The killing of UnitedHealthcare’s CEO has sparked a lot of conversations about political violence and also about health insurance in the U.S. and the many frustrations people have with their coverage.

Today on The Metro, we discuss the state of health insurance and health care in metro Detroit and beyond with three guests; and look at how things like medical debt affect a person’s quality of life. 

Subscribe to The Metro on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

Dr. Elisabeth Rosenthal is the senior contributing editor for health news analysis at the Kaiser Family Foundation. She’s also the author of “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.”

She says health care has placed too much of an emphasis on profits.

“We are talking about not a health care system, as we used to do, but a health care industry,” Rosenthal said. “It’s not a system, right? It’s a bunch of big businesses and poor patients are left struggling in this land of the giants to just get the care they need.”

While medical innovation ranks well in this country, things like insurance coverage, quality, and cost are all pretty bad compared to other First World nations. 

Dr. Abdul El-Sayed, director for the Wayne County Department of Health, Human & Veterans Services, says his department is working with the nonprofit RIP Medical Debt to relieve residents from medical debt. 

“We realized that there was an opportunity for us to step in and take on the scourge of medical debt for our county,” El-Sayed said. “We identified the fact that we ranked No. 8 for medical debt in the entire country, and that this was an opportunity for us to be able to wipe clean $700 million in debt.” 

Oakland County launched a similar program last year in partnership with RIP Medical Debt.

David Kendall, a senior fellow for Health and Fiscal Policy at Third Way — a think tank that champions modern center-left ideas — also joined The Metro to share his ideas on how to improve health care in America. 

He discussed how some states are giving tax exemptions to hospitals extending care to people below a certain poverty level. 

“The thing about it is that Michigan hasn’t done this yet, so about half the states have,” Kendall said. “So if you’re out there thinking about what to do on this issue, that would be a good first thing to contact your state legislator and say, ‘Can we get the hospitals to, you know, provide a certain minimum level of charity care?”

In the second hour of The Metro, we asked listeners:

“Have you ever avoided seeing a doctor or not gotten a prescription because of the cost of health care? Have you ever struggled with medical debt?”

Adam in Detroit said: “My company is located out of Utah, and they don’t cover anything. They don’t cover anything that I actually need. Like, what I will need is Adderall basically, right? But what they cover is the generic version. And right now there’s a shortage of amphetamines in the United States, which is really crazy. So like, I’ll go to the pharmacy after getting this doctor’s visit that was really hard to schedule, and then I’ll go from the doctor’s visit to the pharmacy, and they’ll be like, ‘Oh we don’t even have that.’”

Use the media player above to hear the full conversation.

More from The Metro on Dec 17, 2024: 

• Detroit Youth Choir is ready to strut its stuff and branch out a little bit this holiday season. If you’re not familiar with the young performers, they have lit up stages from “America’s Got Talent” to Carnegie Hall. This Friday, DYC will perform two concerts for audiences. The first half of the concert will include soulful renditions of classic Christmas songs. To discuss the concerts, as well DYC’s new album released this fall, Detroit Youth Choir Director Anthony White joined the show.
• The Michigan Poison & Drug Information Center has seen more and more calls about nitrous use and how it’s making people sick — prompting a new state law banning the sale of nitrous oxide paraphernalia. Varun Vohra, a professor at Wayne State University and senior director of the Michigan Poison & Drug Information Center, joined The Metro to discuss the growing problem.
• Stellantis is going through some changes. The automaker that includes the Fiat, Chrysler, Jeep and Dodge brands among others is going into 2025 without its CEO, Carlos Tavares, who has led the company since its formation in 2021 until abruptly resigning on Dec. 1. Automotive News Executive Director and host of the Daily Drive podcast Jamie Butters joined the show to help us understand what’s next for the company.

Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming on-demand.

The Arab Community Center for Economic and Social Services, or ACCESS, has recently launched a new caregiver respite care program called EXHALE. It’s funded through a $300,000 grant for three years.

Amne Darwish-Talab is the director of Social Services at ACCESS, and she oversees EXHALE. She says the new program supports caregivers through bi-monthly gatherings, connecting to resources and recreational outings.

“We want to do all this with the aim of the program by having caregivers of all backgrounds join fellow caregivers twice a month for connection and support from health providers and other experts,” she shares.

Talab says the program aims to break stigma and stereotypes around caregiving in a culturally sensitive environment. She says in the Arab American culture, caregiving is a family obligation. 

“There’s a stigma around having a non-family member taking care of the elderly in the family, or this also extends to the notion of even placing an elderly in a facility such as a nursing home or rehab or any type of living where they’re going to be living away from the family,” she says. 

Talab says many times family members get burned out and need extra support, but people are hesitant to ask for help for fear of judgement. The EXHALE program aims to overcome stigma by connecting people to culturally appropriate supplemental resources and assistance as needed.

“Society is changing, and the duties of the children or grandchildren or daughters-in-law, or whoever it may be, or siblings, has changed, because the lifestyles have changed, and now most of the family members are working. And sometimes they’re forced to reach out for assistance for their caregiving,” she explains. 

Through the EXHALE program, caregivers receive an annual stipend.

The grant was awarded by the Ralph C. Wilson, Jr. Foundation. ACCESS partnered with the Senior Alliance for this support group.

For more information, visit bit.ly/ExhaleProgram.

“As winter approaches, the horror in Gaza continues to grind on with no end in sight.”

Those are the words of a United Nations official addressing the UN Security Council in November. 

Israel’s war in Gaza, following the attacks last October led by Hamas, has reportedly claimed the lives of more than 44,000 Palestinians and 1,700 Israelis and foreign nationals, the UN reports.

Even before the war, life in Gaza was fragile due to the Israeli blockade and occupation. That blockade deeply affects health care access. 

Recent research in The Lancet found that before the war, 35 hospitals operated at full capacity in Gaza. Those hospitals had roughly 3,400 beds for a population of over two million people.

Now, more than half of Gaza’s hospitals are completely out of service due to Israeli bombardments, according to the United Nations. 

Still, those numbers do not reflect the magnitude of the problem, said Dr. Adam Fahs, a metro Detroit-based orthopedic surgeon and member of Doctors Against Genocide. He said the facilities that are still operating resemble small clinics rather than well-equipped medical facilities.

“These are ‘hospitals’ you can drive by and easily miss,” he said. “I don’t want people to think that these are major Level 1 trauma centers like we have here in the States.”

He said these clinics were already “not fully staffed, not fully functioning…supplies were missing.” 

The Israeli blockade has forced doctors to make impossible decisions: “Now we have to figure out when we’re preparing someone for surgery, do we use sterile gloves for this person, or do we save that for another patient; is this knife blade really needed here? Or can we save this for someone else? These are all things that a hospital trying to take care of maimed and injured people shouldn’t have to be considering,” he said.

Fahs traveled to Gaza last December as the humanitarian crisis unfolded there. During his medical mission in Gaza, Fahs was uncertain he would return to the U.S. alive. 

“I feel that maybe one of the reasons why God did bring me back was that I could share…my account of what happened there, because I don’t think people really appreciate and realize the extent of the destruction that’s happening.”

Use the media player above to hear the full conversation.

WASHINGTON (AP) — The Supreme Court heard the most high-profile case of its term on Wednesday, weighing Tennessee’s ban on gender-affirming health care for transgender minors.

Similar laws have been passed by other conservative-leaning states. Challengers say they deprive kids of treatment they need, while the states defend them as protecting minors from life-changing decisions.

The conservative-majority court appeared ready to uphold Tennessee’s law. It comes against the backdrop of escalating pushback to transgender rights, notably from President-elect Donald Trump.

Here are some takeaways from the arguments:

What did key conservative justices say?

In the arguments on Wednesday, five of the court’s six conservatives seemed skeptical of the argument that the ban on gender-affirming care for minors is discriminatory.

Two key conservatives, Chief Justice John Roberts and Justice Amy Coney Barrett, repeatedly challenged the arguments from lawyers challenging the ban.

Roberts questioned whether judges should be weighing in on a question of regulating medical procedures, an area usually left to state lawmakers. Barrett sounded skeptical of the administration’s argument that the law discriminates because of sex.

Conservative Justice Neil Gorsuch was notably silent, asking no questions.

The court’s other three conservatives seemed to favor Tennessee. The three liberals largely backed the challengers, with Justice Sonia Sotomayor highlighting the risks of suicide among kids with gender dysphoria.

What’s the court’s track record on the issue?

The litigation marked only the second time the high court has heard a case that represented a fundamental test of transgender rights.

In a case involving LGBTQ+ rights four years ago, two conservative justices, Roberts and Gorsuch, joined with its liberals to expand protections for transgender workers. Barrett wasn’t on the bench at the time and had no record on transgender rights.

Gorsuch wrote the opinion, which left open claims of discrimination in other situations.

What happens next?

The court isn’t expected to rule for several months. The decision could have direct effects in the 26 states that have passed versions of the bans, and might have ripple effects on other measures that restrict sports participation and bathroom use by transgender people.

Supporters of the health care laws argue the gender-affirming treatments are risky, and the laws protect kids from making decisions before they’re ready.

Challengers say many medical interventions come with some degree of risk, and families should be able to weigh those against the benefits. The arguments in favor of Tennessee’s ban could also be used to back federal restrictions, said Chase Strangio, the ACLU attorney who represented three families challenging the law.

Tennessee Attorney General Jonathan Skrmetti said that his state’s arguments would still let each state set its own policy.

Reporting by Lindsay Whitehurst, Associated Press

A new program from the Detroit Health Department will provide free rides to doctor visits for new and expectant mothers for one year.

Subscribe to the Detroit Evening Report on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

The “Rides to Care” program will provide all Detroit women who are pregnant, and anyone who takes care of an infant up to one year of age, with free transportation to and from prenatal visits, postpartum visits and pediatric visits for the baby.

The program aims to remove a common barrier to expectant mothers and their babies receiving proper care: access to transportation.

“Every expectant mother and new mom in Detroit deserve the security of knowing they can get to their prenatal or postnatal appointments so their baby can have their best start in life,” said Detroit Mayor Mike Duggan in a statement. “With Rides to Care there is no reason to miss a vital medical appointment, because free roundtrip transportation to every doctor’s office visit is now an automatic benefit to them as a Detroiter.”

The service is available 8 a.m. to 6 p.m. Monday through Friday and 8 a.m. to 2 p.m. Saturdays. Participating residents’ health care providers must be located in Detroit or up to five miles outside the city.

To book a ride, call 313-876-0000.

Other headlines for Friday, Nov. 22, 2024:

• The Toyota Mobility Foundation has selected 10 semifinalists to receive $3 million to participate in its Sustainable Cities Challenge to develop innovative solutions for Detroit’s iconic Eastern Market. 
• The Rink at Campus Martius Park opens for its 21st season on Saturday, Nov. 23, with a variety of celebrations planned throughout the weekend.
• Ray J is passing through the Motor City on Saturday to host Slow Jams: An Ultimate R&B Experience at the Detroit Shipping Company.
• The Canadian Pacific Holiday Train will be passing through metro Detroit on Monday, Nov. 25, after an evening event in Windsor, Ontario.

Do you have a community story we should tell? Let us know in an email at detroiteveningreport@wdet.org.

There are several nonpartisan organizations and groups that will be offering free transportation to the polls on Election Day in metro Detroit and around the state.

Subscribe to the Detroit Evening Report on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

Among them are APIA Vote MI, which has teamed up with Lyft to provide free rides with the goal of helping to increase voter turnout in the region.

Executive Director Rebeka Islam says lack of transportation can prevent people from voting. 

“We hope that by providing one reliable and free transportation, we can increase voter turnout, especially, again, amongst our committees who might otherwise face logistic challenges or feel like you know, it’s not important to vote,” Islam said. “We want to make sure that we empower our community, that every vote counts.”

Other organizations offering free rides to the polls on Tuesday include:

• Detroit Alumnae Chapter of Delta Sigma Theta Sorority, Inc. – Rides are available to and from polling locations on Election Day (November 5). Request a ride by calling (888) 328-4283 or email contact@oakland-service.com. Rides are wheelchair accessible.

• Detroit Bus Company – Rides are available on Sunday, November 3 from 8 a.m. to 5 p.m. and on Election Day (November 5) after 9 a.m. Request a ride by calling (313) 444-2871 or filling out this form.

• Detroit Downriver APRI – Rides are available from Saturday, October 26 through Election Day (November 5). Request a ride by filling out this form. We encourage you to fill out the form one day in advance.

• Voter Transportation Project – Rides are available now through Election Day (November 5). Call or text “Detroit” to (866) 759-8683 to book a free Lyft ride.

• Warriors on Wheels – Rides are available from 9 a.m. to 5 p.m. from Thursday, October 31 through Sunday, November 3 and from 8 a.m. to 8 p.m. on Election Day (November 5). Request a ride by calling (313) 552-2916 or filling out this form. Rides are wheelchair accessible.

For a complete list of discounted or free rides around the state, visit MichiganVoting.org/rides. 

Other headlines for Monday, Nov. 4, 2024:

• The Justice Department says it will dispatch election monitors to check for compliance with federal voting rights laws in Warren, Ann Arbor, Hamtramck, Detroit and Flint for the general election Tuesday.
• Real Estate firm Bedrock is bringing Cosm, a new experiential entertainment venue, to Downtown Detroit.

Do you have a community story we should tell? Let us know in an email at detroiteveningreport@wdet.org.

Detroit is another step closer to passing an ordinance that would put some limits on protesters outside health care facilities.

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The proposed ordinance would create a 100-foot zone where protesters could not come within eight feet of a patient entering the facility without their consent. It would also restrict people from gathering or picketing within 15 feet of the entrance.

While the ordinance would apply to any health care facility in the city, supporters say it’s most needed at clinics providing abortion services. Abortion rights opponents call it a violation of their First Amendment rights.

Monica Miller is a self-identified “pro-life sidewalk counselor” who said she’s been doing that in Detroit “for literally decades.” She told council members during a hearing Monday that a buffer zone would restrict them from engaging in “real human interaction.”

“We approach the moms. We accompany them. We talk to them,” Miller said. “We show them love and compassion and give them real material help so that they will turn away from their decision to abort their children.”

But ordinance supporters say that’s exactly the point. They say patients at clinics are routinely harassed and intimidated by protesters, often by people who come from outside the city or state to do so.

Council member Gabriela Santiago-Romero, who’s sponsoring the proposed ordinance, said she witnessed such tactics during a recent clinic visit. She said one man who mistook her for a patient approached her directly, using inflammatory language meant to inflict “psychological pain.”

“So we do have people from outside of the city coming and telling our residents what to do with their bodies,” Santiago-Romero said. “And quite frankly, it is not all peaceful.”

A person found guilty of violating the ordinance would be subject to a misdemeanor penalty and fine. The council is expected to hold a final vote on the issue next week.

-Reporting by Sarah Cwiek, Michigan Public

Other headlines for Tuesday, Oct. 1, 2024:

• A new report on Michigan’s economy from the Michigan Center for Data and Analytics shows more residents have jobs now than at any time in the past 20 years. 
• The Dorothy and Peter Brown Jewish Community Adult Day Program will be offering a dementia-friendly Kol Nidre/Yom Kippur service at 11 a.m. this Sunday for the Jewish High Holidays. 
• This Wednesday is Student Count Day in Michigan — one of two days during the school year when school attendance is used to determine school funding. 
• The city of Detroit is offering free flu vaccinations from noon-3 p.m. on Wednesday, Oct. 9 at the Coleman A Young Municipal Center. Those interested are asked to register at flu.vna.org and enter the Clinic ID 2654 and the Clinic Passcode xtuca8m. Complete and bring the Assessment and Consent Form from the registration site along with a valid ID and medical card.  

Do you have a community story we should tell? Let us know in an email at detroiteveningreport@wdet.org.

More than a year after state lawmakers eliminated the five-year waiting requirement for certain immigrants to qualify for Medicaid, the state is now opening coverage for immigrants who are under the age of 21 and pregnant.

The Michigan Legislature allocated $6.4 million from the 2023-2024 general fund to get rid of the five year eligibility waiting period for legal residents joining dozens of other states across the country in providing the benefits.

States have had the option to waive the five-year waiting period since 2009 through the Children’s Health Insurance Program Reauthorization Act.

“There might be people who have maybe previously thought they weren’t eligible for benefits, it might be a good time to go and see if they’re able to sign up, and their local offices should be able to get them signed up if they’re lawfully residing,” said Elinor Jordan, supervising attorney at the Michigan Immigrant Rights Center.

According to the Centers for Medicare and Medicaid Services, the coverage extends to lawfully residing children and pregnant women, including green card holders, immigrant survivors of battery or extreme cruelty and their family members, as well as those with temporary protected status.

Public policy experts estimate the expansion could benefit nearly 10,000 people statewide.

“This policy change would bring Michigan closer to covering all children—and providing affordable, quality care to thousands more children in our state—while aligning our state law with that of most other states,” stated Simon Marshall-Shah, policy analyst at the Michigan League for Public Policy, in a 2021 analysis of the policy.

The change also includes postpartum coverage for up to a year for qualifying recipients. Before the expansion, legally residing pregnant individuals were eligible for Medicaid coverage for emergency services, including some prenatal and postnatal care.

Jordan says the move makes coverage much more comprehensive while also preventing medical debt for some people.

“We often work with clients, who are lawful residents and are contributing so much but have this crushing medical debt,” she said. “It can really take away from their productivity and their ability to full engage in their communities.”

Eligible Medicaid recipients can apply for the program directly on the state’s health department website.

Editor’s note: A previously uploaded version of this episode included incorrect audio from an earlier episode about grief and loss.

A staggering amount of metro Detroit’s polling stations are not accessible for disabled people — 84%, according to a 2022 audit by Detroit Disability Power.

Subscribe to Created Equal on Apple Podcasts, Spotify, Google Podcasts, NPR.org or wherever you get your podcasts.

Another, less visible, barrier to democratic participation is equitable access to information. Yet nearly half of Detroit households don’t have broadband access.

That picture only gets worse when you account for household income. 

Voting sites inaccessible 

There were four criteria Detroit Disability Power used in their audit to define accessibility at a polling location: 

1. An accessible parking area with a clear pathway into the building
2. A fully accessible voter assist terminal (VAT)
3. An accessible entrance into the building
4. An accessible booth for casting paper ballots privately

Dessa Cosma from Detroit Disability Power says that being able to vote in-person without barriers is a democratic issue, but the state of polling location accessibility now is not acceptable. 

“I can tell you as a disabled voter, it is frustrating and demoralizing and dehumanizing to go exercise my right to vote and realize that people weren’t prepared for me to show up,” Cosma said. “When they were thinking about who mattered and people they needed to set up their day for, I wasn’t on their list.”

Detroit Disability Power plans to conduct another audit of metro Detroit’s polling locations for the general election in November. 

Internet access 

Democratic acts such as voting, accessing a city hall website, attending virtual public meetings, or contacting representatives are all reliant on having internet access.  

Detroit is among the worst-connected cities in the nation, with nearly 40% of homes without a broadband connection. 

But access to broadband internet is only one of three pillars of digital equity, says Christopher Ali, telecommunications research at Penn State University. The other two pillars are affordability and skillset. 

“The internet is our window to the world right now. It’s how we get news and information […] it’s how we engage with the many of the governmental services we need to do on a daily basis. It’s how we book the COVID vaccine and apply for benefits and file our taxes,” Ali said.

Cosma and Ali both joined Created Equal on Wednesday to discuss equitable access to voting and information.

Guests:  

• Dessa Cosma is the executive director of Detroit Disability Power

• Christopher Ali is the Pioneers Chair in Telecommunications and professor of telecommunications in the Bellisario College at Penn State. Ali is the author of “Farm Fresh Broadband: Politics of Rural Connectivity.” 

Listen to Created Equal with host Stephen Henderson weekdays from 9-10 a.m. ET on 101.9 WDET and streaming on-demand.