107. J.J. Bartlett, Fighting for Fishing Families

Show Notes:

J.J. Bartlett kicks off the conversation with a short explanation on how his wife shaped his career in various ways. He took healthcare management in graduate school and his primary reason for this was his interest in extending healthcare coverage. The President Clinton and Hillary Clinton Health Plan had just failed in 1994, and he was interested in finding new ways to extend coverage.

Health Coverage for Fishers

J.J. shares his connection to the fishing industry, which includes individual fishermen working on boats as independent contractors. The majority of these individuals are men, with some women. He explains the situation of fishermen in the 90s, where half were uninsured, while the other half only had coverage through their spouse, Medicare, Medicaid, or junk coverage. The conversation turns to the structure of the plan for community health plans for independent professionals in Massachusetts which was a collaborative effort between fishermen, politicians, and other stakeholders. The plan was designed to provide coverage for those directly related to the fishing industry, requiring more than half of their income to come from fishing. This was done to ensure that income from commercial fishing was counted, and that no whaling or other issues were present. The plan was funded through federal and state funding, with the federal money being kicked in early and the state program being a state program. The federal money allowed the program to reduce the rate that fishermen paid on average by 60%, which was beneficial for taxpayers as they could afford it. This was done on a sliding scale that was redid every year to accommodate fluctuating incomes in the industry. The plan smoothed out a period for fishermen to afford coverage over a period of time, rather than going on and off coverage. J.J. shares a recent example of this which led to fishermen not being eligible for mass health. 

The Model for Obamacare

J.J. talks about the origins of the Fishing Partner Health Plan healthcare system. The conversation turns to the Massachusetts State Health Plan, which became the model for Obamacare, and was influenced by the people involved in the Fishing Partner Health Plan healthcare system. Some of the lessons learned from the Fishing Partner Health Plan healthcare system include the importance of not carving out the most endangered population in the country, but recognizing the importance of providing healthcare through enrollment offices. J.J. shares an example of a successful implementation of the Fishing Partner Health Plan healthcare system. The lessons learned from the Fishing Partner Health Plan healthcare system can be applied to other industries to help ensure that the most vulnerable populations receive the necessary care and support.

The Health Plan Today

The health plan initially provided treatment for those in shock or depression following an accident, but it stopped in trying to get them insured. However, they now have a system of care available, including safety training for fishermen and a national grant program. This is a preventive measure for the deadliest job in the country. Additionally, they have relationships with trauma centers, providing treatment for those injured or witnessed the accident. This trauma care is available to employers within their HR department. After 15 years, Obamacare allowed people to transition to the new system. 

The Fishing Partnership Support Services

J.J. talks about how many workers in many occupations do not have adequate coverage or even the ability to take time off for illness. At the top of the list are Massachusetts fishermen. The organization, Fishing Partnership Support Services, has been in operation since 1997 and focuses on providing various services to the fishing industry. It trains community health workers to help people transition from uninsured to insured, especially for fishermen with fluctuating incomes. The organization also runs a community health program that provides preventive care. They have also begun behavioral health services, addressing the issue of opioid overdoses among fishermen. J.J. also talks about the problem of dealing with extreme pain and addiction. Fishermen are more likely to die from opioid overdoses due to their job-related pain and the high costs associated with working on boats. The organization's navigators help address this issue by educating fishermen about the importance of their jobs and the need for first aid. They also provide training on carrying Narcan and its use, with navigators trained as recovery coaches. The organization partners with various treatment groups, including trauma support, to help fishermen navigate the challenges of substance use disorder and other workplace issues.

Influential Harvard Courses and Professors

J.J. highlights the importance of the people, such as Governor Maura Healey and Mayor of New Bedford, who have supported the program and worked with him. He also mentions the connection between the fishing industry and the city of Boston's history. He also mentions his experience working with Senator Kennedy and his staff.

Timestamps:

02:04: Career Beginnings and Graduate School 

03:36: Healthcare Coverage for Fishermen 

05:18: Challenges and Successes of the Health Plan

06:30: Healthcare Options for Independent Workers 

14:34: Structure and Funding of the Health Plan

21:44: Transition to Statewide and National Reform 

24:30: Impact on the Fishing Industry and Community 

43:39: Current Work and Future Goals 

43:53: Reflections on Harvard and Career Influences 

Links:

Website: Fishingpartnership.org.

Featured Non-profit:

The featured non-profit of this episode is The Boys and Girls Clubs of America, recommended by Jenny Atkinson who reports:

“Hi. I'm Jenny Atkinson, class of 1992 the featured nonprofit of this episode of The 92 report is Boys and Girls Clubs of America. Boys and Girls Clubs are places young people can go during out of school hours to get educational support, participate in sports, arts and other programs, build positive relationships with peers and adults and just have fun. They're usually in the most under resourced communities in a city or town. I started volunteering at a Boys and Girls Club when I was a freshman at Harvard, and have worked at the national office and as an executive director of a club and always a supporter of their work. You can learn more at BGC, a.org where you can search for the Boys and Girls Club nearest you. Check out your local club. They're some of the most hopeful and joyful places I spend time. And now here's Will Bachman with this week's episode.”

To learn more about their work visit: https://www.bgca.org/