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Reviewing Tim Walz's Healthcare Policies · CareTalk: Healthcare. Unfiltered.

• 0:00
  Democratic vice presidential candidate, Tim Walz has an extensive track record on healthcare policy, but his personal connection to reproductive freedom as an IVF dad might be the most salient factor in this election.
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  What has Walz accomplished in healthcare as a congressman and governor?
• 0:17
  And what impact might he have as vice president?
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• 1:06
  Welcome to Care Talk, America's home for incisive debate about healthcare business and policy.
• 1:11
  I'm David Williams, president of Health Business Group.
• 1:13
  And I'm John Driscoll, senior advisor at Walgreens.
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  We'd love those ratings, David.
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  We sure do.
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  So David, I think that Tim Walz has the most complete record as a leader on healthcare policy and reform of any politician in modern memory.
• 1:47
  He's not a single threaded issue candidate.
• 1:51
  This guy, this governor and congressman has probably the most successful track record at performing healthcare that I've actually seen in modern politics.
• 2:04
  know, sometimes John, especially when they're trying to put up a new justice for the Supreme Court, you want somebody who's like a complete blank slate has nothing to look at.
• 2:12
  But of course, a governor compared with the backgrounds of the other candidates for president and vice president actually has a lot more that he can talk about.
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  And Governor Walz in particular.
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  has done a lot in healthcare, including also when he was a congressman.
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  And there's a lot of stuff to tick off.
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  And I think it goes more or less as a mainstream but progressive playbook.
• 2:35
  But John, think actually that where the vice presidential candidate fits in here is really amplifying this reproductive freedom argument, and in particular, as it relates to IVF.
• 2:48
  I think that's true, David.
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  But again, what impresses me about Tim Walsh When you say who is Tim Walsh at a time when America is trying to figure out who this guy is, he's a leader who has passed common sense healthcare reform bills as a congressman and a governor that have delivered real value, whether it's around affordability, around prescription drugs, or access to healthcare services.
• 3:18
  But let's start with reproductive freedom and where he stands as opposed to the alternative.
• 3:27
  Who is Tim Walz, this person who's actually articulated himself as a warrior for reproductive freedom?
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  Can you maybe tell our viewers a little bit about where he stands and what successes he's already kind of notched already?
• 3:42
  Yeah, well, I mean, the number one success is that he's a father due to in vitro fertilization.
• 3:48
  Bravo.
• 3:49
  Sometimes when you hear someone talk about reproductive freedom, It could be framed as, well, that's just a euphemism for being pro -abortion or something like that.
• 3:58
  But reproductive freedom is broader and IVF is something that people can really identify with and also makes it more of a man's issue too, not just a woman.
• 4:10
  so - Do you wanna, maybe I'm just laughing because I remember when Trump came out on stage during the RNC.
• 4:19
  convention they were playing, It's a Man's World, in the background.
• 4:22
  But maybe talk a little bit about what IVF is and what the issue is, because it's been kind of confused in modern parlance.
• 4:30
  Well, so here's the thing, John.
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  So vitro fertilization means that the fertilization takes place in vitro, meaning in glass, meaning in the test tube, meaning in the lab, as opposed to in the body.
• 4:41
  And so once the embryo is created, sort of offline or in vitro, and then it's implanted.
• 4:48
  and carry to term as a pregnancy.
• 4:50
  Now, what happens is if you look at some of the arguments about banning abortion, you actually get very quickly into seeing where IVF is threatened.
• 4:59
  And in particular, if life begins at fertilization, that is when an embryo is a person, because that's what the fetal personhood movement is about, then IVF suddenly becomes a problem.
• 5:12
  Because in order to do in vitro fertilization, you typically need to create more fertilized eggs, more embryos, than there are going to be ones that are implanted.
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  And that's just the nature of how IVF works.
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  And so when you, as IVF has done here, you're going to have the issue of if these are all actually people, then that's a problem.
• 5:35
  You can't actually create embryos.
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  So Republicans have rushed to say that actually, well, no, they're in favor of IVF.
• 5:42
  Don't get me wrong, just because the Alabama Supreme Court, you know, Take took certain steps to make it look like it you couldn't do it.
• 5:48
  No Republicans are in favor of IVF, but actually Logically, they're not and not everybody actually is no in fact if you actually Followed the logic of the Republican position around protecting and you know sort of not messing with the nor the bot the typical biological production It's sort of unclear what the Republican position is.
• 6:11
  It's actually there are many Advocates on the right in the Republican Party who do want to are very comfortable with banning IVF, but just to be clear, you know, it's 2 % of all births in the US 8 million people in the United States were 8 million babies or are the happy result of in vitro fertilization so the threats to reproductive freedom which include in vitro fertilization, which is a common and in fact a necessary path for some people to have healthy children.
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  The access to contraception.
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  The Republican agenda is pretty aggressive.
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  They're not even stopping at the line of restricting access to contraception.
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  mean, they've been, every time they hit one of these mainstream reproductive freedom issues like access to safe in vitro fertilization or access to contraception, they sort of go all wobbly.
• 7:17
  But I actually think the reason why it's even an issue is because they've made it an issue.
• 7:22
  I think, again, Tim Walz can personally talk about IVF, but his positions on reproductive freedom are even clear.
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  As governor, I believe he enshrined access to free...
• 7:41
  to abortion in the state of Minnesota.
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  He has been a consistent advocate for fair and complete access for women to have, you know, to sort of control their own bodies.
• 7:54
  Again, it's, but his track record on health, on the freedom to access healthcare is even broader than that.
• 8:02
  I mean, he feels, he is articulated as has Kamala Harris, that healthcare should be a right.
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  not a privilege based on income.
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  Maybe we should delve a little bit into what he's been able to do there.
• 8:16
  Do you want to talk a little bit about what he's been doing in terms of healthcare reform in the state of Minnesota?
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  So one of the things that Minnesota has done is embraced the Affordable Care Act as opposed to sort of pushing back on it.
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  So they have the Medicaid expansion, they have a marketplace that they run, and the results speak for themselves in terms of being able to get to a low rate of uninsured, 3 .8 % of people in Minnesota uninsured versus more than double that nationally.
• 8:43
  He's also supported certain aspects of the Affordable Care Act and related laws that haven't always made it at the federal level.
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  So there's support for so -called public option, which would compete with private insurers.
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  And that's actually moving forward and it's supposed to be instituted in a couple of years.
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  There's been a lot of pushback from providers.
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  about that because they worry it's going to pay them lower rates, but that of course ties into affordability.
• 9:08
  So he's done a lot in that area and that's probably the biggest one in terms of actually the overall access.
• 9:18
  But I mean, he also has a long track record of being in favor of capping and limiting the cost of prescription drugs.
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  One of the interesting things that I think that The state of Minnesota does now, and I think it's the law that was passed while he was governor, they actually require the top, I think it's 70 or 100 drugs that have the most, the largest cost increases to be published and then for them to the drug makers to justify why they're gouging consumers.
• 9:56
  The state of Minnesota had a landmark settlement with two of the large insulin makers.
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  which has effectively capped the cost of insulin for when it's actually two pieces, capped the cost of insulin as part of the settlement for all Minnesotans, but also provided access at a very low cost for 90 day emergency access to insulin because there was a 26 year old man who died because he was rationing his insulin.
• 10:24
  I you look at, mean, Tim Walz is a true healthcare warrior around healthcare reform.
• 10:28
  He's He's notched wins in terms of reproductive freedom, safe access to consistent health care.
• 10:36
  What that means, by the way, is that people don't crash into the emergency room because they've got covered through the Affordable Care Act.
• 10:42
  He's capped drug prices, or actually capped drug prices for insulin, and has, I think, started this question of whether the shame and around price gouging can...
• 10:56
  can shame drug companies into actually fairer pricing.
• 11:00
  Maybe we should also talk a little bit about his experience as a veteran and what he's been working on in terms of veterans' mental health.
• 11:07
  For sure, John.
• 11:08
  Let me say one more word on the drug pricing first, which is that I think this is actually consistent with the overall sort of more joyful and positive approach and looking favorably on people.
• 11:18
  So you say, look, someone should be able to get insulin.
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  It's a right to have health care.
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  It's not the attitude that you see on the other side.
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  which is more about, you someone's going to try to come in and steal healthcare for free and they don't deserve it and didn't, you know, didn't take care of themselves or they're, you know, they're an immigrant.
• 11:35
  So it's very much, I think on that positive side.
• 11:37
  Yeah, somebody died because they couldn't get insulin, made sure now you can go to the pharmacist and actually get insulin.
• 11:42
  This $35 a month payment for insulin is consistent with what's tried to be accomplished on the national side, but hasn't always been successful.
• 11:51
  On the mental health side, when he was in Congress, as you say, as a veteran, he was one of the sponsors of what they call the Clay Hunt Suicide Prevention for American Veterans Act, which was signed by President Obama in 2015.
• 12:04
  And that was focused very heavily on this issue of rampant level of suicide among veterans.
• 12:11
  It's bipartisan issue, which I think is also consistent with Waltz's approach overall.
• 12:18
  And then as more recently as a governor, he signed the non -bus mental health bill in 2022 that also addressed this issue of access to prevention for suicide.
• 12:31
  And I think what's remarkable is he's not just stopped there, David, he's actually worked in the state of Minnesota to support an increase in a significant increase in the number of mental health providers.
• 12:49
  mean, he's actually looked at programs to provide loan forgiveness for mental health providers.
• 12:54
  He's dealing with the supply of providers, making sure access is fair and reimbursement is fair.
• 13:01
  He actually was with one of our other guests, Patrick Kennedy, at his mental health summit, because he doesn't, I think, due to the fact that in addition to focusing on suicide prevention, he's really tried to make make Minnesota a place where everyone can get, who's got a mental health challenge, can get access by looking at not just the price, but actually the supply and access challenges that are related to the fact that historically mental health providers have been underpaid by insurance and we actually haven't funded enough positions.
• 13:38
  He's a very thought, that's why I said I'm this is a, this is again, the most thoughtful, comprehensive.
• 13:45
  health care reform candidate that I can imagine now that we've delved into his track record.
• 13:50
  mean, he's even worked on, addressed, and successfully made some progress around issues of medical, the medical debt that's been really sending, burdening some of the poorest patients in America.
• 14:05
  Do you want to talk a little bit about what he's, the successes he's notched as a governor in terms of medical debt reform in the state of Minnesota?
• 14:12
  In Minnesota, they have something called the Minnesota Debt Fairness Act, and it specifically focuses on not allowing providers to withhold care from patients who have debt.
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  Now, it's not a hypothetical measure.
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  It happened that Alina Health, which is one of the providers there, was actually restricting care for patients that had certain levels of debt.
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  So it made it a little easier to actually go against that.
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  So that sparked this Debt Fairness Act, added various regulations for medical billing.
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  and making it possible for providers to be successful, but at the same time, not burden people that really couldn't handle it.
• 14:49
  So there's been more action there of things that have just been talked about at the national level.
• 14:53
  And John, when you talk about - And just to be clear, again, it's a comprehensive solution.
• 14:58
  In addition to not being able to deny care, it suggests that your medical debts can't be transferred to your spouse.
• 15:07
  Medical debt can't can't, crash your credit rating.
• 15:13
  What you see with Tim Walz is a consistent approach to reform, a focus on the details, and frankly, a track record of success.
• 15:22
  I mean, the more we dug into it, David, I mean, the more I was impressed with not just the fact that he's got positions, but he's passed law and invested in a lot of reforms that are gonna make Minnesota a safe place to get sick.
• 15:39
  and a and a a fair access to get get healthy again.
• 15:43
  It's it's it's pretty remarkable john Health care is a big part of the economy, which means there's a lot of people who have a stake in it and in some cases, you know, including us including us, So it's instructive to look at what happened last year where there was a big fight over a perennial, issue that the nurses unions like to bring up which is nurse staffing ratios and so they were looking for basically mandating how many nurses you had to have per bed.
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  And that is not popular among providers, especially because it drives up costs and could reduce capacity if you have to close beds because you don't have enough nurses.
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  And Minnesota is also a place that has some big provider organizations like the Mayo Clinic.
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  It's also home to some of the biggest medical device companies like Medtronic and some of the biggest health insurers like United.
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  So you've got a big health care economy that he has to deal with.
• 16:41
  so originally, the bill was called the Keeping Nurses at the Bedside Act.
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  And it eventually changed to the Nurse and Patient Safety Act.
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  And from the standpoint of the nurses, it was watered down.
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  From the standpoint of others, it was made into a more workable kind of a bill.
• 17:00
  Mayo Clinic, which has got a big national brand and is the biggest private employer.
• 17:07
  in Minnesota, bigger than Target or bigger than any of the other private companies there or public companies said, well, we may invest outside the state.
• 17:14
  So he's having to deal with that.
• 17:16
  And as a result, I think he got something workable that maybe nobody's completely happy with, but it actually occurred and is working.
• 17:23
  Well, I think, again, it shows a willingness to compromise and work with the private sector to come up with a private nonprofit sector in that case, to come up with a solution that worked for most if if not all.
• 17:37
  And that's probably the great advantage of having a governor with the executive experience.
• 17:44
  know, Tim Walz has a great track record actually in Congress at being one of the leading bipartisan congressmen.
• 17:51
  I think he was rated like seventh overall among the nearly 300 legislators that really being a leader in bipartisan legislation, he represented a purple district, a district actually that was pretty red, pretty rural Republican.
• 18:06
  before he was elected congressman.
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  And as governor, in order to get things done, he's knitted together compromises under both, I think, Republican House as well as a Democratic House in the state of Minnesota.
• 18:21
  But what's remarkable is these are solutions that make sense at the headline level and also, I think, are impressive in the details.
• 18:29
  One of the things that he has been a little bit skeptical about is for -profit Medicaid managed care.
• 18:36
  And, you know, I'm not quite sure that that's necessarily fair, given the track record of for -profit versus not -for -profit Medicaid managed care.
• 18:47
  But the long history of the Democratic Farm Labor Party, which is what the Democratic Party is called in Minnesota, has always been a bit skeptical about any for -profits.
• 18:57
  But maybe we could talk a little bit about how one of the other large employers in the country, as well as in Minnesota, United Health Plan, was...
• 19:06
  kind of tweaked about that.
• 19:07
  Yeah.
• 19:08
  Well, it is interesting, John, that if you think about, you know, who are the, you know, who are the big players and United being the biggest one for for -profit health, they really haven't been able to do that much business in Minnesota, which is their home state, because it is not a state that's friendly to, you know, nonprofits.
• 19:25
  It's kind of like Massachusetts in that respect.
• 19:28
  -profits, you mean?
• 19:30
  That's right.
• 19:31
  That's correct.
• 19:31
  So I misspoke.
• 19:33
  But Massachusetts, where you've got a lot of nonprofits, we also don't have any big for-profit health insurers.
• 19:39
  In Minnesota, you do.
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  And for a long while, they were not allowed to participate in Medicaid.
• 19:45
  And then they were allowed for a while.
• 19:47
  And now they're not being allowed again.
• 19:48
  So that's getting a fair amount of pushback.
• 19:50
  Ajaan, I don't know whether this for -profit versus not -for -profit designation is that meaningful when it comes to healthcare.
• 19:58
  These are businesses.
• 19:59
  Some are for -profit businesses.
• 20:01
  Some are not -for -profit businesses.
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  The main difference being about whether they pay taxes or not.
• 20:06
  There are some differences and maybe not -for -profit is a little bit friendlier.
• 20:12
  I think the issue with Medicaid insurance plans in general is that while you've got some providers that might want to do something that's innovative, like more of a value -based approach, something that addresses things more broadly, the Medicaid HMOs are more likely to squeeze them on unit reimbursement levels.
• 20:32
  and not allow that type of innovation to occur.
• 20:35
  That's one of the arguments against it.
• 20:37
  And there's some populations within Medicaid that are particularly vulnerable.
• 20:41
  And I think there's concern about having them be subject to a Medicaid HMO.
• 20:45
  Yeah, just think the track record, you've got to look at the track record of outcomes.
• 20:48
  And I think it's mixed on both for -profit and the non -for -profit side.
• 20:52
  And I would hope that the regulators would be open to looking at outcomes and not just getting stuck ideologically.
• 20:59
  But again, what impresses me about Tim Waltz is he's clearly a progressive reformer on healthcare, but these are common sense issues.
• 21:08
  He's the healthcare leader who wants to make common sense solutions work for average Americans, whether it's access to reproductive services, health services, whether it's fair prices for drugs, and whether it's...
• 21:25
  solving some of the bigger social challenges we've got, like suicide with ex -military folks, and suicide, mental health issues, access to mental health in general.
• 21:34
  think it's going to be, he's, he is a, you know, I think we've discovered in our work, David, a lot of substance to this person who's been a little bit of a question mark in the national stage and has really gotten the most, makes the most progress by pointing out the fact that the Republican party, positions are kind of weird.
• 21:57
  Yeah, they are, John.
• 21:58
  So let's end on one of those things that shows why he's bipartisan and practical.
• 22:03
  So I mentioned this, you know, nurse staffing ratio bill as it started out.
• 22:07
  One of the things that ended up in the bill was a focus on protection against violence in the workplace, which is a nonpartisan issue that affects nurses in particular.
• 22:18
  And so that's where a lot of the emphasis was placed in the bill and also providing benefits for nurses.
• 22:25
  And so that's one way that it actually worked out and people could be happy about it at the end of the day and continue to endorse him, even if they didn't agree with everything that he was doing.
• 22:34
  Well, that's it for yet another episode of Care Talk.
• 22:37
  We've been talking about the new Democratic vice presidential candidate, Tim Walz, and his extensive track record in health care.
• 22:44
  I'm David Williams, president of Health Business Group.
• 22:47
  And I'm John Driscoll, senior advisor at Walgreens.
• 22:49
  If you like what you heard or you didn't, please subscribe on your favorite service and we deserve you.