Donna Shalala, U.S. Representative for Florida's 27th congressional district. Courtesy photo

What can law firms and legal professionals do to improve health care?

It sounds like a big ask, but a Miami panel discussion hosted Friday by Greenberg Traurig offered some street-level answers for ground-up solutions.

U.S. Rep. Donna Shalala, D-FL, the former Health and Human Services secretary who represents most of Miami-Dade County, said she volunteers when on boards of directors to serve on the benefits committee and closely examines the offerings.

"What we want businesses to do is look at the whole picture," she said, noting her district has the highest Affordable Care Act enrollment in the country. "You have to understand people's lives."

That extends to benefits that don't look health-related, like employer tax credits for mass transit. Transportation is often a barrier to reaching medical appointments, so passes translate to getting to work and health care providers while reducing employee costs and stress, a health risk for cardiovascular disease and an aggravator for asthma, diabetes and hypertension.

As a class assignment while she was president of the University of Miami, she asked students to find out about their health insurance plans. Most had to ask their parents, and Greenberg Traurig senior chairman Cesar Alvarez happened to have a daughter in her class.

Alvarez reviewed coverage with her, examined the firm's health plan and pushed for some changes as a result.

Shalala offered a personal push for paid family leave. On a presidential campaign issue, she said she didn't "want to advocate too much" for a single-payer system but noted the Veterans Administration is a single-payer system. One unsung VA benefit is the way it integrates nurses much better as health care providers.

In community visits, she said, "All anybody talks to me about is out-of-pocket costs," which translate to self-rationing health care. She noted some employers offer to pay the first $500 or $1,000 of medical spending to help improve their employees' health.

At the intersection of health care and law, fragmented social services are more accessible when attorneys volunteer in landlord-tenant cases, Fair Housing Act enforcement, food stamp access and benefit denial appeals.

Attorneys acting on referrals from Legal Services of Greater Miami, the panel organizer, also offer education seminars on fraud, debt reduction, wills and domestic violence restraining orders.

"There's a lot of situations where I can't just give them a pill or I can't just do surgery and cure them," said Dr. Panagiota Caralis, Miami VA Women Veterans Program medical director, a University of Miami internist and a panelist.

Fellow panelist Janisse Schoepp, vice president of the Health Foundation of South Florida, notes the philanthropic group pushes the largest employers to look at their organizational practices and policies to create a locally inclusive economy that buys, hires and invests locally.

Shalala said she borrowed from a Goodwill project in Milwaukee to open a UM laundry when she realized the private university was sending its laundry to Orlando. UM became the laundry's anchor business, UM Health joined, and the service expands next month to the Miami-based Baptist Health system. About 300 jobs have been created in Miami's low-income Overtown neighborhood, and many employees are disabled or have criminal records.

UM "identified a way of keeping that business in the community," she said. "We literally went through every business and every contract we had."

Shalala noted health benefits spring from something as simple as sending school kids home on Fridays with backpacks full of fruits and vegetables, fighting urban food deserts on the backs of children.

To everyone, Shalala said, "Want to make a contribution to our society? Get a flu shot." People who don't get the flu aren't going to the hospital and won't add to patient counts even if the Covid-19 coronavirus gains a larger foothold. "We've made it absolutely convenient."