After being thrust into the national spotlight following inflammatory remarks made by conservative pundit Rush Limbaugh last March — remarks that garnered national attention even at UR following a professor’s controversial blog post — Sandra Fluke, an attorney and women’s rights activist, spoke at a panel discussion entitled “Sick of it: Issues of Health Care in Contemporary America” on Friday, Oct. 12 during Meliora Weekend.
The Susan B. Anthony Institute for Gender & Women’s Studies (SBAI) presented a luncheon prior to the panel, which featured keynote speaker Deborah Richter, an advocate with Physicians for a National Health Program. UR professors Ted Brown, a specialist on health policy, and Charles Phelps, a University of Chicago-trained economist, joined Richter and Fluke for the panel discussion moderated by professor of medicine Nancy Bennett, which focused on the Affordable Care Act (ACA), women’s rights and the future of American health care.
Bennett begean by asking panelists to explain what they see as the positive and negative aspects of the ACA.
Fluke said that she thinks a positive aspect is that it extends effective insurance coverage to many people, but on the negative side, cost control is not a large enough component. She also said that the current debate among states about the expansion of Medicare to 138 percent of the poverty line will show whether or not the overhaul will be successful and praised the expansion of preventive care for women, children and families.
Richter said that she does not think the ACA goes far enough, stating that she believes on a state level it will be more effective. Phelps said that he thinks there is “a lot wrong but a lot good” in the ACA and lauded the clause about pre-existing conditions, which he said has “barely gotten any attention,” but is “extremely important.”
“It has lots of important things,” Brown said, but added that “it’s a patchwork on an already patched system.”
There are no effective cost control measures built into the ACA and premium rates have continued to rise, Brown said. He imagines that it will end up analogous to employment-based insurance policies seen in the 1940s and 50s as an alternative to the politically unacceptable single payer option. He thinks that a single-payer Medicare for all systems is the only possible solution if this one fails.
The moderator then asked where the panelists think insurance will go as a result of the ACA.
Phelps said that he is against employment-based insurance policies, but failed to elaborate on a system he found workable.
Richter said that allowing employers to decide presents problems for people with chronic conditions.
“The direction we’re headed now is bad because we’re allowing privilege where it’s not needed,” Richter said. “We can do it with public financing of healthcare. A for profit system is not going to work.”
Bennett then brought up the issue that likely drew many to attend the panel, given Fluke’s presence — women’s health and where it stand in the United States.
Fluke described the country’s current state as “rough,” noting the recent “major cuts to reproductive health services” and “unprecedented” legal limiting of rights.
“It’s not been a good two years,” she said, adding that on the upside, people are becoming more “aware and engaged” in the trend.
“Hopefully we’re turning a corner,” she said.
Fluke referenced two key acts that have a “major impact” and are currently up in Congress — an act preventing violence against women and an act against sex trafficking.
Following this, Phelps remarked that the problem with having a single payer system is that the government decides on benefits; there is a risk to having single point control because there is no guarantee that the government will get it right, he said.
To this, Fluke commented that we are already facing concerns without being in a single payer system, noting that it became legal this year to allow employers to restrict certain aspects of coverage. Turning the decision over to the government or to employers is equally as egregious, she said.
Bennett then asked how the panelists think the system will address the social and behavioral determinants of health.
Phelps referenced the fact that drunk driving has been radically reduced in recent decades, which was “socially changed” — largely the result of Mothers Against Drunk Driving (MADD) and “nothing to do with health care.” Prevention has not been built well into the system, he said.
Richter said that for preventative regulation it’s necessary to have a public invested in the outcome.
“We need to make health care a public good,” she said.
Brown countered Phelps’ point by sharing the example that in the 1990s a government agency was involved with the campaign to reveal the actions of the tobacco companies, which he called “involving the public through the government.” His comments raised a discussion about who should act first, as the government can do little until the public does something, with the moderator raising the issue of taxation.
Fluke then said that she thinks it is necessary to invest in “making it possible to engage in healthy behaviors,” such as encouraging primary care physicians to ask about experiences of violence during regular visits.
During a question and answer session that followed, audience members posed questions that spurred dialogue on topics including disparities in health as observed in inner city areas, the fact that many primary care physicians are trained in foreign schools and are foreign born, global budgeting, prescriptions and generic brands and abuses of emergency medical services in cities.
Following the panel, Fluke noted that while she “knows and is aware” of the controversy surrounding UR professor Steven Landsburg’s controversial comments about Limbaugh’s remarks, which included his labeling of her as a “slut” for advocating for contraception, this was not what brought her to UR. She was in Rochester campaigning for Democratic Congresswoman Louise Slaughter, and encouraged all students to go out and vote in the election.
“I was honored to be invited to speak on the panel,” she said. “It was an interesting, really respectful dialogue.”
Student reception seemed equally positive.
“The panel had great dialogue and was extremely informative,” sophomore Brianna Isaacson said. “I was very impressed by the whole thing and thought that the [SBAI] did a wonderful job organizing the event.”
Senior Hilary Wermers, who is the student assistant for the SBAI, said she was “very pleased” with the panel, which drew about 200 people.
Stephen Supoyo ’10, who said he came to the panel to see Richter because of her health care work in Vermont, said he thought the panel was “really interesting” and presented a “broad view” of the issues. He noted that he liked the addition of an economist.
“If you’re going to advocate for a single-payer system, you have to see the different sides,” he said.
Buletti is a member of the class of 2013.