What if the real crisis in America isn’t a lack of healthcare, but the absence of health itself? In this episode of We Can Stay Human, I tell the story of a scooter crash that exposed the truth about our for-profit system, the difference between healthcare and public health, and why Medicare for All isn’t enough. We need a model that funds wellness, supports prevention, and makes health the default rather than the exception. And I close with a reminder that real healing often shows up first through solidarity, not systems.
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The Full Story
It was supposed to be a simple night out with the guys. A Friday evening, nothing reckless, just a couple of drinks, laughter, and some deep conversation about faith, politics, and how to be better men before walking home. Two and a half miles, an easy stretch for someone like me. I take care of myself. I work out five or six days a week. Most evenings I cook high-protein, Mediterranean inspired meals. I pay attention to what I put in my body. At fifty, my doctor still looks at me sideways when I hand in a blank medications list. “None?” she asks, eyes narrowing. “Not even aspirin?” None. I am the outlier, healthy, disciplined, and freakishly strong for someone with a frame as thin as mine.
That night I walked to the bar, not wanting to deal with downtown parking or folks driving from bar to bar. Coming back, late and tired, I spotted one of those citrus fruit scooters. Not my first time riding one. Quick, efficient, why not shave off the last mile? I hopped on. The pavement blurred beneath me, wind brushing past, the city humming its usual midnight pulse.
And then it happened.
An Unexpected Accident
The front wheel caught something, a divot in the pavement, or perhaps some kind of sewer portal. Whatever the case, the handlebars whipped ninety degrees. Before I could blink, my body was airborne, still clinging to the scooter like a lifeline. Then gravity had its way. I slammed elbow-first into asphalt. My knee, hip, and the entire right side of my body scraped across the street. The scooter itself finished the job, landing on top of me.
The crunch of bone. The sting of raw skin. That sudden silence after an impact, when adrenaline floods your system and your brain insists you are fine. I picked myself up, bleeding and shaky, climbed back on the scooter, and finished the ride home. Walking was no longer an option.
At first I thought it was just road rash, messy scrapes, a little swelling, nothing I couldn’t handle. By morning the truth set in. My elbow throbbed with a deep ache. Within days, fluid ballooned around the joint, bursitis, an angry sac of liquid that pulsed with every movement. A push-up was impossible. It would be three months before I could do one again.
Another Layer of Complexity
And here is the kicker: this happened five weeks after I lost health insurance.
I had looked at my options. COBRA would have cost $650 a month for the $5,000 deductible plan I’d had with my employer. Colorado’s Health Exchange with subsidies would have cost $450 a month, but the deductible would now be $10,000. Thousand dollars before I could get any real care. For someone who hardly ever sees a doctor, who does not take prescriptions, who does everything possible to stay healthy, that is not healthcare. That is a shakedown. That is a protection racket dressed up in sterile white. So I’d put off signing up for anything, playing a game of insurance roulette.
What I ran into that night was not just an injury to my elbow or a reason to be more disgruntled about how we do insurance in the US, it was a collision with the way we confuse two very different things: healthcare and public health. We talk about them like they are interchangeable, but they are not.
Healthcare vs. Public Health
Healthcare is what happens once something has already gone wrong. It is the hospital room, the surgeon’s scalpel, the prescription pad. It is reactive by design, waiting until the body breaks before stepping in.
Public health is everything that keeps us from getting to that point in the first place. It is clean water and safe streets. It is sidewalks that do not suddenly vanish, food that nourishes rather than inflames, air that does not choke our lungs. It is collective, preventative, and often invisible. Until it fails.
The difference matters. Healthcare is the ambulance waiting at the bottom of the cliff. Public health is the fence at the top of it. Healthcare is pruning diseased branches. Public health is tending the soil so the tree stays healthy in the first place.
In my situation, odds are high I crashed because there was no protective infrastructure: a missing bike lane, uneven pavement, not enough street lighting to see potential threats, no path built for bikes and scooters. My elbow met concrete precisely because our cities are not structured to shield bodies in motion.
We are seeing the results of poor public health in city after city. Emergency rooms are filling with people whose night out ended like mine, only harder. In 2024, the number of scooter injuries in the United States nearly doubled, close to 116,000 people walking through hospital doors with fractured wrists, concussed heads, or shattered elbows. Denver tells the story in miniature: ER visits from scooter crashes jumped by nearly half in just three years, and the bills for those visits averaged more than $19,000 each.
Each of those numbers hides a face, a body, a story like mine. A friend who thought the scooter would get them home quicker. A tourist navigating an unfamiliar street. A worker catching a late ride after a shift. Yes, some of them crashed because they were drunk and/or foolish, but all too often, the crashes come because the road beneath us was not built to hold us.
And here is the deeper tragedy: we spend billions on the ambulance that scraps people up off the street. We invest more than any other nation on the pruning shears to cut off disease, but we let the soil erode. We ignore the cliff even after the bodies have started to pile up. Why? Because there is little profit in prevention, but endless profit in managing symptoms.
Failures in Public Health
And public health is not just about sidewalks and scooter lanes. It is also about what sits on our plates.
A society that values public health makes it easy to eat food that heals. Instead, we subsidize corn and soy, flood the shelves with cheap calories, and leave fresh produce to rot in overpriced corners of boutique grocery stores. Whole neighborhoods in our cities, usually those dominated by Black and Brown residents, are food deserts where the only choices are between fast food and a gas station mart. In those places, public health has already failed, and no pill or surgical intervention can undo the slow corrosion of poor nutrition.
What we offer instead are so-called “healthy swaps.” We see it in Bobby Kennedy Jrs. moves to remove food dye from Skittles and other candy, replace oil with beef tallow, or swap fake sugar for real sugar and declare some kind of victory. These changes are marketed as public health interventions, yet they are little more than cosmetic tweaks, and as I understand it, miss the hear of the MAHA movement they claim to represent. They do not transform the food system that feeds us sickness. They do not make vegetables affordable or fish accessible. They do not teach a family how to prepare a meal that nourishes rather than inflames.
This is the irony of how we approach public health in America. We settle for the appearance of reform while avoiding the harder, truer work of ensuring that everyone can access what actually makes us well.
Healthcare That Isn’t About Health or Care
But the failures of public health are only half the story. Because even when prevention breaks down, even when accidents happen and bodies break, what we call healthcare is not really health care at all. It is not built to restore wholeness, it is built to manage decline. It waits until we are already sick or already injured, and then charges us dearly for the privilege of being patched together.
This is the tragedy at the heart of our system. We call it healthcare, but what we actually have is a sickness management industry. A lack of public health breaks us and then the medical system sells us the illusion of repair for the financial benefit of a few.
Big Pharma and Insurance
Consider the pharmaceutical machine. Every ache is an opportunity, every restless night a market, every childhood diagnosis a stream of lifetime revenue. Medications multiply not because we are healthier with them, but because Wall Street demands quarterly growth. Prevention does not pay. But a drug you take forever does.
Consider the insurance industry. Their profit model is not care, it’s denial. They thrive, not when you are well, but when they find a way to say no. They collect your premiums and then reject your claims. Prior authorizations, surprise billing, endless paperwork designed to exhaust you into silence, these are not accidents of bureaucracy, they are business strategy.
No wonder millions of Americans saw reports of UnitedHealthcare’s CEO being assassinated and thought, “Yeah, that makes sense.” When your business model is built on denial of care, on profiting from suffering, on grinding families into bankruptcy while executives cash stock options, you are planting seeds of rage.
The Shadow Brokers
And then there are the pharmacy benefit managers, the shadow brokers of American medicine. They decide which drugs make the list, which ones your insurance will cover, and at what cost. They negotiate rebates with pharmaceutical companies, pocket the difference, and leave patients with inflated prices at the counter. Their profit depends not on you getting the right medicine, but on how much margin they can skim from the transaction. It is one more layer of denial and delay, another place where your body’s need becomes someone else’s opportunity.
As a result of all this, even when care is granted, our hospitals are no longer temples of healing, they are debt factories. The number one cause of personal bankruptcy in America is medical bills. People lose homes, savings, entire futures not because they refused to take care of themselves, but because they got sick in a system that sees sickness as cash flow.
This is why calling it healthcare is a lie. It is not about health or care. At best it is about extraction and sometimes symptom abatement. It manages decline, it monetizes injury, it packages desperation into quarterly earnings reports.
A Vision of Health
What we need instead is a vision of health itself, and here’s where one of the most popular “solutions” falls short.
Many people look at this mess and say the answer is Medicare for All. And on the surface, it feels like a bold solution: cover everyone, remove the fear of medical bankruptcy, make sure no one falls through the cracks. And yes, universal coverage matters. No one should have to play insurance roulette the way I did after losing my job.
Medicare For All?
But here is the problem. Medicare for All still operates inside the same sickness management framework. It is universal access to the very system I have just described. A system that is reactive, not preventative. A system designed for managing decline, not cultivating health. Expanding that system may ease the edges of our crisis, but it does not heal the heart of it.
To be fair, a true single-payer system would blunt some of the worst abuses. Administrative waste would shrink because private insurance overhead and marketing costs would be eliminated. Denial practices tied to maximizing insurer profits would be reduced, because the incentives to say no would no longer sit in the hands of private corporations. Prescription drug prices would fall, because one public payer could negotiate with real leverage. Hospitals would no longer be allowed to charge wildly different prices for the same procedure depending on which private plan you carry. The hidden brokers of American medicine, the pharmacy benefit managers, would lose their stranglehold on pricing and rebates.
Yet even with all that, the underlying model would remain. Medicare for All, if left at that, still rewards procedures over prevention, and still defines health as the absence of symptoms rather than the presence of flourishing. Even public systems can ration or delay care when capacity is short, and even single-payer models can remain stuck in the loop of sickness management if providers are rewarded only for doing more rather than for helping people live well.
We need more than just universal coverage. So what could a vision of health look like?
A Fuller Vision
Imagine a system where the doctor’s office is not simply a place you visit when something has gone wrong, but a place where you are equipped to live well. Where providers are not measured by how many procedures they perform, but by how many of their patients flourish. Where nutrition, movement, mental health, and rest are treated as essential medicine, not afterthoughts.
Single Payer
In this vision, a single-payer system is not just an insurance model, it is a foundation for wellness. It removes the fear of losing coverage and replaces it with the assurance that care is always there. And because everyone is in the same system, there is incentive to keep people healthy rather than patch them up after years of neglect.
Strong Public Health
But this vision also requires a robust public health structure alongside it. Because no doctor, no matter how skilled, can make a child healthy if her neighborhood is a food desert. No amount of medical training can undo the damage of polluted air or water. No surgeon can prevent the injury that comes from crumbling sidewalks and absent bike lanes. Healthcare and public health must live together, each serving a different role in the ecology of human thriving.
Public health is the scaffolding of wellness. It is what makes it possible for people to eat well, breathe freely, move safely, and rest deeply. Healthcare is the safety net when bodies break or illness strikes. Both are essential. Together, they create a system not of sickness management, but of human flourishing.
This is what a truly humane vision would look like: universal coverage through a single payer that does not stop at paying bills, but leans into prevention and wellness. Providers resourced to be educators and guides. Communities structured to support the daily practices that make health possible.
Doing Good or Going Broke?
This kind of dreaming, of a society where staying well is the default, not the exception, is often met with a scoff and a calculator. The bean counters ask the same question every time: how much will it cost? But here is the surprise. Shifting from sickness management to a society that focuses on flourishing saves money. Enormous amounts of it.
Employer Savings
Right now, employers already buy the equivalent of a small car every year for many employees’ family coverage. Average family premiums hit about twenty five thousand dollars in 2024, with workers paying roughly six thousand and employers carrying the rest. That burden climbs most years and drags on wages, hiring, and the survival of small businesses. It is money poured into a hole, and the hole only gets deeper.
System Savings
A single payer that is designed for wellness can redirect those vast pools of money. Start with administrative waste. Duplicated billing departments, armies of clerks processing denials, endless negotiation between insurers and hospitals, this costs us hundreds of billions of dollars every year. Streamlined into one public system, those costs collapse. One study projected more than six hundred billion dollars in annual savings, money that could be redirected into actual care rather than paperwork and profits.
Drug Cost Savings
Drug spending bends the same way. When a single public payer negotiates on behalf of everyone, rather than leaving each private plan to cut side deals with drug companies and pharmacy benefit managers, prices fall. Rebates and markups that fatten middlemen shrink when the rebate lever is centralized and transparent.
Savings Through Prevention
Now pair those savings with prevention that pays for itself. Trust for America’s Health reports that strategic prevention investments generate net savings within a few years. The CDC has shown that every dollar invested in community-based prevention programs returns more than five in reduced medical spending. Vaccines make the logic plain: the 2024 CDC analysis of routine childhood immunizations found that every dollar spent delivers eleven dollars back to society. That is not wishful thinking. It is math as hard as the asphalt I landed on that night.
Put the pieces together. Trim administrative waste and inflated prices. Capture a portion of those savings to fund real public health: safe streets, food access, clean air and water, education that helps families cook and move and rest. Use the rest to make healthcare reliable and simple. The net effect is not just a moral win. It is a financial one.
Other Bottom Line Benefits
And the ripple effects stretch even further. When workers are healthier, they take fewer sick days. The Milken Institute estimates that chronic disease costs U.S. employers over a trillion dollars a year in lost productivity. Imagine reclaiming even half of that, not just in dollars, but in energy, creativity, and human presence.
Small businesses, too, are strangled by premiums. Right now, they pay into a system that siphons off more than six hundred billion dollars a year just to keep employees covered. Single payer lifts that weight. It levels the field, letting a three-person start-up compete with a multinational. It frees entrepreneurs to take risks without calculating how they will cover their families if something goes wrong.
For owners, the picture is just as clear. Today’s average family premium in the mid-twenties of thousands flows out of the business whether or not anyone gets healthier. In a wellness-oriented single payer, employers stop being de facto health plan administrators. They hire and invest instead of wading through renewals, network maps, and prior authorizations. The economy gains in productivity because healthier people miss fewer days, recover faster, and bring more focus to their work. Premium growth projections show how urgent this relief is, with costs expected to keep climbing under the status quo.
It’s Not About the Money, But Who Gets It
Here is the simple narrative spine. We already spend enough to cover everyone and to build healthier places to live. We are just spending it in the wrong places. Cut waste. Bargain drug prices. Invest a fraction in prevention that pays back. Use the balance to guarantee care when bodies break. That is how the healthcare side funds the public health side. That is how the project becomes reasonable on a spreadsheet as well as righteous in a neighborhood.
But it’s not like those bean counters don’t know that. They do. But they aren’t interested in those actual costs, they’re wanting to know what it’s going to cost them. Their objection is about their bottom line, where the quarterly report makes no attempt to measure: happier humans, steadier families, or communities that thrive.
Benefits Beyond the Bottom Line
And there is one more bottom line worth naming. Anxiety and depression rise when people live one accident or one diagnosis away from ruin. Families crack under the stress of bills they cannot pay. Workers drag themselves to jobs sick because they cannot afford to miss a paycheck or lose coverage. The mental health burden of our current system is incalculable, and yet it touches every household.
A system built on wellness would ease that weight. It would free people from the constant low-level panic about what happens if something goes wrong. It would let families breathe, plan, and even dream. The return is not just financial. It is psychological, emotional, and communal. It is the quiet relief of knowing you are covered, the dignity of choosing work you love without fear, the steadiness of a culture where health is the soil we all grow from.
That, not removing food dies, frying with beef tallow, and using real sugar in Coke is how you make America healthy again.
What Can We Do Today?
So that’s the dream, but what do we do in the meantime? In the end, what saved me after my accident wasn’t an insurance plan or a system designed for human thriving. It was people.
A friend from the gym who practices traditional Chinese medicine opened her clinic doors and placed needles where pain had gathered. Another gym friend lent me infrared equipment to coax healing back into my tissues. A chiropractor I’ve known for years reset what the crash had thrown out of alignment, charging me less than the cost of a copay. A doctor friend who also happens to be a two-sport physician for Team USA, experimented with non-surgical treatments, gifting me sessions not only for my healing but for the sake of discovery.
My body began to mend not because I had access to a card in my wallet, but because I had access to a web of care. Friends showed up. Neighbors carried part of my load. Community became the hospital.
That is the cruel paradox of our current moment. We live inside a system that calls itself healthcare, yet it is built to extract, not to heal. And still, in the cracks of that system, real health emerges through solidarity. Not through premiums or deductibles, but through love and shared presence.
Imagine if our public systems were shaped that way, if the same care my friends offered one another was baked into the structure of how we all live. Imagine a model not of sickness management, but of human flourishing.
It would invite us all to stay human.
Practices To Move Towards Health
Here are three practices to help you move towards health. Whether your day only allows for a 60-second reclamation reflection, your week a one-hour resistance ritual, or you find yourself ready for a full on rebellion against a world that assaults your humanity, I have something for you.