[Intersection Podcast] Episode 001 - The Bridge Builder

Podcast Hosted by Bobby Rettew, MA

Rozalynn “Roz” Goodwin is vice president for engagement and a lobbyist for the South Carolina Hospital Association (SCHA). Passionate about improving the well-being of populations through health and human services, Rozalynn serves as the primary link with many private and public sector stakeholders, including policy-makers, community and advocacy groups, insurers and employers.

In 2008, I met Roz when South Carolina Hospital Association hired me to craft a series of stories to demystify the stigmas of medicaid in South Carolina. Our journey together continued as I worked alongside Roz capturing and telling stories of the uninsured across South Carolina. Her passion and commitment to the underserved population comes from her childhood in rural South Carolina.

Roz’s commitment and compassion to every patient having access to quality healthcare provides a unique intersection, where her faith, passion, and her amazing ability to speak up and tell her own story build broader bridges across the state she diligently serves and calls home.

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Bobby Rettew:
Intersection is brought to you by Social Health Institute, exploring new and innovative ways for hospitals and health care organizations to develop and enhance their social media and digital marketing strategies. Learn more at socialhealthinstitute.com.

Rozalynn Goodwin:
My first reaction is, “I’m gonna fix that. I’m gonna change that.” That’s always been me.

Bobby Rettew:
Welcome to Intersection. I’m Bobby Rettew, storyteller.

Rozalynn Goodwin:
I am Rozalynn Goodwin. I am vice president for engagement for the South Carolina Hospital Association and the South Carolina Hospital Association represents all the hospitals in the state of South Carolina. I have been with the Hospital Association now for 14 years, before that I worked at Palmetto Health, one of our larger health care systems here in the state in business development and strategic planning, and then before that I worked in the office of Governor Jim Hodges in health and human services policy.

I am a native of South Carolina, rural South Carolina. I’m a native of Mount Carmel, South Carolina, and part of my destiny is to put it on the map, so I have to give you some details about Mount Carmel, South Carolina.

Bobby Rettew:
In 2008, I met Roz when South Carolina Hospital Association hired me to craft a series of stories to demystify the stigmas of Medicaid in South Carolina. Our journey together continued as I worked alongside Roz capturing and telling stories of the uninsured across South Carolina. Her passion and commitment to the underserved population comes from her childhood in the rural town of Mount Carmel.

Bobby Rettew:
I want to learn about Mount Carmel a little bit.

Rozalynn Goodwin:
Mount Carmel has a population of 231, well maybe 230 since my cousin just got married last week. All of us are related, or kin, like we say back in Mount Carmel, and until recently we had a single wide trailer with wheels on it painted red, white, and blue for our post office, so if that gives you any indication of how special small town rural South Carolina is, definitely Mount Carmel is special to me, and that rural upbringing, of course with everyone being so close and caring for one another, my parents still being in Mount Carmel and still actively serving their community in public service, in community service there, still very active, 77 and 75, and are busy everyday trying to make life better for everyone around them, that’s instilled in me and helps drive who I am and what I do today.

Bobby Rettew:
How did you find yourself in public policy? Background is you went to Lander University with my wife.

Rozalynn Goodwin:
Yes.

Bobby Rettew:
In Lander University, did you say, “I am going to fight for the underserved and underprivileged in health care in South Carolina?” How did you find yourself in that public policy space?

Rozalynn Goodwin:
I think going back to my upbringing, I was also raised in the African Methodist Episcopal Church, so the AME church, and got exposed very early, not necessarily to politics, but I guess governance and kind of government, because at an early age we were in the young peoples division and you had to run for office, and there were oratorical contests that I would enter and win and there were different levels of the statewide organization of our YPD, our young peoples division, as we would call it. I’d be around other people from other regions of the state and we’d run for office and compete and then talk about our bylaws and the AME Church has been, always has been since it’s inception, very engaged in public policy. That was instilled in me very, very early that the role of the church is to be that light and beacon of the community and speak up for those who are underserved. That was the beginning of the AME Church out of … it was kind of birthed out of discrimination toward black people worshiping. That was instilled very early.

My parents, I have a father now who’s on county council, but he didn’t enter in to public policy as far as service in that capacity until about 14 years ago. I didn’t grow up around politics. It was just kind of ingrained in me to be an advocate. I didn’t know necessarily that I wanted to be in politics, but I did know very early that I wanted to be an advocate. I can go back to stories in high school where somebody was being picked on and I stood up for them, or even controversial issues, like when the case with Susan Smith and her sons and what horrible thing that happened there, even at the height of the Confederate Flag issue, before it came down off the dome here in South Carolina, we had a debate about it in high school, and I was always at the center of it.

It went on in to college where we had black face incidents and really trying to work on racial reconciliation and unity, even in college. From grade school through college, I’ve always been an advocate or just someone to speak up for what’s right and people have tended to follow, so I’ve always kind of emerged as a leader. I think part of that was just part of my purpose in being born in the environment that I was born in. I didn’t realize until probably as an adolescent.

My great-grandmother raised my mother because my mom’s mom had her when she was 12, so I’ve always been very passionate about teenage pregnancy for that reason, but my great grandmother helped raise us and when I was 12 years old, she was almost 90 and had experienced home health care, nursing home care, just every facet of the health care environment or system, so I was very close to her and saw that experience first hand and got I guess the urge to really try to help in health care.

I found a passion in health care at 12 years old, and actually got my first apprenticeship at McCormick Nursing Home when I was 15. I knew I wanted to be in health care and then once I found out in undergraduate school that I could blend health care with my passion to be an advocate, I thought it was a no brainer. I said, “I’ve got to be in health policy. I’ve got to be in health politics.” I’ve been in this vein, gosh, since 12 years old.

Bobby Rettew:
Why health care? I mean, you could have taken that passion anywhere else, but you chose to follow health care. I guess one of the reasons why I ask this question specifically is because you are basically the central person for Medicaid and Medicaid expansion in South Carolina, and you have worked hard for that, and I see your passion. How did you get connected to that topic, and how did you get connected to that issue? I know it’s one that’s been a part of South Carolina Hospital Association’s initiatives, but how did you get started with really pushing for that initiative?

Rozalynn Goodwin:
I think the why health care also goes back to my love for my great grandmother and some of the, I guess, injustices we experienced with her care. When I see injustice, my first reaction is, “I’m gonna fix that. I’m gonna change that.” And that’s always been me, from elementary school to high school to college. That’s kind of where it was birthed. To get into health care, I kinda always knew as I was in college and studying and researching what all was there, I was even a Truman scholar finalist and my essay was about health care insurance for all, developing the system, this is way before the Affordable Care Act, this is before all those things. I spent a lot of time researching how I can get access to health care to people.

I guess when you’re raised in a pretty poor part of rural South Carolina, I would visit family members who did not have indoor plumbing. This was in the ’90s. So when you’re that … and we were fortunate to not live in those type of conditions, but those conditions were just a mile down the road. My parents raised us to care. So when you see those types of inequities in one state, even in one county, one small town, it really drove that passion to change things. Even when I got my first apprenticeship in the nursing home, I was thinking then, I was like, “Well, I’m gonna run nursing homes. I’m gonna change nursing homes.” Then when I got in a clinical setting, I realized, “Okay. I don’t do well with death, so I probably can’t be in a nursing home every day.” I was just emotionally distraught when Mr. Bell died. That happened a lot. I knew I couldn’t be clinical and I worked at a surgical practice.

I kind of explored different things. I worked in state public health agencies. I worked for surgeons. I did a stint with information and research for a state government agency. Worked at a nursing home. I was able to get a lot of different settings to gain invaluable experience, but it also helped kind of direct me to, “Okay, I’m not probably gonna be a clinical person.” When I worked in a hospital and did strategic planning, I said, “Well, I’m probably not gonna be a hospital administrator.” That’s not my [inaudible 00:09:48]. I really want to do something more statewide, more global. I really want to impact and change policy. I need to be in policy.” The role just kind of evolved that way. I was at Palmetto Health actually. I was doing an internship and I was just intent on meeting the people who were doing jobs that I really admired.

At the time, Governor Jim Hodges had a female, African American, female, woman who was advising him on health and human services policy and I spent probably six months emailing and calling almost every day just trying to shadow her for 30 minutes. I basically, when I finally got to her, I said, “I just want to follow you around. I’ll fix your coffee. You won’t even know I’m there. I just want to see what you do. I’m just amazed by it. That 30-minute shadowing turned into an all day visit and meeting with her, and at the end of the day she offered me a job. I ended up working in health policy for Governor Jim Hodges and loved every second of it. I knew then that this is what I want to do. I really want to be at the table and help shape some of these decisions that impact our state.

Bobby Rettew:
I want to touch on something real quick that you just said that I think is interesting. How important for you was it to see at your age fundamentally another black woman serving in public policy in the state of South Carolina, and wanting to go see what that looked like? How important was that to you, to find your niche and find your place? Is that a fair question?

Rozalynn Goodwin:
It’s definitely a fair question. Had she been a white male, I would have done the same thing, but the fact that she was a black female really helped me see this is doable. You can do this. It wasn’t just that she was a black female. Virgie Chambers is the most brilliant health policy person you will probably every meet in your life. She understands Medicaid more than anybody I’ve ever met. I still call her to this day. She is amazing and brilliant. Now she’s working in the Department of Education doing some similar work, tying in education and health care for superintendent Molly Spearman. But that experience was a bonus to see someone who looked like me in that type of role. Like I said, had it been a white male I would have done the same calling, but it certainly gave me another image that you can never deny how impactful that was.

Bobby Rettew:
Can you take me to the moment when you realize you were gonna start working on Medicaid expansion and Medicaid in the state of South Carolina for the Hospital Association? Can you think back to your beginning journey. Those huge policy pieces.

Rozalynn Goodwin:
You know, it really wasn’t something that we were sitting on a management team meeting and I got assigned. It just kind of evolved as the Affordable Care Act, we recognized that it was becoming law. Of course, for years there’s been a lot of discussion about some type of reform and when it looked like it would pass, I do what I tell a lot of people I mentor now, I don’t know if I did consciously, but it’s just something I did, I wanted to know everything I could about the Affordable Care Act. It was exciting to me. Of course, … before I get up before anyone and talk about the Affordable Care Act, I am not saying this is a perfect law, but the fact that we had passed something that several presidents had attempted to do for decades was exciting to me. This was one of the, I would say the, biggest change in our health care delivery system since the passage of Medicare and Medicaid in the ’60s.

I really just kind of emerged myself in understanding the law, not necessarily to build a niche like I tell my mentees to do now, but I guess looking back, that’s kind of what I was doing, but I wasn’t doing that trying to be the Medicaid expansion lady or the ACA lady. I wasn’t trying to be that person. I was just trying to understand what was going on, but as I was learning more about it, understanding, reading, going to seminars, just really emerging myself in it, our Hospital Association was called upon to explain it to boards.

Rozalynn Goodwin:
Was called upon to explain it to boards and community organizations, and universities, and a hospital board of trustees, and a lot of groups started calling on us to explain what the ACA was, what it meant, what it wasn’t. I ended up being sent out by our association to do that, because I had spent so much time learning the affordable care act. As I was speaking about the affordable care act, now I’ve stopped counting, but we were counting at one point, and I’ve addressed over 300, probably close to 400 groups now about the affordable care act since this passage, just because so many people were asking us to do that. It was groups. It was radio interviews, it was television interviews, it was all those things because people were trying to understand what was going on with the health care system now. After the supreme court, of course we’re following all the challenges to the law, and then the supreme court’s ruling came that made Medicaid expansion optional, we knew that as we were had been even before the affordable care act passed, our association had partnered with our medical association, our blue cross blue shield, and our business chamber.

We had already come up with a plan related to coverage and that worked. Just kind of paused because the affordable care act passed and a lot of what we were proposing was in the affordable care act. We had already made our stake and our claim that the association of hospitals of South Carolina was for coverage. When the supreme court decision about Medicaid expansion being optional to states was handed down, and within minutes, our governor at the time said no way we will not be expanding Medicaid under my watch, we had no choice but to say, “Wait a minute, let’s have an honest discussion about this state.” Then it became a big, I guess, part of our advocacy program to have discussions about expansion and how it would benefit South Carolina, what will be the pros, what will be the cons, what would it cost. It really ended up being our role, fell in our lap to be that spokesperson related to this aspect of the affordable care act.

As I was already out speaking about the ACA, I was already speaking about the ACA. I was, it kind of fell into my lap to already be talking more about medicaid expansion. We got a little bit more aggressive about going out and speaking. There were town hall meetings and a number of other things that were going on at the time. Our Medicaid director at the time was also very aggressive, going out to different places, so we often meet up across parts of the state with different points of view about Medicaid expansion. It was a hot topic, and people wanted to talk about it, so I was on TV, and I was on radio, so I ended up being kind of [coined 00:16:50] as the Medicaid expansion lady in South Carolina. That’s how it all happened.

Bobby Rettew:
Now a quick break to give the quick shout out to the network that supports Intersection. Touchpoint Media, a collection of podcast dedicated to discussions on all things healthcare. Including digital marketing and online patient engagement strategies, CIO and technology strategies, the challenges of the online physician, the power of the E-patient, and most importantly, the power of storytelling. To learn more, go to touchpoint.health. That is TouchPoint.health. Let’s rejoin the show.

Bobby Rettew:
Let’s understand the state of South Carolina from a healthcare perspective at that time. Specifically, when the affordable care act came out, obviously it was a hot topic for all the hospitals, but also medicaid expansion was a big topic because of the underserved South Carolina, the people that did not have access. Give us a state so we can understand what that would mean to South Carolina, and who were the people in need. Just kind of explain that at that point in time what was going on.

Rozalynn Goodwin:
Recognizing, which we still have to communicate now, that the affordable care act had passed and we were going to be able to have hundreds of thousands, to 300, 400,000 people eligible now for subsidies or tax credits to reduce the cost of their healthcare insurance if they purchased through the affordable care act marketplaces. But that decision to make Medicaid expansion optional, and then our state resisting the option to expand the Medicaid program would leave about 200,000 South Carolinians in what we’d call a coverage gap. Those were the people who were living beneath the poverty level but were too rich to qualify for existing Medicaid program.

Bobby Rettew:
Roz’s commitment and compassion to every patient having access to quality healthcare provides a unique intersection where her faith, passion, and her amazing ability to speak up tells her own story, and the stories of the working poor.

Rozalynn Goodwin:
A lot of people assume that our Medicaid program, our existing Medicaid program covers everyone who’s poor. That couldn’t be further from the truth. I mean, of you’re a single mom with one child and you make $11,000 a year, your child qualifies Medicaid but you’re too rich to qualify for Medicaid. If you’re making that type of money, you’re probably working at a convenience store, and they don’t offer healthcare insurance. You make two … You’re too rich to qualify for Medicaid but you’re too poor to get a subsidy, because subsidies only begin when you’re making well over $12,000 a year. They’re caught in this gap. They’re working but they can’t afford healthcare because they can’t get a subsidy and then they can’t qualify for Medicaid. Now, the dilemma she’s in is if she stops working, she can qualify for Medicaid. Now, what sense does that make?

Our policy is set-up such that we de-incentivize people to work. Somebody really wants to work, they want to get out of poverty, they want the confidence and everything that comes, and the self-assurance that comes with working. We have set it up so that we are punishing because they are working. If they’re not making high enough wages, they can’t afford healthcare. We’ve got about 200,000 people that are just caught in that gap, and gosh, I mentioned that I meet people all the time in our open enrollment event, so they hear about these events and they hear about the affordable care act, and they hear about people coming and getting healthcare insurance for $10 a month, and doing it in less than 10 minutes. People line up, and we try to warn them before they get there, but it’s really difficult to explain. You have people who between working two jobs in one day, come and get in line to see whether they qualify for healthcare insurance.

I would never forget this woman who had on a uniform for one job, and she was rushing because she had to get to the next job, and when she found out she did not qualify for any assistance, as she works two jobs, she was devastated. I was too. I mean, I never get comfortable with that type of situation, and we try to direct them to clinics in the area, but it’s not healthcare insurance. We can direct you to some services but that, you don’t have the assurance of a financial security of having healthcare insurance in case something happens to you. In case you get some type of diagnosis that you won’t end up in medical bankruptcy because you don’t have health insurance. That is what we were, and we continue to express that to people, that we’ve got this gap of people inside Carolina who are working, that we’re really encouraging not to work, and we’re giving two very different messages that we want people to work, we want to bring jobs. We want people to be self-sustained and all those type of things, self-sufficient. But we have a healthcare system and a policy setup that de-incentivize them to work at this point. There’s about 200,000 people in South Carolina it impacts.

Bobby Rettew:
I think about these stories, and I think about the first time I went with your team to hospital day at the state house. Standing in between the two sessions, between the senate and the house, and the nasty name was Obama Care. Talk about what it was like for you to take those policy positions into those chambers, and outside those chambers, on that inside that the walls of the state house to advocate. What was that like in the early days?

Rozalynn Goodwin:
Oh gosh, it was very contentious. I mean, we had finance who, of course right now disagree with us on, not necessarily that we should expand. I’m going to tell you a typical conversation I have with people who voted against this, pulls to the side and say, “Look, we know this is the right thing to do. I just can’t do this and be reelected.” I mean, it’s a hot potato. It is, in some cases, I don’t know if the environment is as bad as it was a couple of years ago, just like political suicide to say that you’re voting for Obama Care. Of course, I’m referencing the affordable care act, but it’s blended as Obama Care politically. Anything that you do as a politician, particularly to [abase 00:23:44] that is anti-Obama, anti-Obama care, they weren’t willing to take that chance. Quite honestly, we’ve got great political friends, great hospitals that we didn’t want to put in a position to take that chance. We didn’t want them to commit political suicide.

Four years ago, that’s what it was. It was political suicide, Obama was still in office, it was Obama Care, it was socialized medicine, it was government trying to take over my medicine. The environment was just so, so toxic and so bad related to the law. There’s a lot of misinformation about the law. I mean, I sat on panels with professionals who were just making up stuff, because they didn’t understand the law. I had to call a couple of them out a couple of times. It was bad. It was really ridiculous. We didn’t get very far, but it didn’t stop us from our education efforts to explain what Medicaid expansion was, what it was not. On the surface, it looks like, “Wow, you’re really fighting and got nothing done.” But we were able to educate people across the state, and mainly our policy makers on the benefits to a point that I think they understand and they get it now. It is just, as one of our senators say, I hold on to, it may take South Carolina a while, but we’re going to do the right thing. It may take us longer than others, but we will eventually do the right thing.

I hold on to that, that I think as the environment is a little better, now that president Obama is not in office, and we’ve seen a number of red states that are similar to South Carolina take advantage of this billion-plus dollar income for healthcare coming into the state to increase jobs in healthcare, and even jobs that are indirect to healthcare because of the ripple effect of that much money coming into the state every year, about two billion dollars now, that we’ve seen other states take advantage of the funds, and then create their own conservative-type model that is not traditional Medicaid expansion, that we’ve been taking the dollars and bought [for 00:25:56] a bit of healthcare insurance plan for people who are eligible for this expansion. We’ve seen these models, and I think we’ll warm up to it when the time is right.

But we don’t regret the conversations, being contentious and us doing what we had to do to educate our state and our policy makers on something that greatly impacts 200,000 people in South Carolina, and that we’re paying for it anyway. Our taxes are still paying for Medicaid expansion whether we’re taking it or not. Those are dollars that are going to other states.

Bobby Rettew:
Let me ask you, we started partnering together and started telling the stories of the uninsured, started shifting … You all shifted strategy a little bit and said, “Look, what if we start appealing to the emotion?” Talk about some of the early stories and why we started telling those stories? Why was that so important to talk to the underinsured and the uninsured, and go to these big clinics and show pictures of the thousands of people coming to receive care? Why was that so important to what you all are doing at this time period?

Rozalynn Goodwin:
I’m so glad you brought that up, because this work really began way before the affordable care act passed. We had an option to expand the Medicaid program. It began with access health, and those days of care that we provide at stadiums, that people could come and they would line up wee hours in the morning just to get screenings, or eye care. We had people even come from other states. I think that was so important because we recognize really early, and it’s still part of the problem now, the stereotypes associated with people who are uninsured or on Medicaid are so often very false, and those stereotypes that people have come out in the way they vote. It comes out with policy makers and arguments they make against access to healthcare insurance, or access to healthcare for those who are underserved. There’s just this assumption that people who would benefit from these services are all people …

Rozalynn Goodwin:
People who would benefit from these services are all people who are not working. They are lazy. They are ethnic minorities. All of those things impact the way people think about these services and how they vote. It’s sad to say, but it’s so very, very true. We recognize … I was riding in a car with a coworker. This had to be probably six years ago, and we were talking about something else. I stopped him. I said “We have passed by three billboards for Medicaid companies. Everybody on the billboard is black. This is the problem. People think that everybody on Medicaid is black. It doesn’t touch their emotion.” Now, I know I’ve talked about race quite a bit on this podcast, like “Who has Bobby invited on this podcast?” But we are in South Carolina. This is real.

Bobby Rettew:
It is real. It’s an important topic because it’s a topic that is discussed everyday. We spent a lot of time together talking about breaking that stigma, to showcase different families from all walks of financial and geographic situations across a state. Talk about the intentionality to admit that there’s a population, that a good portion of the population may be African-American, black, whatever, however we want to term it, but there is also a large population that are white-

Rozalynn Goodwin:
Yes.

Bobby Rettew:
that have lost jobs, good-paying jobs that need just help. Talk about the faces of what we found and who we’ve talked to from your perspective.

Rozalynn Goodwin:
The majority of people we’re trying to help whether they’re uninsured or would benefit from expansion or Medicaid are not minorities. They are white. The majority of people on Medicaid are working. They’re in working families. It’s not something that people get on and stay for the rest of their lives. The average length of time that people are on the Medicaid program in South Carolina is about two years. It is something that people are on temporarily until their situations get better. That is totally opposite from what people think.

As soon as you say the word Medicaid … That’s why we’ve not been able to use the word Medicaid expansion. We tried to come up with all different types of terms to talk about Medicaid expansion because people immediately have this image when you say Medicaid. This image goes back to the ’90s and the ’80s or welfare queen or all these things that were invoked on the federal level. People still have those images today: someone gaming the system, taking advantage of the system, not working, all those type of things. It’s totally opposite.

We had to try to change the image, get rid of the myth related to Medicaid and the uninsured. That work began even before the Affordable Care Act passed because we recognized that, before we make any progress related to coverage, we’ve got to help people see the face of who actually is uninsured, who actually is on Medicaid. We talked to people who were college students or college-educated people with children who were born with health conditions that they could not afford even with private health insurance from a job to take care of all of the bills that were necessary. We talked to those and you helped us put their story on video, and we went around the state to really show people “These are the faces of Medicaid. Get that other stuff out of your head. It’s incorrect.”

People’s stereotypes about who they think will be benefiting from something really impacts how they feel, how they vote, how other people pressure them to vote for it. The stereotypes and stigma of course is something we will continue to deal with. Even now, there are people who would benefit from the Affordable Care Act, could bet a subsidy, but the stigma of it being Obamacare, they said “Well nevermind, I don’t want it. I don’t want that Obamacare. Yeah, let me hear about that Affordable Care Act.” It’s the same thing, but they don’t want anything associated with Obama. Now, what’s the root of that? You can’t tell me it’s not something related to race. If you hate Obamacare but you love the Affordable Care Act, come on. It’s something going on with race there. I need you to dig a little deeper.

Bobby Rettew:
I’ll never forget the time that we spent together on all these different big events, and I would walk in to these big mission events. We called them mission. All this was funded tremendously by the Duke endowment, Blue Cross Blue Shield, and so many partners of these big events where people would come and there’d be lines of them, lines of people across the state. I would look at them and [Roz 00:32:45], these people looked like me. I would look-

Rozalynn Goodwin:
Yeah.

Bobby Rettew:
… and it would just break my heart that we would have these events downtown on the fairgrounds of Columbia, and it wasn’t two miles up the road that the state house stood. It would be amazing if those legislators would just walk down or drive down two minutes. They could meet every one of the people. I was just amazed the disconnect between those in need and what was two miles up the road based on the numbers, just the shear mass of it. Did that magnitude of it, of that disparity get to you at any point in time of like “God, we are climbing a big hill here?”

Rozalynn Goodwin:
Oh, man. It got to me quite a bit. The promises I made to Senator Pinckney, keeping a picture of my children on my desk, those things keep me motivated. They keep me moving. Going back home and my cousin next door struggling with trying to get access to healthcare and keeping a job, those things keep me grounded because of my roots. There are certainly days that I’m like “Gosh, there’s a whole lot more I could be doing with my gifts and talents.” Like Lebron said, I can be taking my talents somewhere else, but I can’t. It’s part of my purpose. Like I promised Senator Pinckney, we’re going to fight til we win.

I mean it is definitely. We encourage. We’ve invited legislators, but sometimes they’ll come and get exposed to it. Others just kind of turn their head. It is not until … And which we always encourage constituents reach out. “I need you to share your personal story. Make a visit to the state house. I vote for you. I’m in your district. Explain to them what is going on,” and that is what really moves them. Like I said, on the surface, it looks like we haven’t made a lot of progress, but these type stories, mission, the pictures, the constituents reaching directly out to their legislators are making an impact. It is pricking their hearts. They’re certainly thinking about it. While it’s taking us a while to do, I do believe that at the end of the day, like our senator said, we’ll do the right thing.

Bobby Rettew:
Well progress is being made because Medicaid expansion was on the primary ballot for the Democratic side in South Carolina. That’s a big move.

Rozalynn Goodwin:
It is. It is.

Bobby Rettew:
Talk about that. What does that mean just by getting something on the ballot for people to voice their opinion in a collective space?

Rozalynn Goodwin:
I think it means that, particularly with the results, it is still a big issue for the Democratic party. I know that the newly elected Democratic nominee for governor has also made it very clear even with one of his first ads that access to healthcare will be one of his top priorities. He didn’t shy away from that. I think the conversation certainly is still there and will continue to be there even as we move forward with debates [inaudible 00:35:59] the next couple of weeks once the Republican nominee for governor is determined after the run-off. It will continue to be a conversation. That’s a good thing. It’s not something that’s just going away.

There of course are red states that are moving forward, even southern states. Virginia will be moving forward with expansion in the coming months. Utah has it on their ballot. There’s movement that’s going on across the country. I believe South Carolina will be in one of those waves coming forward to the southeastern states. That’s really kind of the bulk. If you want to look at a map, that’s where most of the states who’ve not yet expanded are in, but we’re part of a shrinking minority. 18 states at this point. It’ll probably be close to 17 or 16 states very soon. Everyone else has taken advantage of these dollars to expand access to healthcare in their states, and eventually South Carolina will join them.

Bobby Rettew:
There’s movement and changes in narratives that are happening here in South Carolina. You have seen it and witnessed it. Something you shared with me many, a few years ago — I can’t remember exactly when, but it has always stuck with me — is fighting for these issues like expanding access to care, but each day you would have to walk up to the state house past the Confederate flag as a black woman that is lobbying for the underserved and the underinsured. You shared that that was a struggle to walk past that sometimes. Even I’ve heard people share how Senator Clementa Pinckney, that was a struggle for many people to do that. When you saw it come down, that has to give you no … To know that there is progress being made and the narratives are changing. What are your thoughts there with that? How have you seen the changes, very simple changes that are coming along the path here for your work?

Rozalynn Goodwin:
Many people thought that that would never come down, and the fact that the movement to bring it down, I guess the bipartisan movement to bring it down happened so quickly, it certainly gave us hope and encouragement related to any other issue that people think can never happen. If that happened, we will do what’s right related to access to healthcare. I just truly believe that. It was an amazing day. It was, particularly for me, amazing to see some of the legislators who have been fighting for so many years, people like Representative [inaudible 00:38:38] Cobb-Hunter, to be in tears, I mean almost weeping that day. It was particularly moving for me.

There’s nothing that’s impossible. Once we get the will and particularly the bipartisan support — and that’s what we’ve always strived to do — I believe that South Carolina can come up with a plan that is specific to them, that is conservative with our core values and our beliefs, and that we can get bipartisan support for it, whatever it is. We’ve got the flexibility to do that under the Trump administration. Once we have the will to work together to do it similar to what we did with the Confederate flag coming down, it can happen and it can happen quickly. That’s encouraging.

Bobby Rettew:
Roz, thank you. It is the most awesome honor, number one, to work with you on a daily basis; number two, to interview you; and number three, to witness your journey. I’m very thankful that we have crossed paths.

Rozalynn Goodwin:
Likewise, Bobby. You’re an amazing storyteller. I’m thankful you have this platform to share your gifts with the world.

Bobby Rettew:
Thank you for joining us. We hope you enjoyed the conversation and exploration. Most importantly, the many intersections inside the world of storytelling. Intersection is powered by Touch Point Media Network, podcast dedicated to discussions on all things healthcare. Go to TouchPoint.Health for many other podcasts exploring digital marketing and online patient engagement strategies, CIO and technology strategies, the challenges of the online physician, the power of the new patient, and most importantly, the power of storytelling. To learn more, go to TouchPoint.health. That is TouchPoint.health. Have a good day.

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