Healthcare Innovation and Personal Wisdom with Jeffrey Lewis

Discover how innovative healthcare solutions can transform lives as we chat with Jeffrey Lewis, President and CEO of Legacy Health Endowment. In this episode, we explore the unique healthcare challenges faced by middle-income families in rural California counties like Stanislaus and Merced. Jeffrey reveals how his organization steps in where government assistance falls short, providing critical services such as a $2 prescription drug program and free eye clinics. Learn how these initiatives make a significant impact on communities often overlooked by traditional healthcare systems.

You'll gain insights into the scalability and broader implications of these pioneering healthcare programs. Jeffrey discusses the remarkable $2 generic drug initiative, which offers a thousand different medications, including life-saving insulin for diabetics not covered by Medicare, Medicaid, or VA benefits. We'll also uncover effective strategies for promoting public health initiatives like COVID-19 vaccinations, utilizing social media, radio ads, and community influencers. This episode underscores the essential role of government and philanthropic support in sustaining these vital services.

Finally, we delve into personal stories and life lessons from Jeffrey's own experiences. Hear about the importance of listening, kindness, and flexibility, as Jeffrey reflects on his upbringing in Detroit and the value of empathy and teamwork. We'll also touch on personal joys such as creative writing and the therapeutic value of smoking cigars. Jeffrey even reveals how quotes from everyday people enrich his work and life. Join us for an enriching conversation that blends practical healthcare solutions with heartfelt personal wisdom.

Transcript

Speaker 1: 0:00

Welcome to Interesting People, the podcast where we delve into the lives and stories of fascinating individuals from all walks of life. I'm your host, justin Wallen. In each episode, we bring you inspiring, thought-provoking and sometimes surprising interviews with people who are making an impact in their fields and communities. There's only one common thread that the world is more interesting because of them. Get ready to be inspired, entertained and enlightened as we spotlight the extraordinary. Let's dive in. I am joined today by my good friend, jeffrey Lewis, president and CEO of Legacy Health Endowment, and has done a heck of a lot more over the course of a illustrious career, and I am fortunate enough to not only call Jeffrey my friend but also my client, and it's terrific to have you here today. So thank you for joining us.

Speaker 2: 0:52

Delighted. It's always an opportunity to be with you, whether it's on video, orally or otherwise, and let's roll.

Speaker 1: 1:00

Absolutely Well. I was wondering if you might be able to tell me a little bit about what you're doing with Legacy, because you do incredible stuff in a part of the world that has unique challenges, and you work with people who are uniquely overlooked in a special way, and it's terrific work. I'd love to hear a bit about.

Speaker 2: 1:21

So we operate in two rural counties in California, stanislaus and Merced counties in the California Central Valley. So you're about two hours from a major metropolis. It's been in a highly defined metropolis but you know it's a very international melting pot community. It's heavily it's predominantly Latino but you have Ukrainian, afghan, hmong, punjabi, sikh, a Portuguese, swedish, african-american and a few white people, you know, sprinkled in. So it's a really amazing place because it's become such an international melting pot for you, pot for the immigration service to place people.

Speaker 2: 2:08

But the health care challenges that are faced by these communities that are not eligible for Medicaid, the federal income program that helps poor people, middle income and lower middle income families suffer. They are constantly looking for solutions financial assistance, foregoing care because they have a high deductible health plan and typically mom or dad are going to make sure the kids get what they need but they will forego care for themselves. So we build solutions to assist them. You know my belief is middle-income families should not be penalized because they're not poor and that government has a responsibility which they fail to achieve. So philanthropy can be that partner in making up the difference and using charitable dollars to create a $2 prescription drug program like we have for a thousand different generics or a community-based long-term care program for aging elderly people living at home with a loaner, with a spouse or a child of an aging parent, where we can provide those services to free to help them stay in their homes and not have to spend their retirement nest egg. And when you do those kinds of things you see great results and the people are enormously grateful. But you know you walk around at least I get to walk around with my heart always smiling.

Speaker 2: 3:41

Called Patterson, we're hosting a free eye clinic for anybody from our 19 zip code area, but predominantly the west side of the county. Now we have 300 people signed up for Monday and 250 people signed up for Tuesday. We're doing it with a vendor called Optical Academy out of New Jersey, which is just a stellar organization, and you come in for a free eye exam and if you need glasses, they take your results, they produce the glasses on the spot. At the end of the day, you pick them up and you walk away with a free pair of glasses and an exam For kids. This is essential. We found that when we did this about two months ago in five public school systems that the average number of children who needed glasses was ranging from 30% to 65%, so they all got free glasses they can see and then a large percentage of kids who needed new lenses. So when you can use charitable dollars like a venture capital fund, like we do, or private equity, and you invest in communities, you can see real great results.

Speaker 1: 4:56

It's remarkable work. I want to talk about the programs in a moment, but first the gap, the need. Maybe you could paint some color around that, because you know the insurance in America has always been storied and it's always been expensive and challenging, and I think it's one of those things that you know. If you're in a light mood, it's the sort of thing that all Americans can joke about, but they do it darkly. And the largest change to America's medical structure was ACA recently and we're told that we're covered. But what you're describing illustrates something very different. But what you're describing illustrates something very different. So what does that look like for folks? You described briefly who they are middle income. Can you describe that a bit more? And can you describe a bit more the gap that they're facing and how that impacts them?

Speaker 2: 6:05

impact impacts them. So middle income families, traditionally in working, are buying high deductible health plans that range from $2,500 to $10,000. They have to meet that piece of the deductible before the plan kicks in. They buy a high deductible health plan because the monthly premium is less. So while you have Obamacare out there under the Affordable Care Act and they offer all these programs and it's great that they offer them more and more people are buying high deductible health plans because it's less expensive to buy and they can check the box and say I got coverage. But when you've got a couple of kids and you've got, you know, parents or whoever they might be in a mid-40s and they're trying to work, they're trying to save for a rainy day, they're trying to save for education, they're trying to save for retirement, they're trying to save, they're 10 steps backwards because they don't have the discretionary income you know whether they can meet the 403, 401k or the 403b contribution, which means if they don't put the money in, the employer doesn't match it. That's middle class America today. Defined benefit plans of 20, 30 years ago that were great, that you went to work for somebody, they had a pension plan. You left after 20, 25 years or whatever the years you were, but you had a retirement plan in place. That's not America today. That is bipartisan neglect. You can't blame Republicans, you can't blame Democrats, you can blame them both. Because working families suffer because of their neglect.

Speaker 2: 7:45

Healthcare has just made it worse. Yes, the Affordable Care Act was provided. You know it was a big deal that it got passed and it has served a lot of people. But it's also expanded the Medicaid population, people who are poor, people who come in as immigrants, who get free healthcare services. California, you know, the governor lifts the veil on giving more free health care to illegal immigrants. Well, that's great. It keeps them out of the hospital, they go to the hospital, they can pull out their card and the hospitals can get penalized. But what about the middle class? What about middle-income families who've never stopped working and strive to do that? That's the picture in California Central Valley. But that's the picture of America today.

Speaker 2: 8:31

And imagine that this population of people, as they age in place, their biggest asset, if they have one, is going to be a house. So they age in place and if that's their biggest asset and they have to hold on to that, if at some point they can sustain themselves or not. That asset has to be sold and it depends on the economy what the value of that home is. America is in a very challenging position. When you were a kid and you paid or I was a kid 19 cents a gallon for gas, I can remember like it was yesterday. You're paying in California for premium gas. The cheapest is about $4.69 a gallon.

Speaker 2: 9:16

You go to a store and buy a gallon of milk. You're going to pay somewhere between $3.50 to $5, depending on the kind of milk you want. A loaf of Wonder Bread? Just basic white bread $3.50 to $5, depending on the kind of milk you want. A loaf of Wonder Bread, you know, just basic white bread? Yeah, $4.

Speaker 2: 9:30

Families are struggling because they're often stuck. This is America's forgotten middle. You know this is who politicians hope they speak to but never really focus on, because if they focused on it, we would see more tax cuts in place. We would see more incentives in place. It's not just about being a good environment and buying a car that's got an electric battery and you hope how long it will last. It's really about rewarding people for doing a common thing and commonly well, rewarding people for doing a common thing uncommonly well, and legislatures of state and federal, and Congress have forgotten about that. And presidents, despite who they might be, when they were in Senate or elsewhere, you know they can say whatever they want about the middle income, but doing is a whole nother thing.

Speaker 1: 10:22

Yeah, and those plans they were. They were touted as being plans for the young and the healthy. That's what they were described as. You have high deductibles because you're not going to need these services really except in the case of emergency. But they're really being used in a practical sense by the middle class and it's a gamble, right. Because they're being used because they can't afford higher insurance or better insurance but at the same time, nor can they afford to fill in that $8,000 to $12,000 deductible. So when those costs come in, they are taking money not from a jet ski but from the eyeglasses fund or from their retirement. And that part's important right, that particular component which you described Americans not planning for the retirement, because that's the structure that we have and not being able to fund that retirement has a long tail of impact to America and to other Americans. There's a lot of reasons to fill this gap.

Speaker 2: 11:25

The opportunity that I have in the Central Valley is to be the gap filler, to figure out what the solution is, to build the solution, use charitable dollars to create it, test it, making sure that it's affordable for people. When I mentioned earlier that we have a generic drug program, that we work with one pharmacy where a thousand different generic medications are available for $2.

Speaker 1: 11:50

Which is remarkable. That's just amazing. I mean, it is the meme of our time. The cost of medication it's extraordinarily high. How can you do that with them and make it work?

Speaker 2: 12:05

And we're doing the same thing for insulin-dependent diabetics who are not Medicare, medicaid or VA eligible. But imagine, you know, when the Congress talks about or the President talks about, you know, $35 insulin and it's a big deal for Medicare. But when they forget to take care of the other medications that they're taking, what we've heard is comorbidities. Those dollars amount up so that $35 means you've got typically three to five other drugs that they're taking. That $35 becomes $75, $100 a month. It's still more money out of their pocket because they didn't extend, they didn't figure out, put that circle around that diabetic to really care for them. But our program, we say to any person who's insulin dependent you come to the same pharmacy. We have a $2 program. We make up the difference in the copay or what the deductible is, using charitable dollars because you're a working class family and you can put that money back in your pocket, buy food, buy gas, whatever you're gonna buy.

Speaker 2: 13:03

And the same thing as we look at, how do you look at the public health of the nation or the public health and where we are in those two counties. The challenges are enormous and public health, from all aspects, is important because that's what drives the nation's health. You know, a lot of people never got a COVID vaccine, never thought about it, never wanted it. Never got a COVID vaccine, never thought about it, never wanted it. No, we figured out a way to get people vaccinated by rewarding good healthcare and we found a vendor who wanted to give them a gift card. They gave them a gift card and they came in the doors. 100, 200, 300, 350 people. So there's an incentive. But, more importantly, what you're providing is you're teaching them about good public health and the importance of having their children vaccinated so they don't get sick.

Speaker 1: 13:58

Yeah, that's an important part because it has a communications element to it, right? I mean you have to speak to people in a way that they're receptive to. That modifies their behavior. How do you go about that?

Speaker 2: 14:13

I wish there was one answer and I would answer your question this way. You use all the tools in the toolbox, from social media in English and Spanish, to newspaper ads, radio ads, sometimes billboard ads. You test multiple options to see what succeeds. There isn't one thing that speaks to every group. There's a Facebook program that's targeted for moms. There's a radio ad that's in Spanish on the largest radio station, hitting the Hispanic population. There are other social media sites, like you see candidates today who pull up Instagram and some political ad pops up because they want something. You don't want something.

Speaker 2: 15:01

We wanna just tell you about something that's not gonna cost you anything an education and we've found that you just continue to throw stuff against the wall to see what works and sometimes spin in the population, whether it's a Punjabi population or a Hispanic population or Afghan population. You figure out the right way to get in the door. Hispanic population often have a large group of promotores. You know, typically women, who are community influencers who help explain how the world works to new immigrants and helps them out. You work with them to do this. You find the priests in the Catholic Church speaking in English and Spanish, depending on what time of the Sunday it is, and asking him for help, or the head priest for the Assyrian church, the Church of the East. I wish we could come up with a single communication strategy, but what my experience has been is that we try multiple things to see what is the most successful and there isn't one really successful term to use. It's multiple.

Speaker 1: 16:13

We just keep throwing multiple strategies out there and you pick up different pieces so you, you've made these impacts in the 19 zip codes under the purview of the endowment. How does something like this well? The first question is how has this not been scaled in the past? With, of course, the second question is how do you scale it? Is it even possible? Or are these things really something that need to be highly, highly regionalized, highly focused and they're not scalable? Why don't we see this on a larger scale?

Speaker 2: 16:53

Well, traditional philanthropy likes to fund stuff that doesn't focus on the middle end. They may do a little bit here, a little bit there, but that's not their focus. It's a bunch of other things and they do incredible work. You know, what I've realized over the years is how you scale. Something is the population that you're targeting. So everything we do is scalable. Whether it's affordable is the next question. So you could design a $2 prescription drug program in any city, large or small, across America. You find the right pharmacy partner who's willing to work with you. You find the right pharmacy partner who's willing to work with you and you find a philanthropy who's willing to underwrite the cost between the two dollars and what the original copayment did. It's a great way to do it. You could pass a city ordinance, a tax provision in a city or a county where one half of 1% would go to covering the cost of prescription drugs for anybody that lived in Stanislaus County. If the voters wanted to do that, you could create a long-term care community-based solution in any city or county, using tax revenues and recognizing that. Why should Medicaid people on Medicaid get free services when the middle class are striving to survive with little or no help buying Medicare supplemental plans or a wraparound long-term care plan. That becomes exceedingly expensive the older that they get because they didn't plan for it. So it's scalable.

Speaker 2: 18:25

Government has a role. If you are willing to focus dollars on that, as opposed to just constantly raising the gasoline tax, why not put a tax in place that's dedicated to long-term care services for anybody not Medicaid eligible up to, let's say, 500% of the federal poverty level? And you're really hitting the middle end. You could do the same thing in any city or county. The political will to do this is gone Because some like to raise taxes on stuff to penalize millionaires and billionaires.

Speaker 2: 19:06

What they don't realize is that string only stretches so far and those millionaires and billionaires. What they don't realize is that that string only stretches so far and those millionaires and billionaires leave the area. They go to another state, they go to Texas, they go to New Hampshire. They can pick an area, but the electeds are so focused on the reelected themselves that the needs of the country go unaddressed. You look at the border, you look at these other places and the collapse of society. Social media how do we educate more children and parents about the impact social media has on your child's mental health. But we responded. We produced state-of-the-art publications on you know everything a parent should know about social media, everything a parent should know about gaming. Pop it on the website. Make it available for free. We've got people assigned to go out and talk to parents about it and educate them.

Speaker 2: 20:03

But do I have a member of Congress who wanted to put it on you on, introduce it and put it in the congressional record Not kind of a deafening sound back there, and that's what it takes. You know it's how do you say to publicly elected officials let's do something. The difference I have. I have a city mayor of Turlock who a majority of the city council, love the work that we're doing, so they're a financial partner in the process. Well, we just launched a free telehealth program for any adult 18 and over, with commercial insurance or uninsured. 12 visits a year, all asynchronous. You sign up for the program, send a text, you send an email to the program, you're talking to your medical care provider. That way they answer your questions, they respond, you know your test or you get your medication they send to one pharmacy. We have a city manager in turlock who made sure that every resident 75 000 people in their utility bill got a copy of what we call so Cares. So they all knew about it. Whether they sign it for it's a different issue, but at least it's a great way to communicate with people when you have leaders like the mayor of Turlock, the city manager for Turlock, a couple of county supervisors who are great partners and you help people.

Speaker 2: 21:27

Or I got a city council member, carlos Rocha, who's in Patterson. He cares about the individual because he lived there before. He knows how tough it is. He knows what those Hispanic families are going through. He's dedicated to making their lives better for whatever it takes to do. That that's a lot of in the 19th century. We have a lot of elected officials like that. We also have the ones who just talk a lot and don't do a lot. But I would say to you you know you got a mayor like I have in Turlock, and a city council member like Carlos and Patterson, and our county supervisor Vito, and another county supervisor, chance. You know you find the good in people. We help them look good too.

Speaker 2: 22:17

Remember, I've done this stuff for so many years. I'm behind the scenes. I don't have to have a TV camera talking to it, I'd rather have you talk to the TV camera. So how do we optimize programs? To grow them and make them successful is by making somebody else successful. That's what really works. I could write the op-ed. I'd love to have it in the paper, but you know what If I put your name on it as the director of this program. You're invested and you get those calls in the morning from people ah, it's a great piece. All right, I saw you. You know they love that. Well, I don't need that. I'd like my piece in the New York Times or the Wall Street Journal. So I still strive for that. But you know when you can take local leaders and help them. You know again, do that common thing uncommonly well, learn how to grow, and they don't have to talk a lot, but they can do more.

Speaker 1: 23:15

They learn very quickly. Doing is all it's about. Yeah, that has to be some of the best advice I've ever heard to anyone who wants to make change in their community and do noble things, because it's practical right and it is meaningful, and it speaks to what drives people in an eyes open and, I think, respectful way to what makes us human beings right. This response to that and you have been doing this for a long time what else would you tell somebody who is and I'm thinking about our younger folks who want to make the world a better place over the course of your career and that one thing, that's it. That's fantastic, but is there anything else that you would suggest as good to keep in mind? Lessons that you've learned along the way that were hard won?

Speaker 2: 24:11

The first is learn how to listen.

Speaker 2: 24:16

It doesn't matter how long that person is talking. Give them the opportunity to talk, don't interrupt them. Take a little piece of paper, a card. Write your notes on it where you're going to have questions, maybe a rebuttal, but let them talk and so you can listen to what they said. Don't just hear them, but listen to them.

Speaker 2: 24:39

The second part is, and not in any particular order is kindness. Remember that the life, that that person who could be homeless or have a challenge or something that could be you. I've never forgotten what it was like growing up in Detroit, michigan, where we were poor. We didn't know we were poor, but we were poor. Michigan, where we were poor, we didn't know we were poor, but we were poor. But you never forget. You don't forget values and the importance of. I am my brother's keeper, and those are things that I will tell you. I wish I could teach people these things, but it really becomes intuitive. Some people just don't have it and others exude just every day, because that's the fabric of who they are, you know.

Speaker 2: 25:27

I think the last thing would be have flexible fabric. Allow your life to be very flexible, allow yourself to pivot. It's a really interesting thing. Could I take two months off and go work on a campaign. You know what? Go do it Because it'll be a great experience. You might be licking envelopes, but you're on the team. Life is about being a team member. Lots of rookies out there, lots of all-stars who are individuals, but when you're part of a team team and we're all working collaboratively, you are making yourself and everybody around you and you're learning from them because you're listening and you're watching an act of kindness that you might have not thought about. And don't forget the one thing that said you know that could be me. I got to make sure I'm helping that person in some way. Things you listen to and learn about and never forget.

Speaker 1: 26:34

Final thoughts what do you do to make for yourself, so that you're happy, so that you can do everything that you do tirelessly? What keeps the engine going?

Speaker 2: 26:51

Four things, maybe more, but four things. First, I've been married to the same person for 41 years. We've been together for 43 years, my second marriage. I did something right the second time I married up. I don't know why she married me, but I'm blessed and lucky at the same time. But besides having just an incredible partner and she is she's smarter than I am, so I've learned how to listen and there are things that she does that are just incredible, and I have to remind myself one to not say anything, not ask questions yet, but to watch what she's doing. She's an artist and not a real artist, but she's an artist. How she does things, how she thinks about things. I learn from her. It's a great lesson in life.

Speaker 2: 27:40

Second thing is I we work in two different areas of the state. She lives on the coast, I'm in the Central Valley, so for three and a half days a week we're living in different cities and there's some healthy parts to that, but frankly, it's lonely. I live in a cigar bar the rest of the time mostly, or back there with a couple of friends and smoke cig time mostly, or in a backyard with a couple of friends and smoke cigars with them. So I stopped drinking years ago. I started smoking cigars. I've become a cigar snob, I guess one could say.

Speaker 2: 28:10

But the other thing that's really my salvation is writing. You know, I looked at I started this job in 2016. I've published 100 op-ed pieces since June 2016. Now they don't. They make the Turlock paper. They make some of the smaller papers, occasionally Modesto, occasionally a big paper.

Speaker 2: 28:35

But the other thing that I really do is I've gotten back into poetry books. So every year, at least once a year, sometimes twice, I sit in the cigar bar called Chirrut in Modesto, California. It got advertised for me. Great place. It's owned by a great woman and I listen to what's around me. And I listen to what's around me. I don't listen to the conversations as much as I'm listening to the words that they use and I'm writing little notes. And I got my iPhone, I got my note thing.

Speaker 2: 29:08

I'm typing in ideas, but I'm thinking about ideas and how do I write something that the average person could respond to? We might see a nugget in it that they'll take away from, and it's a great vehicle for not only sharing. But I have a publishing company called Otis Press. They produce a couple of hundred copies a year. I nail them around the country to friends and family, and mostly friends and colleagues, but it's a great way of channeling other energies into something positive. But look, I take on topics that most people don't talk about or are uncomfortable with and try to make them so you'd be less uncomfortable. The newest piece I'm writing now is called Fear Walking, and it's all about courage. So I'm creating a new poetry book about courage. It's such an interesting topic and not one that's well written about, at least poetically. So, other than that you know, four bottles of hint water every day, or more, and some Diet Coke with lime, I'm good to go.

Speaker 1: 30:32

And I've been fortunate enough to have you share your poetry with me, and it really is wonderful. It's been more than a true pleasure having you on, and thank you, my friend, it's been great. I sincerely appreciate your time and your thoughts. Thank you.

Speaker 2: 30:48

Wonderful having you on. No, it's my honor. It's not a pleasure, it's beyond a pleasure, it's an honor. I mean, I love people with big brains. Clearly, when we hired you for all the work that you do as a consultant for us, your brain just explodes. I'm the sponge.

Speaker 2: 31:03

So if there's any lesson I could teach people, besides being a great listener, is be the sponge. Soak it in in terms of what that person is talking about. Take away something whatever maybe two words, it could be one line and journal it and go back to your journal. I've got a book I carry actually not this one, but it's like this called and it contains it's a book full of pages of quotable quotes, not from Nobel Prize winners, but from average people who are. I use their some portion of what they said in something that I'm writing to make it more impactful and more meaningful. But your brain is one of the best in the country, which is why I like you, but more probably why I respect you. You're too kind.

Speaker 1: 31:52

Thank you. Have a great day. All right, my friend, you too. Thank you for tuning in to Interesting People. I hope you enjoyed today's episode. If you liked what you heard, be sure to subscribe, rate and review the podcast on your favorite platform, and don't forget to follow us on social media for updates and behind-the-scenes content. I'm Justin Wallen, and until next time, remember that the world is more interesting with you in it.