Ngozi Ezike, MD (Host): Hello everyone, I'm Dr. Ngozi Ezike. And thank you for tuning into another episode of More Than Medicine. Today, I'm so excited to be talking about equity as a healthcare priority with none other than Congressman Chuy Garcia. Throughout his storied career, Congressman Garcia has been a strong voice both as an organizer and as a legislator. He's been fighting to improve the lives of his constituents, many of whom are immigrants just like himself. He is a coalition builder committed to expanding access to quality education, affordable housing, and economic opportunity. Thanks for joining us, Congressman. What a pleasure to have you.

Chuy Garcia, BA: Good morning and hello to everyone who is listening to the podcast. I'm glad to join you to talk about healthcare for all.

Host: That's right. So usually, how we like to start is-- I don't know who doesn't know you, but let's assume there's a couple people living under rocks. Can you tell us a little bit about yourself and how you got started along your incredible journey?

Chuy Garcia, BA: Gladly. So, I came to Chicago in February of 1965, I've got an anniversary coming up, and didn't speak any English. I came from a small village in the northern state of Durango to the Pilsen community. Experienced, of course, a great cultural shock coming from a rural area to the big city and, of course, quickly learned the ways of the city in the Pilsen neighborhood. We used to call it 18th Street at that time. And I became familiar and exposed to many things. Attending Chicago public schools, the racial, ethnic diversity of the city. And I was soon exposed and learned about the civil rights struggle.

As a young boy, I would listen to the radio, to black radio, at that time and what we used to call soul music. Along with the music came news and commentary and analysis about the civil rights struggle. As a young man, I heard the sermons and speeches of Dr. Martin Luther King, and that had a profound impact on me at a very young age. Then, I learned about a man called Cesar Chavez and the Farm Worker Movement in California to improve the lives of farm workers. And then of, course, in the Pilsen neighborhood, I was exposed to many rich social justice movements in the community, including one at a community organization called Casa Aztlan that opened a free clinic for people in the community, because the Brown Berets in that part of the community wanted to provide medical health access to everyone in the community. I think they were following the example of the clinics that the Black Panthers had brought to many communities across the country. So, this was one of the forms of community organizing that I was exposed to as a very young man.

But the point of all this is to say that I grew up in a very rich environment that exposed me to social justice movements and learned early on that access to healthcare was one of those fundamental human rights that we should struggle for in our lifetime. And of course, that led me to other forms of community organizing experiences and exploration. And of course, as one organizes and brings people together, one learns about power, one learns about political power. And that is what sort of provoked my interest in government and in politics and, ultimately, what sort of set the stage for me to run for public office as one of the first Latino aldermen in the Chicago city council, helping elect Mayor Harold Washington as Chicago's first progressive and black reform mayor. And then on to the State Senate, and later, the Cook County Board. And for the past five years, I've been a member of the U.S. Congress. So, that has been my journey. I'd like to think that that only happens in America, but it's been a wonderful experience to be able to make a difference in people's lives. And of course, healthcare has always been one of the most important issues and causes that I fight for.

Host: Thank you so much. What an incredible journey. I just want to highlight, I mean, if anyone missed all of that, I mean, a young person coming from a rural town in Mexico, from Durango all the way to 18th Street, seeing mixed community there and seeing like community organizing. I mean, you had these influences from Dr. King and Cesar Chavez. And it just seems like you really need to be bathed in all of these great experiences. And that was the fuel that allowed you to be successful. Look at all these levels of government. You were an alderman, you were in the Illinois Senate and Cook County Board of Commissioners, and now the U.S. Congress. It is such an incredible story and I'm so grateful for all of the social justice movements and all of the wonderful people that have poured into you to allow you to be this successful leader. And we're very blessed to have you representing us.

You know, you have worked on so many bills that impact the communities that we serve at Sinai, Chicago. I really want to highlight access to hospital interpreters to certified translators for patients who don't speak English well, with limited English proficiency. That is so important to us. In our hospitals, half of our patients are Spanish-speaking and some of those Spanish-speaking patients speak only Spanish. And so, being able to give them the highest level of care requires us to have individuals, whether it's providers who are fluent or hospital medical interpreters, to make sure that we are getting the right information, so we can make the right diagnosis, so that we can make sure there is good cooperation as we talk about these plans of care.

So, thank you for your leadership on that important critical aspect. And tell me, what else are you doing now that will also impact the communities that Sinai Chicago is serving?

Chuy Garcia, BA: Yes. Thank you, Dr. Ezike. I want to underscore that I've had a long-term relationship with Sinai Health. Going back to one of your predecessors, Ruth Rothstein, who headed up the system for many years, who did service at the Cook County health system, heading up Cook County Hospital, today known as Stroger Hospital.

And one of the most important distinguishing features of Sinai Health and people that I've collaborated with is our commitment to ensure that we provide everyone with access to good quality healthcare regardless of their ability to pay; low income people, uninsured people, underinsured people, and of course, the fact that Mount Sinai is the only trauma center for many folks who live on the west side and the southwest side as well. So, that is very, very important. And I've represented in my public service, whether the City Council, the State Senate, the County Board, or in Congress, large numbers of uninsured people because of their immigrant status in many instances or they could not qualify for Medicaid or Medicare. So, you all have always been there for that community and, yes, ensuring that everyone has access to healthcare, whether they speak English or not, whether they might be hearing-impaired or speech-impaired, was the basis for my introduction of the Language Assistance Act when I was in the State Senate. And of course, public health remains a great cause for me. That's why I have been a sponsor of the Medicare for All Legislation in Congress that we continue to strive for to make sure everyone has access to healthcare.

 But another experience that all of us had recently was the COVID pandemic. This was a real test of our health system, of our public health system, of our readiness in communities. It also tested the vulnerabilities and the inequities in our communities and some of the structural issues in our society, including in healthcare. So at the very beginning of the COVID pandemic, I helped found, for example, Illinois Unidos. This was a coming together of many community organizations, healthcare providers, and others, including elected officials, and we connected them with service providers and health experts, a one of a kind coalition that of course pushed for shots in the arms, of funding and legislation in support of their and our constituents. It's not just about passing legislation, which I know that we'll talk about more, but it's about ensuring that our communities know how to access services. So, it's state policy and local policy, along with federal legislation that can be very important to the quality of life in a community.

I am, currently continuing to push for, and I've been a proud sponsor of the Health Equity Act in the Congress. This is an important undertaking to ensure that we bring health equity to everyone across the country. I believe that our healthcare industry needs big structural change, for example, in the area of Medicare for all. I recognize that even as we try our hardest, it's going to be difficult to pass this bill, but we've got to lay the groundwork for its passage one day. Remember that we've come a long way. At one point, there were only 50 co-sponsors of that type of legislation. Today, there are over 105 co-sponsors in the House alone, so we keep working with Congress and in Congress to continue to build the coalitions that will, of course, be required to make it the law. And as we work to do those things, you know, we can continue to expand access to healthcare, thanks to the Inflation Reduction Act, a legislation that we passed in 2022. We've brought insulin costs for Medicare recipients, we've capped them. It's now $35, and the price of insulin is capped at $50 for millions more. So, capping prices on dozens of prescription drugs in addition to that, from diabetes drugs to cancer and health medication is another of the important steps that we have achieved legislatively in the last two years alone. So, we are making progress and continuing. People can expect for other drug prices to come down on other medications as we are requiring negotiations between the healthcare department at the federal level and pharmaceutical companies to make medication more affordable for more people. I am active with the Congressional Hispanic Caucus, working with the Congressional Black Caucus and the Asian American Caucus as well to address disparities in healthcare and in the workforce and in clinical trials as well, equity in health and nutrition access as well as removing barriers to nutrition programs like the SNAP program and, of course, inclusive diabetes research and education as well.

So, that legislation, these three caucuses of people of color in Congress is a most important policy pursuit that we are continuing with. And we think that the Health Equity Act is built on our shared belief that everyone deserves access to affordable quality healthcare.

Host: I feel like I should just make this gratitude podcast, where I just thank you for all the incredible work you've done. When we think about the communities that Sinai Chicago serves, one of the largest contributors to a shortened lifespan is the chronic disease, and diabetes being one of those top conditions. And so, patients being able to afford their medicine to try to manage this very serious chronic disease, that is critical to being able to give life and a higher quality of life. So, thank you for your work for bringing down the cost of insulin and we look forward to the other drug prices that are going to come down as well, because all of these pieces come together to having people have a better chance to elevate their quality of life.

I know the Congressional Hispanic caucus is such a vibrant, powerful force and you being at the center of that. Thank you for the invitation to join the Congressional Hispanic Caucus just last month, and I just really appreciate the momentum and all the important work that's being done.

As you said, groundwork is there's a ground game to some of these important pieces that have yet to come. And so, I thank you for your patience and diligence as you put the pieces together so that we can have eventually a situation in a country where everyone gets what they need in terms of healthcare and it's not debated and we don't have this tiered system. So, I'm so grateful for all of your work and know that we're going to get to the ideal state with your continued hard work and building that coalition that you're already getting more and more partners together. I guess that's your community organizing background at work and we're seeing the fruits of that.

So, I see all the great things that you're doing through government. I want to know how an institution like Sinai Chicago, how can we better partner with you, partner with government to get where we need to go. We are one strong community anchor and we have many other community partners. What would you say to us as a partner that wants to continue the great work being done?

Chuy Garcia, BA: you know, it's been great working with Sinai and all of your team over many years because some of the things that we've achieved through all the learning that we've done about fighting for greater equity include the expansion of one of the county clinics, the Jorge Prieto Clinic in Little Village that serves folks from Little Village and North Lawndale.

You know, in part of my community organizing, I was fortunate enough to be involved in the fight for a new Little Village Lawndale High School at 31st and Kostner. It was a community effort that included a 19-day hunger strike by community residents. And one of the things that included in that building was the creation of a health clinic, a school-based health clinic as well. In addition to that, as a county commissioner, I was very fortunate to be a part of the class of county board members when we created and established under the leadership of President Toni Preckwinkle, the County Care program that has ensured it's helped many people obtain health insurance and care and the modernization of the healthcare system in Cook County for low-income people, to ensure that they are getting that type of healthcare.

So, I just wanted to underscore that, to your question, I think that for far too many people who remain uninsured in our country, including many of my constituents who pay too much for their medicine and care. And, of course, no individual should ever have to choose between healthcare and paying rent. And that's why in Congress, inspired and trained by much of the work and public health, public education that you've done around healthcare, I'm fighting in Congress to ensure that everyone has access to affordable and quality healthcare. I'll continue to support measures that move us along toward that goal, and I know that you support these things and you put these things into practice as you care for people in your system.

Fighting to protect Medicare, Medicaid, and Social Security is very important. Closing the uninsured gap, as I've reiterated. Protecting people with pre-existing conditions so that they don't fall through the cracks and suffer dire consequences. Addressing the prescription drug affordability crisis is another of the aims that we ought to have to bring about greater equity. And finally, I'd say reducing health disparities among different communities. This is a true test of the progress that we're making as a society.

And we've got to also recognize that there are many factors that determine the health of community and of a person, things like air quality, clean drinking water. That's why we've got to remove leaded pipes from Chicago. And I'm working as a member of the Transportation and Infrastructure Committee in Congress to bring that funding to Chicago. Access to nutritious food, very essential. It's very simple, but not everyone has access to nutritious food. And of course, the impacts, as you've, discussed, Dr. Ezike, of chronic stress that so many people in poor communities are subjected to. So when I think about addressing healthcare disparities, our solutions must be equally broad. I think that passing legislation like the Green New Deal is a matter of health equity. The ZIP codes that I represent have some of the worst air quality in the world. Understanding the impacts of carbon dioxide emissions from the trucking industry and asthma rates is a matter of health equity. Ensuring that with budget shortfalls are addressed so that eligible mothers and children are not put out from waitlists is a matter of health equity.

I could go on and on, but I think those are some of the important priorities to ensure that people have a better quality of life, and underscoring all of that, of course, is their healthcare.

Host: Thank you for highlighting how broad the issues are in terms of helping people live their best lives. It's food, it's housing, it's air quality, it's healthcare, it's water. I'm so grateful that you're working on all of these things. Because, like you said, the true test of progress is going to be if we see those disparities shrink between different communities.

I mean, it seems like a no-brainer that everyone would want everyone to have good air quality and clean water. What really are the barriers? Like, what is actually holding us back from achieving these equitable healthcare system? And how do we remove these barriers?

Chuy Garcia, BA: Yeah. I would say current healthcare coverage reflects broader inequities in our society. Communities of color and people in underserved urban and rural areas tend to not have access to the same options and quality of healthcare with legislation, such as the Medicare for All Act, which will ensure access to this crucial program and ensure that my constituents and other communities across the country in urban and rural areas isn't tied to costly, complicated insurance plans. We've got to invest in our health system so that it enables and, of course, promote the highest level of health for our increasingly diverse nation.

Host: As we think about the barriers that we have to overcome, but also the progress and all the strides that have been achieved, what makes you hopeful for the future?

Chuy Garcia, BA: What makes me hopeful is that incrementally we've succeeded in taking steps toward greater health equity by passing national legislation like the Affordable Care Act, also known as the Obamacare, the fact that we've brought down, we've brought under control insulin prices, that we're bringing the cost of certain, medications, drugs, down well.

I think if you told me 10 years ago that Medicare for all would have more than 100 co-sponsors in the house, and more than a dozen in the Senate, you know, people would not have believed you. In our communities, there's a new generation of organizers and leaders who are bringing energy and urgency to the fight for healthcare, for health justice, for racial justice, for climate justice, economic justice, and of course, more people are seeing how these fights are fundamentally connected and we're building stronger, more effective coalitions as well. And we've gotten better at advocating for good public policy and for change.

Host: I always want to end on that hopeful note, and that is great. And again, the take-home message is there, is like incrementally we are succeeding and there are more successes to come because of the amazing foundation that have been laid by you and your partners. I want to end it there and just say thank you, thank you so much, Congressman for not just joining me today, which I do say thank you for making time, but also for your long and amazing career and just your unwavering dedication and tireless work to pursue and advocate for true equity. And you've done it across all the different spheres for healthcare, for economic opportunity, for education, for housing, for clean air. And I really appreciate how you have supported the West side of Chicago. You're a true treasure to our community and it's always a pleasure to be in your presence.

So, I'm honored for this time that you've shared and thank you, and more, more strength to you as you continue this incredibly important work.

Chuy Garcia, BA: Well, thank you, Dr. Ezike, and recall that I still owe a visit to the campus. And I have to confess, I was on campus without authorization last week as I visited the new restaurant, Catedral Restaurant on the first floor of one of your new buildings, relatively new buildings out there. And it's also exciting to see the new housing development that's going up as well for that area. So, this is a really good sign of progress. And I look forward to having coffee and a good breakfast or something with you

Host: Absolutely. You are always welcome. Always, always welcome. But next time, I will be looking forward to joining you. So, thank you so much.

Chuy Garcia, BA: Muy bien. Así quedamos.

Host: Muchísimas gracias.