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Supporters of U.S. Sen. Bernie Sanders (I-VT) hold signs during an event on health care September 13, 2017 on Capitol Hill.(Photo: Alex Wong/Getty Images)

How This Rural Wisconsin County Put Publicly Funded, Non-Profit, National Health Care on the Ballot

Is it possible that the people of these rural communities, under the stress of a broken health care system, can spark a movement to fix health care for the nation?

Kay Tillow

Citizens of Dunn County, Wisconsin, have a plan to place national, publicly-funded health care for everyone on their November 8th county ballot.  In June and July at meetings of the County Board of Supervisors, many spoke of a broken health care system and their proposal to fix it.  After the third meeting, the Board voted unanimously to put the following question on the ballot:  

“Shall Congress and the President of the United States enact into law the creation of a publicly financed, non-profit, national health insurance program that would fully cover medical care costs for all Americans?”

Located in central west Wisconsin and blessed with lakes and farmland, Dunn County is far from bustling cities. About 16,000 of its 45,000 residents live in Menomonie, the county seat, named by the Smithsonian as “One of the Best Small Towns in the USA.”

“Nobody in my family is going to retire sitting pretty and most of the reason for that can be laid at having to pay off medical expenses, even though we were insured, for months and months and months, and that is money we did not spend on all the things that you can spend money on right here in beautiful Dunn County.”

By focusing on the health care crisis in America’s heartland, the people of Dunn County hope to propel the issue onto the nation’s agenda.  They believe that rural concern for neighbors just may outweigh the rancorous partisan divide, and with the idea spreading, influence a Congress that has, so far, refused to consider Medicare for All.

On July 27, 2022, between the pledge of allegiance and the story of how the county fair proceeded despite the windstorm that took out the electric milking machines, they stepped to the microphone at the Board of Supervisors’ meeting to insist that those who represent them allow their voices to be heard in a ballot referendum.  

Margie Hagerman of Menomonie spoke first. “The health care of the majority of Americans has been declining in recent years with lower life expectancy than other developed countries. Other… countries have found ways to cover everyone through a national, non-profit, health insurance system. Why can’t the United States?”

“If you put a referendum out you're giving a voice to the people--you need to do that because we exist only by the consent of the people,” said Michel Brandt.

John Hoff said, “currently the drug pharmaceutical system is totally stacked against the individual—yes, they're working on something in congress but that's only for 20 drugs.” 

Tom Walsh told of his son, a small business owner, who, since the Affordable Care Act, has paid $750 a month for insurance with a $5,000 deductible. “He can get one physical exam a year—that will be free…but the rest of it he pays out of his pocket.  We need Medicare for All basically to save small business owners, save people that are susceptible to bankruptcy because they can't afford to pay for their insurance and if they do have it the deductible is so high it really doesn't help that much…so we really need a national health insurance program.”

Steve Hogseth called attention to the top 23 countries ranked for their democracy and asserted that, of them, the United States was the only one without universal health care of some form.

Lenore Mercer spoke of working in a clinic when the former governor suspended Badger Care. “I'll always remember a clean-cut, hard-working, full-time employed father breaking down and saying I’m not worried about myself, but for my kids, how will they get to see a doctor? I thought this is so wrong.” 

“Our for-profit driven system balloons profits for insurance companies and drug manufacturers and now millions of Americans can't afford health care,” Mercer concluded.

Retired physician Lorene Vedder ended her comments by asking those in the audience who supported putting this measure on the November 8th ballot to please stand. All rose.

Monica Berrier, Dunn County Supervisor for District 13, weighed in at the Legislative Committee Meeting. “I want to make the argument that it really is in the county's interest to be advocating for a better health care system… I'll do this through the perspective of our budget and whether the current system is a responsible use of taxpayer dollars.”

She said that the county spends about $500,000 each month on health insurance and that in the 2022 budget, $10 million out of a $90 million budget has been set aside for health insurance. The $90 million is not just for personnel but includes all county operations. 

“So we’re spending a lot but when we compare that to what the employees are actually getting it’s a pretty bad deal. They’re part of a system where delays and even outright denials of care are routine.  I believe that as elected officials and stewards of taxpayer dollars we have a responsibility to demand better of the federal government that serves us.”

Berrier laid it out. “I want to close by thinking about what we could do with this money instead.  We all know that the budget process comes down to higgling over fifty dollars here a hundred dollars there.  A couple months ago we had a good discussion about the wheel tax and many of us including myself are worried about the potential impact that this might have on people who can't afford it.  For comparison, the wheel tax brings in just $700,000 every year and that's peanuts compared to the 10 million dollars we are budgeted to spend on health insurance this year…instead of wringing our hands over the wheel tax we could be just fixing the roads instead. I think that we as elected officials really have a responsibility to advocate for a more efficient health care system”

Dr. Vedder had spoken earlier to the Dunn County Executive Committee.  “My chief concern is a decreasing life expectancy that we have in this country. If you compare Canada to the United States, they live 4.5 years longer than we do.  Back in 1970 we lived the same life expectancy so why are we seeing this difference?

“People are afraid here in our country to access health care because of the excess cost of medical care--30 million people in this country don't have health care insurance, 44 % don't have the funds to obtain medical care even if they have insurance.

“We access health care a lot less than any developed country in the world. By avoiding health care we have our people…coming to emergency rooms when it's too late to treat them, their disease is too advanced.  We bankrupt people over medical bills—nowhere else in the developed world are people bankrupted by their health.”  

Someone announced that the issue would be placed on the agenda for the Legislative Committee.

The health care advocates came prepared to speak at the Legislative Committee Meeting on July 20.  At a couple of minutes per person, they filled the first 35 minutes of the meeting.  Dr. Steve Brown told of his wife using health care services in Portugal, receiving x-ray, lab services and IV antibiotics.  She was diagnosed with Legionnaires disease and received good care.  He said that even though they did not have travel insurance, the bill was reasonable—about $160.

Steve Carlson of Trego spoke of a precedent in Wisconsin for a health care ballot question fourteen years ago when county voters agreed that everyone in the state should have health care coverage equal to state officials.  He said that people in Washburn, Douglas, and Portage counties are working on placing referenda, like the current one proposed in Dunn County, on the ballot for the Spring election.

Louisa Gerasimo told of medical bills that depleted retirement savings. “Nobody in my family is going to retire sitting pretty and most of the reason for that can be laid at having to pay off medical expenses, even though we were insured, for months and months and months, and that is money we did not spend on all the things that you can spend money on right here in beautiful Dunn County.”

Commission Hager commented that this issue had roused the most public interest and comment since the ATV county road expansion.  The supervisors voted unanimously to place the issue on the ballot.  Chair Kelly McCullough said, “Looks like we will be having the referendum all right…that also answers the question of pressuring your legislators—does it work—it looks like it all right.”

Rural health care is in deep crisis. Over 800 rural hospitals are under threat of closing.  Rural physicians struggle to survive on the meager payments of Medicaid.  Mergers and acquisitions accelerate the pain as hospitals are bought up by those whose only concern is profit.  Delayed care causes untold suffering and death.  Is it possible that the people of these rural communities, under the stress of a broken health care system, can spark a movement to fix health care for the nation?

Some people in Dunn County think so and are working to make it happen. 


Our work is licensed under Creative Commons (CC BY-NC-ND 3.0). Feel free to republish and share widely.

Kay Tillow

Kay Tillow is the coordinator of the All Unions Committee for Single Payer Health Care, which builds union support for national single payer health care. She lives in Louisville, Kentucky.

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