What are enough profits for the health care industry?
by Ronnie Shure, HCFA-WA President

One of my favorite memories is singing a song called “Dayenu” on Passover as I grew up. The melody is great fun, and the chorus is so catchy that you can easily join in even if you don’t know Hebrew. Dayenu means “it would have been enough.” Each verse refers to a different event experienced by the Jewish people. After each verse, we sing the chorus to emphasize that it would have been enough if that event was the only time that God intervened on behalf of the Jewish people. As I grew up, I became increasingly aware of the consequences of unbridled materialism as opposed to a sense of sufficiency. Whether it was income inequality, climate change, social justice, or health inequity, I found myself advocating for ways to ensure enough of our basic human needs for everyone. The goal of achieving enough for everyone, “Dayenu,” became one of the standard operating principles of my life.

My pharmacy career was dedicated to service for low-income populations in public health, behavioral health, and substance abuse programs. My first mentor was Harry Wise, the director of the local public health department in Norfolk, Virginia. Harry Wise even supported my mid-life move to Seattle by sharing his stories about training as a surgeon at the Public Health Service hospital in Seattle, which inspired him to lead a Public Health Service hospital for civilians in Vietnam during the war. He told me stories about the danger of treating civilians who were considered enemies to either the North Vietnamese or the South Vietnamese troops. For me, he translated that fear while working with those underserved populations in Vietnam into
motivation for my involvement in treatment for similar populations that I worked with in my pharmacy career. This motivation “would have been enough” to give meaning to my life by giving me a rewarding career. Almost like another verse in “Dayenu,” this motivation led me to get involved in Health Care for All - Washington when I retired.

When I first got involved with HCFA-WA about 10 years ago, we formed an alliance with other advocacy groups and labor organizations and grassroots activists, which is called Health Care is a Human Right. The leaders in this alliance met with Rep. Frank Chopp, at that time the speaker of the Washington House of Representatives. We met at his office in the Pacific Tower with Rep. Chopp sharing his pride as a partner in revitalizing this Seattle landmark to become a center for innovation in community health and education. This building started as the home of the U.S. Public Health Service Hospital where Harry Wise had trained to become a surgeon, and I was overcome with memories of stories that had helped motivate my career. The formation of the alliance of health care advocates, combined with memories from my mentor, “would have been enough” to motivate my activism for years to come.

I sat next to David McLanahan, the Coordinator of Physicians for a National Health Program in Washington, which was a key advocacy group in this new alliance. After the meeting, he turned to Rep. Chopp and thanked him for welcoming us to the Pacific Tower, because David had trained to be a surgeon on the very same floor as Frank’s office, when the building was the U. S. Public Health Service Hospital. After we left the building, I told David about my mentor who had trained at the same building, and I shared stories about public health service in Vietnam and eventually with me in Virginia. David turned to me and said, “Was his name Harry Wise?” David went on to share that Harry Wise saved his life and became his mentor as well, when David spent a summer as a Temple University medical student volunteering at that Public Health Service Hospital in Vietnam. We shared details of those stories, about the dangers involved, about having to take a different route to the hospital every day to avoid snipers, and about the value of a mentor like Harry Wise to inspire each of our careers. This connection seemed like one of those miracles that I sang about in “Dayenu.”

David and I are both activists 10 years later. We are part of a large group of people with similar motivations in our lives, who have learned that our health care system must reform itself. We are spending more money on health care in the U. S. than in any other developed country. We already pay enough to provide health care to everybody in our country. We need to stand up to limit the profits in our business-oriented system, so that there can be enough to spend on a health care system that will provide care for everyone. We do not need a miracle, because “there really is enough” money to make it happen. Dayenu.