2020 Presidential Contender Former Colorado Governor John Hickenlooper on Community Health Centers, Health Equity and Safer Gun Laws

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Moderator: Welcome to Conversations on Healthcare, with Mark Masselli and Margaret
Flinter. A show where we speak to the top thought leaders in health
innovation, health policy, care delivery and the great minds who are shaping
the healthcare of the futur e.

T his week Mark and Margaret speak with Formal Colorado Governor, John
Hickenlooper, who is among the candidates running for the Democratic
Nomination for the 2020 Presidential race. Governor Hickenlooper talks
about his focus on expanding access to heal thcare for all Americans and
especially those in rural parts of the country; addressing the Opioid crisis and
the nation’s gun violence issue as well.

Lori Robertson also checks in, Managing Editor of FactCheck.org looks at
misstatements spoken about healt h policy in the public domain, separating
the fake from the facts. And we end with a bright idea, that’s improving
health and wellbeing in everyday lives .

If you have comments, please email us at www.chcradio@chc 1.com or find
us on Facebook or Twitter, iTunes or wherever you listen to podcast. You can
also hear us by asking Alexa t o play the program Conversations on
Healthcare. Now stay tuned for our interview Governor John Hickenlooper
here on Conversations on H ealthcare.

Mark Masselli: Welcome to Co nversations on Healthcare I am Mark Masselli.

Margaret Flinter: I am Margaret Flinter.

Mark Masselli: And we are speaking today with former Colorado Gov ernor John
Hickenlooper , Democratic candidate for the 2020 Presid ential Nomination .
P rior to serving as governor , h e was the mayor of Denver, Colorado and he is
trained as a geologist. He turned entrepreneur launched a brewpub in
Denver, which expanded nationally. He earned his undergraduate degree in
English and his Ma sters degree in Geology at Wesleyan University . And while
he was at Western University , he is one of the founding fathers of the
Community Health Center which produces Conversations on Healthcare .
Governor Hickenlooper, welcome to Conversations on Healthca re.

John Hickenlooper: Well it’s so great to be with you and thank you for not just for having
me on the show, but for all that you ha ve done at Wesleyan which is a place
that, it really is about innovation and entrepreneurs are people that create
innovati on and that's what you have done here. I would argue maybe it’s no
accident that the Community Health Center and your reach in so many of
these facets of healthcare happen so close to a really innovative school .

Mark Masselli: Fertile ground here. Governor you have been traveling around the country
and you have been talking to average citizens about your candidacy and one
of the topics that comes that you were raised by a single mom, your dad died
when you were eight years old. I am wondering if you could t ell our listeners
about your childhood experience and how they ha ve formed your values and
impact your campaign today ?

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John Hickenlooper: And it’s interesting, the Roundtable that we had with some of the
practitioners and clients a t the Community Health Ce nter, had people talked
about adverse childhood experiences . M y father got sick I was four; intestinal
cancer back when they didn’t really know how to deal with it ; they just went
in and kept cutting out more of it, but then he always had infections of one
sort of another; just really a hard time for a kid . I just turned 8 when he
passed away . It really took me a couple of decades to kind of process through
that ; I never really connected that experience to why I was ; I ha d so little
confidence , why I, even though I was an extrover t I couldn’t go up and talk to
the kids .

And certainly as we understand more about the psychology of adverse
childhood experiences and how they have a long tail right , it is interesting to
see places like what the Community Health C enter is doing where you are
merging together this notion that someone who is going to see a kid about
maybe a dental visit or they have got a cold or whatever a nd yet right there
on that day , t hey can s ee s omeone who is a behavioral specialist . I can't wa it
to see the data that you guys collect over the years of getting that rapid
interventi on and just having a difference. C learly my gut feeling is it will make
a huge difference .

Margaret Flinter: A bsolutely . I am going to pivot a little bit if I can from th at and I
always appreciate your sharing , your personal story t here I think it rings true
with people. Everybody experiences loss , but you have made it onto
Wesleyan that you went from English to Geology and you West as so many
people have over the years ; became a G eologist and were laid off and you did
something incredibly creative started a brewpub back when there was not a
brewpub on every corner of every major city . I have always admired how you
created a neighborhood and then revitalized a business co mmunity and you
took that national . How does that experience as a small businessman and
then somebody helping other small business people kind of influence , what
your thoughts are in this political campaign ? W hat do you bring to politics
from that experien ce ?

John Hickenlooper: I guess in a funny way , w e all are descendents of our previous
experience and certainly when my mother was wi dowed twice before she
was 4 0 and she would t ell us you can ’t control what life throws at you, but
you can control how you r espond . W hen I got laid off in Colorado there were
no other Geology jobs 10,000 Geologist got laid off , no one was hi ring. That’s
why I had to do with that and my mother's lesson right and she never
complained , she was just very flinty . And you know that m odel really serve d
me well, because it took a couple years to get that brewpub started . We
th
were the 12 brewpub in North America and people didn’t know what it was .
And so often with entrepreneurs that there really is white space out there ;
people haven’t seen this before. You have to sell something, but it's the
innovation , it’s something they have never seen before so for many people
it’s hard for them to believe or invest in something that they have never
experienced .

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B ut those experiences of getting th e other restaurant owners in lower
downtown Denver to work together , collaborating and really building that
neighborhood and then going up to the city and becoming Mayor and then
getting all the suburbs to work with the city . W e got all 34 Mayors to suppor t
a Transit Initiative right what we call Fast Tracks but you know 34 Mayors, 21
Republicans all support a major tax increase to build Fast Tracks a s the most
ambitious transit initiative in modern US history and we were united . T hen
when I ran for Governo r in 2010, I became the First Denver Mayor in a 120
years to get elected governor , that’s how wicked the animosity had been . But
on a state level , w e did the same thing , we said we are going to lift everyone
up and we weren’t going to leave behind the rura l areas . B y the end of 2020
Colorado would be the first state with high - speed broadband in every city
and town . We have had the number one economy the country according U.S.
News & World Report but w e think for 2018 , w e will have the number one
rural econo my and I think that almost means more to me that we all one we
want to make sure we don't leave behind some parts of our of our
population.

Again o ne of the things about the Community Health Center Movement is
you guys are pioneers in telemedicine , pioneer s in making sure that we get
good health care coverage in the rural parts of America . Y our models of
family nurse practitioners , telemedicine , t hey are ways of providing high
quality excellence, but at the same time finding ways to do it in rural areas
whe re you can do it and still be cost - effective .

Mark Masselli: Now I want to talk a little bit about healthcare access because it seems that
through the lens of being raised by a single mother and I would say our
experiences that single mothers have difficul ty accessing healthcare , but also
small businesses have to make decisions between investing capital and
paying good wages and providing good benefits and that's been an historic
problem . B ut the third point just talked about rural communities. How have
tho se shaped your thinking about what you would like to see happen a s you
think about the country as a whole ?

John Hickenlooper: I think America is transitioning to a place where healthcare is a right in
this country . A nd where are those places where we have the great est
challenges in single moms obviously so often are working multiple jobs ;
certainly teenage mothers who are single moms .

One of the big programs we pushed in Colorado part of our healthcare has
always been that women have authority , they get to control their own
healthcare , that they get to control their own bodies . And remember there
was a book when we were kids Our Bodies Ourselves is still in print.

Margaret Flinter: Still there.

John Hickenlooper : Right, but that's the foundation of that bel ief. We provided 15 to 25 -
year - old young women t he access to total healthcare before the included
family planning so they could decide when they want to have a family . I f you

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look at the statistics that have come out of this , again we have provide d long -
ac ting reversible contraception ; w e reduced teenage pregnancy and teenage
abortion by 60% . S o often before that intervention a young teenage mother
of 17 or 18 would have a second child as a single mother before they turn 20 ;
we really have interrupted that cycle .

In a very similar parallel way , small businesses have different challenges
people don’t realize how much harder it is to start a small business today . F or
the last 50 years , w e have been allowing more and more mergers and more
and more acquisitions we have had one more and more red tape and so the
would be entrepreneurs are more and more choosing not to start a business .
Think about hardware stores , it used to be, hardware store was a great small
business people would have. 84% of the hardware stores in the country are
owned by two companies . W e ha ve allowed these large corporations to
dominate industry after industry for 25 years now . We have seen a decline in
the number of new businesses created and that hurts jobs , it hurts upward
mobility , it incr eases the income inequality that we have seem ed to be
accepting .

And that same structure , guess when you are talking about rural healthcare ,
t he deck is stacked against rural communities as we have become more
sophisticated in our healthcare. Some of these wonderful miracle scans and
tests and images we can do , t hey a re not available in far too many rural
communities. Why are we allowing our rural communities to continue to fall
further behind in broadband you know I a m always , I was beating my chest ;
Color ado will have br oadband in every city by the end of 2020 that’s not
happening everyone in the country. We have to look at not just to make sure
that healthcare is freely available in rural parts of America but they a re not
paying through the nose for their insurance and their coverage which
certainly in Colorado , w e continue about that . A gain Community Health
Centers are one of the key constituents in providing affordable rural
healthcare and in many cases it allows small businesses to offer portable
benefi ts right in other words, their healthcare can go with them, portability ,
the affordability , t he quality and excellence .

Margaret Flinter: I want to ask you about something that is on our minds almost all the
time and that’s the opioid crisis . I n the last s everal years , it has burst upon
the national scene , communities all over ; certainly calls for a strong national
response . And I a m wondering what do you think we ought to be doing as a
country about the opioid crisis ?

John Hickenlooper: Well, first we have to recognize there were some bad actors in the
pharmaceutical industry who convinced us that pain mitigation should be one
of the highest most important elements of our delivery of healthcare. They
also were persuasive , c learly that you can diminish this pain with no or very
small risk of a -- .

Margaret Flinter: And the provider in the field, absolutely.

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Mark Masselli: I mean we got to call that out and I think there obviously need to be legal
consequences.

John Hickenlooper: We need to address the reality that we are in a difficult period in this
country where mental health issues have risen to the surface. 2012 when I
was part of the N ational Governor ’s Association, myself and Governor
Bentley of Alabama chaired Opioid Task Force . S o making sure that your
pharmacies, your drugstores, they a re all connected it with technology so
that , someone is trying to take one prescription and get more Vicodin or
Percocet , they can't do that . How do you make sure people realize that the
stuff sitting in their medicine c abinet can be stolen by their teenage kids and
sold, all that stuff is real. But I think this epidemic of depression and it's all
across the country , part of it is a function of our income inequality and how
our system of capitalism ha s walked away from be ing a place where anyone if
they work hard can have a chance to pull themselves up the economic
ladder , we have lost that ability . I think it’s also tied in somewhat with our
embrace of technology and certainly within social media , t here's a lot of
suggest ions that there are more h a ters and bullying in the classroom is much
more prevalent than it was. We certainly need to begin providing more
comprehensive behavioral health services in real - time.

Mark Masselli: You know I think you have rightfully connect e d the opioid and in the mental
health issues together . A nd homelessness which you had a big initiative when
you were in Mayor's office as well as Governor , maybe you can address both
the homelessness but also come have out recently with the whole platform
on the issue around guns and maybe take homelessness first , because you
had a big initiative in Denver really trying to end homelessness.

John Hickenlooper: Absolutely , w hen I was Mayor , w e made chronic homelessness a
primary goal . I n five and half years , w e reduced c hronic homelessness by
75% , w got the whole community focused on it, because it is a place where
we have solutions that are cost - effective. I was spending $40,000 to $45,000
a year per person , for the chronically homeless and for $20,000 year m aybe
even $15 ,000 - $20,000 , w e can provide the not only a small apartment but
also wraparound services . S o we can get them counseling for their addictions ,
we can give the m, if they have got mental health issues we can provide them
medical support . J ob tra ining I mean for the chronically homeless , job
trai ning is hugely important on that -- .

And gun safety and this is just so sober that we are now , i f you do define a
mass shooting a s fo ur or more people shot in one incident , we are having just
about one mas s shooting a day ; that should sober anyone . You know we are
trying to take away people's guns and obviously in Colorado , we were purple
state , w e passed universal background checks and limit the size of magazines ,
but we want to go further than that. O ne thing I would like that you know
the nationals health collect data and treat this as a public health issue they
been denied by Congress the ability but I mean we are not trying to take guns
away from people, but if you a re a teenager and you are coming of age you

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want to be able to drive an automobile, you have to study for it and you take
a test and get a license . I think 21 should be the right age for buying a
weapon . And you should have to learn and demonstrate that you know how
to handle a weapon proper ly and you will have a store, the firearms, but also
the ammunition is safe, secure place . B asic blocking and tackling that would
make our society much more secure .

A nd still there's a resistance to it again , t he lobbying efforts behind making
sure that no one is ever prevented from buying a gun , t he moment they want
to . Sure I mean again, almost one mass shooting a day , what more can you
say.

Margaret Flin t er: Well you are visiting a lot of people around the country , think it must
be an amazing opportunity to be a candidate and ha ve the chance to visit
many community health centers and brewpubs , hopefully lots of other kinds
of organizations and communities. If you would just share with us what are
you hearing from people? What do people want to see happen in this country
and what are they worried about it ?

John Hickenlooper: It’s so funny that you phrase it that way, because I was telling
somebody that I feel that it's a great gift I mean really that I go into a
stranger's home , in the center of Iowa and th e re are half - dozen neighbors
t here and within 20 minutes they are telling me their deepest fears and their
wildest dreams. It’s a level of intimacy that even running for governor , I have
never seen . And it’s in Iowa, New Hampshire, and South Carolina , t hes e of
the early primary states that the citizens really take the ir responsibility very
seriously ; that they are out here doing a job interview for each one of these
73 people running -- .

Margaret Flinter: Maybe since -- .

John Hickenlooper: Only 24 people ru nning at this point, but I hear again and again
healthcare , it is probably the first thing that comes up, the re are less people
you care about climate change, but often times they care about climate
change and nothing else for good reason that were within 10 to 12 years of
going into unknown territory right irreversible damage . B ut healthcare
people care about your coverage and making sure their existing conditions
can be taken care of, but it's not just that it's the inflation has spiraled,
peoples co - pays are just going up .

And if I get elected president , I guarantee you I will sit down with all the key
industries right , you have to have the doctors, the American Medical
Association , you got to have the hospital s, you got to have the
pharmaceutical industr y , you get everybody in the room and say, we all have
got to give a little, but there is no reason why a doctor in the hospital can't
tell you what they are going to charge for tonsillectomy. We need
transparency and again for 30 or 34 years the American p eople are
subsidizing and paying a large part of the cost of medical research that
creates these miracle drugs . Once it’s discovered, the price support to make

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that research possible are in place in the United States that the
pharmaceutical companies can g et paid for the ir research. Whereas you
know if you a re someone who needs insulin in Canada versus in New
Hampshire the person in New Hampshire is paying 30 times more per unit of
insulin for that medical drug that miracle drug -- ; and they have already pa id
their part of that research happening in United States. I think that has to
change , it’s going to take some level of government regulation to get back to
a level playing field where the whole world is helping pay for that research .

The other big one an d Mark started talking to me about this maybe 40 years
ago, but the whole thing about our preventative healthcare and why don't
we have a Pres ident’s Council on physical fitness a gain ; w hy aren't we playing
up the importance of activities and recess and ex ercise, physical fitness,
exercise our high schools and our middle schools are training kids at an
amazing level to be of to memorize things and regurgitate . In a funny way we
are almost a filter for the really institutions of higher education. But what we
really should be doing is teaching kids stuff they really need to know, like how
to work in groups , how to solve complex problems , how to innovate and how
to be healthy , in other words, how to exercise and have a fairly simple
exercise regime that they ca n take care of themselves . That has got to be a
huge part of future of healthcare in this country . And in Colorado we have
tied that to the Outdoor R ecreation Industry.

Margaret Masselli: Thinnest state in the country , the leanest state .

John Hickenlooper : The leanest state in the country , but we want to make sure that any
advantage that we have and I think a lot of that ’s in migration , people come
and they love to hike so they come to Colorado. We want to make sure that
we provide incentives and motivatio ns so that people are more active so that
down the road we don't get swept away by this incredible inflation of
healthcare cost.

Mark Masselli: We have been s peakin g today with former Colorado Governor John
Hickenlooper Democratic C andidate for the 2020 Pr esidential Nomination .
You can learn more about his campaign by going www.hickenlooper.com or
you can follow him on Twitter by going to @hickenlooper. G overnor , t hank
you for your public service and for joining u s on Conversations o n Healthcare.

John Hickenlooper: W hat a treat and thank you.

Mark Masselli At Conversations on Healthcare, we want our audience to be truly in the
know, when it comes to the facts about healthcare reform and policy, Lori
Robertson is a n award - winning journalist 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: Social media post wrongly claimed that states legalizing marijuana
al so have legislated that those who use the drug cannot have guns. A ctually a

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long - standing federal law prohibits marijuana users from possessing or
purchasing firearms a s state s continue to legalize marijua na for medicinal or
recreational purposes those state policies continue to conflict with federal
law that ’s because marijuana remains a S chedule 1 drug along with heroin,
LSD and other and is therefore illegal in the eyes of the federal government .

Posts r epeatedly shared on Facebook, however, distort the facts around the
issue and how it relates to gun rights. The post claimed that state that have
legalized marijuana have also barred gun ownership for those who buy or are
prescribed the drug that is mis lea ding , it’s existing federal law, which date s
back to 1968 that prohibit marijuana users from purchasing firearms . F ederal
law prohibits any person who is a n unlawful user out or addicted to any
controlled substance from shipping, transporting, receiving or possessing
firearms or ammunition, regardless of whether his or her state has passed
legislation authorized marijuana use for medical purposes is an unlawful user
of a controlled substance. That means that such a person “ prohibited by
federal law from pos sessing firearms or ammunition. ”

Karen O'Keefe with the advocacy group Marijuana Policy Project confirmed
to us that she didn't know of any state legalizing marijuana and then
legislating to restrict gun access for those who use it. But state lawmakers
hav e acknowledged, it is still a federal offense to possess both marijuana and
a firearm and that’s my fact check for this week , I a m Lori Robertson,
Managing Editor of FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factual accuracy from the c ountry’s
major political players and is a project of the Annenberg Public Policy Center
at the University of Pennsylvania. If you have a fact that you would like
checked, email us at www.chcradio.com , we will have Fa ctCheck.org’s Lori
Robertson, check it out for you, here on Conversations on Healthcare .

Mark Masselli: Each week C onversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives . Of the 6.6 million
births per year in this country over half are unintended and among teens
those rates are even higher. Colorado has been conducting an experiment for
several years to examine what might happen if sexually active teens and poor
women were offered the option of long - ter m birth control such as IUDs or
implants.

Dr. Larry Wolk: The word - of - mouth among st these young women to each other and
the network of support that was built to access this program through the se
clinics really did result in the significant decreases in uni ntended pregnancies
and abortions.

Mark Masselli: Dr. Larry Wolk, Medical Director of the Colorado Department of Health and
Environment .

Dr. Larry Wolk: The resultant decrease is in both categories , p regnancy and abortion ,
w hen you extend this out over an additional year more than 50 % even

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approaching 60% reduction in those unintended pregnancies and abortions.

Mark Masselli: There was a significant economic benefit to the state as well.

Dr. Larry Wolk: We have seen a significant decrease in the number of y oung moms
and kids applying for and needing public assistance. We hope that then
longer term this will translate into better social and economic outcomes for
these folks . A nd amongst young women 15 to 24 , we have seen a decrease in
sexual transmitted infec tion and the rates are now below the national
average .

Mark Masselli: A free long - term contraception program offered to at - risk teens and women
trying to avoid the economic hardship of unplanned pregnancies, leading to a
number of positive health and econo mic outcomes , n ow that's a bright idea .

[Music]

Mark Masselli: You have been listening to Conversations on Healthcare.

Margaret Flinter: And I am Margaret Flinter.

Mark Masselli: Peace and health.

Moderator: Conversations on Healthcare is recorded at WESU at Wesleyan University,
streaming live at www. chcradio.com , iTunes or whatever you listen to
podcast. If you have comments please email us at [email protected]
or find us on Facebook or Twitter. We love hearing from you. The show is
brought to you by the Community Health Center.