paper. From a safety and quality point of view think about how important
it is that when you go to a doctor in one place for one thing that there’d be a record of
information that that doctor can easily access to know what other things might be going
o n in your health record. Medication interactions, whether or not you’ve had certain

Debra Ness

test, whether you have other kinds of conditions. Having the right information at your
finger tips when you’re treating somebody is a question of safety, it’s also a ques tion of
coordination, it’s still a pretty fragmented system and often one hand doesn’t know what
the other is doing and that means it becomes the patient’s responsibility or a care givers
responsibility to tout paper records from one doctor to another.

Think about the burden and amount of error that can creep into the process, and it also
causes enormous cost to the system and hassle, how many people get repeat test or
unnecessary producers or wrong diagnosis. Think about the cost of the patient to the
s ystem to the employer or the government, and think about the burden in today’s busy
world of people trying to do all this coordination and getting their doctors to
communicate with each other. We knew that from a safety, a quality and a cost
perspective i t was important to move in this direction. We also knew that we live in a
world where people increasingly are being ask to make decisions, tough decisions
about their health care and actually put a lot of money into their own health care. You
want to kno w what’s going on with you, you have a right to know like why is the doctor
making certain recommendations. All of that comes with having better access to
information and that only comes if we can get things digitalized.

Margaret Flinter: You know Debra another area where there’s been progress but more
work needed, and that your organization has dedicated a concerted effort is the whole
issue of medical and family leave protections for tens of millions of American workers
and their families and of course this is especially true for low wage workers. I know that
you have been able to make some progress in a number of states to provide vulnerable
workers with paid sick leave, tell us about those efforts and some of the successes
you’ve achieved on that fron t?

Debra Ness: Well, we live in a world where most adults work and there come times
when people get sick, when people need time in order to either take care of themselves
or their loved ones. We’re really proud of being of the group that passed the Famil y
Medical Leave Act now 25 years ago, but that was unpaid leave and still the people who
really needed to use it so many of them can’t afford to take it because it’s paid. It only
covers large employers, so what do you do when you get sick or you need pre ventive
health care or your kids need to get immunize, what do you do when your child is sick?
If you’re somebody who is a low wage job where you’re unlikely to have any paid sick
days at all, that’s like 80% of low wage workers don’t have a single paid s ick day.

You’re often making a choice between whether you stay home with your sick child or
you potentially lose part of your paycheck or your job. We are fighting for people to
have the right no matter what kind of job they’re in to earn paid sick days. Right now we
have been successful in nine states plus the District of Columbia and 32 local
jurisdictions. We’re making progress, but we really need a national paid sick days law

Debra Ness

and the other thing we need is paid family and medical leave. We really all need the
ability to take paid family and medical leave when there’s a crisis. We’ve made
progress in some states, we have five states that will have paid state leave laws of their
own but that’s still a far cry from everybody in this country, and it’s wh y we need to pass
something called the family act which would guarantee paid family and medical leave
for everybody.

Mark Masselli: Debra listening to the great that you’re doing, tell us about how people
engage your organization and how they might join i n on the causes?

Debra Ness: Well I would say please come to our website nationalpartnership.org,
there’ s lots of opportunity for action and we’d love for you to sign up for our emails and
we’ll put you to work. You can follow us on Twitter it’s Twitter @NPWF.

Margaret Flinter: Great, we’ve been speaking today with Debra Ness President of the
National Partnership for Women and Families a nonprofit, nonpartisan advocacy group
that’s dedicated to promoting fairness in the workplace and access to quality he alth care
for all. You can learn more about their work by going to nationalpartnership.org or
follow them on Twitter @NPWF. Debra thank you for your advocacy, for your work and
for joining us on Conversations on Health Care today.

Debra Ness: Thank you so much Margaret and Mark it’s been a pleasure.

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Mark Masselli: At Conversations on Health C are, we want our audience to be truly in
the know when it comes to the facts about health care reform and policy, Lori Robertson
is an award - winning journal ist and Managing Editor of FactCheck.org, a non - partisan,
nonprofit consumer advocate for voters that aim to reduce the level of deception in U.S.
politics. Lori, what have you got for us this week?

Lori Robertson: This week we’ll turn to the public healt h issue of guns. Our readers
asked us if the Obama Administration had legalized bump stocks for semi - automatic
rifles, as President Trump claimed in a tweet. Well no federal law explicitly addresses
bump stocks. The Bureau o f Alcohol , Tobacco , Firearms and Explosives ruled 10 times
between 2008 and 2017 but certain models could not be prohibited under existing gun
laws. A bump stock is a device that can be attached to the rear of the semi - automatic
rifle to make it shoot almost as fast as a fully automa tic weapon. The device has
became part of the gun debate in October after 64 year old Stephen Paddock used AR
style rifles fixed with bump stocks to shoot people attending an outdoor concert in Las
Vegas killing more than 50 people. That issue is whether the devices meet the
definition of machine gun under federal firearm laws which have prohibited the transfer
and possession of a machine gun since 1986.

Debra Ness

Federal law defines a machine gun as a weapon that quote, “Is design to shoot, to
shoot automatically more than one shot without manual reloading by a single function of
the trigger.” It’s true that under Obama the ATS ruled that it could not prevent the use
of certain models of bump stocks , but it also made a similar ruling in April 2017 under
the Trump Administration. The ATS in the late March proposed a rule to clarify that a
machine gun does include bump stocks type devices. Gun rights groups and advocates
however had said that any final rule could be challenged in court. That’s my fact check
for t his week, I’m Lori Robertson, Managing Editor of FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factual accuracy from the country’s
major political players and is a project of the Annenberg Public Policy Center at the
University of Pennsyl vania. If you have a fact that you ’d like checked, email us at
CHCradio.com we ’ ll have FactCheck.org’s, Lori Robertson, check it out for you, here on
Conversations on Healthcare.

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Margaret Flinter: Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Each year more than one
million babies die at birth and another three million die within the first few weeks of life.
When babies are born prematurely the risks escalate. Newborns and particularly
preemies have a considerable amount of difficulty regulating their own body
temperature, and without access to incubators babies in the third world often succumb
to hypothermia. That got former Stanford MBA student Jane Chen thinking how do we
develop a low cost solution to the problem.

Jane Chen: Something that could work without electricity. We needed something that
was portable something that could be sterilized and reused across multiple babies, and
something ultra low cost compare d to the 20,000 dollars than an incubator in the US
cost.

Margaret Flinter: Speaking at a recent TED Talk Chen said that they developed a
cocoon like device called simply Embrace, a thermal body wrap that encases the baby
and helps regulate body temperature for up to six hours.

Jane Chen: Looks like a small sleeping bag for baby it’s waterproof, but the magic is in
this pouch of wax. It’s a wax like substance with a melting point of human body
temperature. You can melt this simply using hot water and then when it melts it’s able
to maintain one constant temperature for four to six hours at a time.

Margaret Flinter: Chen and her developers have managed to keep the cost of the
Embrace baby warmer at around 25 dollars per unit. Since launching the product i n
2010 they estimate that over 150,000 babies lives may have been saved with the

Debra Ness
device. A low cost, high tech portable temperature regulator design to regulate
preemies body temperatures to ensure that they not only survive premature birth but
ultimately thrive as well, now that’s a bright idea.
Margaret Flinter: This is Conversations on Health Care I’m Margaret Flinter.
Mark Masselli: I’m Mark Masselli, peace and health.
Conversations on Health C are broadcast from WESU at Wesleyan University,
streaming live at www.wesufm.org and brought to you by the Community Health Center.