Hillsdale Hospital News

Episode 80: A Legislative Legacy: Standing Up and Standing Alone for Rural Hospitals

Rural hospitals need support from their state legislatures to operate in a way that not only allows them to best serve their communities, but to survive in an increasingly challenging environment. Fighting for critical funding is often an uphill battle, especially when that means supporting programs that are unpopular in their community or with their elected officials. So, how do rural hospitals ensure that their voice is heard and their critical needs are met at the state legislative level?

On today’s episode, hosts JJ and Rachel talk with Mike Shirkey, State Senate Majority Leader, about ensuring rural hospitals are heard at the state legislative level.


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Audio Engineering & Original Music by Kenji Ulmer




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Rachel: Rural hospitals need support from their state legislatures to operate in a way that not only allows them to best serve their communities, but to survive in an increasingly challenging environment. Fighting for critical funding is often an uphill battle, especially when that means supporting programs that are unpopular in their community or with their elected officials. So how do rural hospitals ensure that their voice is heard and their critical needs are met at the state legislative.

JJ: Level with rooted relationships, mutual understanding, and a champion who is willing to stand up even when it means standing alone?

Rachel: I’m Rachel Lott.

JJ: And I’m JJ Hodshire.

Rachel: And this is Rural Health rising.

JJ: Welcome to episode 80 of Rural Health Rising. I’m JJ Hodshire, president and chief executive officer at Philadelphia Hospital.

Rachel: And I’m Rachel. I’m director of marketing and development.

JJ: So, Rachel. We talk a lot about policy here on Rural Health Rising. And obviously including at the state level where it starts locally and we’ve bantered around some local issues and then really some of the most direct impact as it reserves itself to the state legislature into the types of work that’s being done there and the outcomes from some of that legislation that impacts us negatively and sometimes even positively for us in the position we are as a rural hospital. Our eyes are always on the state legislature in what they are doing. So obviously these efforts that we’re talking about today involving the state’s impact on rural healthcare, I think is an important topic for us as we focus on rural hospitals.

Rachel: That’s right. And today we’re talking with someone who has been directly involved in that effort, having supported and passed legislation that has been truly critical to the success of our hospital as well as other hospitals around the state of Michigan.

JJ: Absolutely, Rachel. Our guest today is my good friend, Senator Mike Shirkey, Michigan State Senate Majority Leader. And we just want to welcome you to Rural Health Rising today.

Mike Shirkey: JJ, thank you. And Rachel, thank you very much for inviting me into your very special studio here. We talked about this at lunch a little bit, but I really, really, really enjoy watching people who are passionate about what they do, do what they do, and you two are great examples of that. So, thank you for what you guys do and represent in this very special community.

JJ: Well, thank you very much.

Rachel: Yes, thank you. That’s a great way to start. Can we tell all of our guests to give us confidence?

JJ: And I did not pay.

Mike Shirkey: Don’t worry, you’ll pay me soon.

JJ: There is that.

Rachel: Well, to start, Senator Shirky, for those who don’t know you or don’t know much about you, why don’t you just tell us a little bit about yourself, your background and your work at the state House over the past twelve years.

Mike Shirkey: Yeah, I never really expected to run for the legislature, but I’m a very, very patriotic fellow. I mean, I just think that we are so blessed to live in a country like we live, with all of its warts and all of its flaws. It still is amazing what we get to experience here in America. And I was too young for Vietnam and started my career and then too old for everything else after Vietnam. And at one point in time in my career, I thought, you know, things are going fairly well and I’m knock on wood a little bit and it’s time for me to figure out a way to pay back. And so, I was always interested in politics and I’ve discovered since then, and you guys have too, that if you’re going to be in business, whether it’s healthcare, manufacturing, whatever in Michigan or frankly in any other state, you better be also involved in politics. You have to government is your partner, whether you like it or not. Or not.

Rachel: Right.

Mike Shirkey: And so, I decided that I would start considering to run for office. And for 19 years I’d say to my wife Sue, I’d say, I’m thinking about running for office. And for 18 years she said, no, you’re not. Oh, wow.

JJ: Is that right?

Mike Shirkey: Yeah. In the 19th year I brought it up again and she goes, well, maybe I stuck my foot in the door before the now there’s a tragedy associated with this. And so, after she kind of gave a tethered green light, I was in a tree stand deer hunting in 2009, I believe the year was the correct year. And she called me and said, did you see what just happened in the news? I said no. Mike Simpson was a state representative at that time, and he was on a road trip back from Cleveland and died suddenly, left the seat open and so there would be no incumbent. So that to me was like, okay, this is the time to do that. And Mike and by the way, he was a Democrat and I’m a rabid Republican, but we were very good friends because he was a very logical fellow and we had a great relationship. So that kind of was the start of me running for office. And then our mutual friend Tim Walberg, congressman Wahlberg was and is remains a mentor of Mine Senior. And so that kind of got the ball rolling in terms of running for office. And I had the pleasure of having put in place some very skilled people in my private business and they have been able to run it for the last almost 13 years now without me being around. I’m not sure they’ll let me back in the door.

JJ: They don’t have to. You have the keys.

Mike Shirkey: We’ll find out in January and see what they say.

JJ: Well, I think it’s been an important aspect to talk about is a small business owner, right? So, when you’re out on the trail and you’re talking from either your leadership position or just in general, you have experience in small business and you want to share a little bit about that experience, and you’ve seen a lot of small businesses fail in me.

Rachel: Sure.

JJ: Too. Especially because of the pandemic. Can you talk a little bit about that experience?

Mike Shirkey: Yeah. So, I’m an engineer by training. I went to, at that time, General Motors Institute. Today it’s called Kettering University, and I was sponsored by a General Motors division called AC Spark Plug back in 1974.

JJ: Wow. It’s a great year. The year I was born.

Mike Shirkey: And back then, AC Spark Plug, we made more different parts for more different cars than any other company in the world.

Rachel: Wow.

Mike Shirkey: And what’s unique about that is that because of that, every known production manufacturing process was under the roof of that facility. So, for five years, I did my internships there. It was a co-op education. And when I finished, I had more experience than most people working in full time jobs for ten years. And so, I stayed there for a while, but I got into my pants. The bureaucracy of Germany is a very big company. I didn’t think it was going to be what I wanted to do. And so, I had an opportunity to identify a product line and a product niche that I thought had some growth potential to it. And so, with the blessing of my wife, we decided to leave the comfort of General Smothers and go out on our own.

JJ: Not heard of that.

Mike Shirkey: And we were living in Flint, Michigan, for about 13 years while we’re going to school and post school a little bit, and then moved back to where we’re both from Jackson, Michigan area to start the business. And since then, we’ve had a lot of success and been very fortunate. But yes, there’s nothing like running a small business. The day-to-day pressures things like having to sign both sides of a check, making payroll, even when there’s not a consistency of income. And it has been and continues to be a very steep learning curve. Now I have family involved with it, and they’re doing great. So, it was both my engineering background and the small business background, plus maybe with a ten-year stint in healthcare provided for me a foundation for the legislature that was priceless. And unfortunately, some of my colleagues in the legislature just never had the opportunity to have that kind of foundation.

JJ: Yes. You’re very blessed. So, the next question I’m going to ask is probably one that we’re going to have one of the best answers. I have a feeling Mike is a passionate man. I actually had a chance to meet him a long time ago. Even before he even thought of maybe he thought of running for office. I should say. Before his wife let him think about running for office. That we met on a campaign trail of our mutual friend Tim Wahlberg. And I remember I was two rows behind him setting with Ken Kurtz and Diane Kurtz Ken was our state representative here for a period of time. But anyway, this very well spoken, very well dressed and very articulate person stood up and I had not met him prior to this. And then he belted out a song and this guy can sing all right, he’s a singer, he can sing, really. He belted out an amazing song that gave us all inspiration and I say that false sincerity. There’s probably 30 or 40 of us there and it was a trying campaign, it was a very difficult campaign. We were getting attacks from left and right all down the aisle. And so that was very encouraging to me and what I took away from that, because I later asked Walberg, who is that guy? And he later shared with me who he was and really didn’t have much interaction. I mean, we attended a couple of those ruby or floats together at Wahlberg’s and hosted a couple of events together. But truly, what we’ve witnessed with Mike Shirky is a man of remarkable faith and I’m being very take away, his leadership role, I’ll say this six years from now, a remarkable character. And when you find a person who professes a faith but is strong and who can push back really hard, but who maintains his faith through some of the most difficult and adversarial times, I would want no other guy than Mike Shirky leading us like he did through the pandemic. His wisdom, his challenge of what was considered wisdom from other parties and other sides was instrumental. And so, Mike, I’m going to ask you a question, because a lot of people want to know this. We’ve heard about your background, we know where you are educated, we know where you’ve worked. I want to know what is your why, what gets you up in the morning? What defines Mike Shirkey? Because I think if we tap into a little bit of knowledge in that, we’re going to know there’s a core here, but I don’t want to ruin that. I want you to tell us what is your why, what do you do? What you do?

Mike Shirkey: So, civics class, 7th grade, Mrs. Hall was going around the room asking each one of us to, what do you want to be or what do you want to do when you grow up? And we’d go up and down the aisles and I want to be a doctor, I want to be a lawyer, I want to be a nurse. And it came to me, I said, I want to get married and have kids.

JJ: Exactly.

Mike Shirkey: And I just want to have a family and enjoy and appreciate and contribute to. Even back then, I just thought America was unbelievably special and I still feel that today. I love it. You haven’t asked me yet where do I live?

JJ: Where do you live?

Mike Shirkey: OK. Thank you for asking.

JJ: Thank you.

Mike Shirkey: I live in the greatest country this world has ever seen and one of the most magnificent states in that great nation in the county that was the birthplace of the Republican Party, in a township called Liberty on a street called Patriot Lane. And my address is, 1776

JJ: oh, wow, I didn’t realize all that.

Mike Shirkey: And it’s all true. And that is a reflection of precisely how I feel. What gets me up in the morning and empowers me is a knowing that I got a family that I got to nurture and encourage and support, but also a country that I never had to go to battlefield on, but I’m ready to do so. I’m ready to do so.

JJ: And I’ve heard you speak and you’ve actually been a frequent speaker at a lot of churches throughout the tri county area. Actually. I want to ask you a question. How does faith play a role in what you do every day for the job that you do? Can you explain that a little bit to us?

Mike Shirkey: All I can say to you, JJ, that if I didn’t have faith, I think I have a nervous breakdown. I mean, seriously, if I didn’t know that there was somebody else in control and if I didn’t know that I have all my sins and all my shortcomings have been taken care of. And if I didn’t know that I could count on that promise, I’m not sure I could do this job. I’m not sure I could have done this job in the last four years, starting with 2019 and a brand-new administration with a, let’s just say a unique governor and then directly going into COVID and that experience and I mean, few have experience absolutely that kind of exchange. But for faith and a loving wife who has stronger faith than I, it’d.

JJ: Been a really tough praying for you back home every day.

Mike Shirkey: Amen.

JJ: So, you could do the work that you well, on behalf of Hillsdale County, thank you for that service. And I know on behalf of the state of Michigan as I travel the state and Rachel and I certainly have a lot of connections throughout the state as we’re talking to other hospitals and other systems, your name is well known and they’re very appreciative. We’re going to get into a couple of the things that have really been landmark that you’ve done, maybe even nontraditional to the party line to create ways for hospitals to be sustainable in the future. But we’re going to get to that in just a minute. But thank you for your commitment and your resolve.

Mike Shirkey: Thank you.

Rachel: So, Senator Turkey, we know that you’ve been an advocate for rural communities and rural hospitals in particular during your time in the state legislature, both as a representative and as a state senator. So of all the things with that role that you could focus your time and energy on, because there’s plenty, there’s a lot that you can do in that role. What made rural issues and health care issues a priority for you?

Mike Shirkey: So, one of the things that attracts me to government is I like, I enjoy identifying, defining, and solving complex problems. And there’s hardly an industry that is more complex than healthcare.

Rachel: You don’t say say it again.

Mike Shirkey: And so, prior to my legislative experience, I had the privilege of being invited to serve on the at that time, it was Foot Hospital. Now it’s Henry Ford shared allegiance on the board there. And that was a completely new experience with a very steep learning curve. In my second year, the board chair resigned and there was nobody being groomed to replace. And this is a good example of that old joke where all the soldiers line up and somebody says, we need to volunteer, and everybody takes a step backwards. The person thinking about what was the question again? And so, I became board chair only two years into my stint and then remained board chair for almost nine years. And in that time, not only were the problems complex, but the learning curve is steep. And if you enjoy life like I know the two of you do, and I do, there’s nothing hardly more fun than learning something new and exploring new ideas. So, I spent almost ten years in healthcare at the board level, learning all of these crazy acronyms, and I thought to myself, well, shoot, if I’m going to go in the legislature, I’m not going to let all that learning experience go to waste. I’m going to apply it. And so, when I first got there, Jason Boulder was the speaker of the House when I was elected. And he said, what do you want to do? And I said, well, I’d like to focus two things. I’d like to focus on health care and I want to be your left tackle. He goes, what do you mean? I say, I’ll make sure you don’t get blindsided, Jason. That’ll be my job. Plus, I want to focus on health care. He’ll affirm that conversation if you spread it to him. He remembers it very well. And I had to act as a left tackle a couple of times for him. But that’s the reason why I have an affinity to healthcare. And frankly, none of us get out of this world without touching healthcare, sometimes more frequently than we’re.

JJ: Right, well, let’s drill down a little bit into some of the legislation that you’ve been instrumental in and that have impacted hospitals, not just rural, but certainly all Michigan hospitals. So first, let’s talk about the CRNA in legislation. And obviously you were, and I’m going to say this again, instrumental. Those are words that were spoken at MHA by our leadership, at MHA, by others around the state. When we say instrumental, he made it happen. And that is exactly what occurred in this particular issue. But we had been fighting for eight years, as you know, testimony after testimony, and there was a lot of conversation about how should a CRNA practice. So obviously after an eight-year effort, you got it across the finish line for us. But I want to ask you a question. What was that legislation all about, in your mind? We know in our listeners in healthcare know what Cron’s do. We don’t need to get into that. But in your mind, what was it all about? And I guess the real question is why did you fight so hard for it?

Mike Shirkey: Sure. So healthcare, what I discovered is that it’s easy for people to get their own sandboxes very firmly established and then they don’t want anybody else playing in their sandbox. It’s kind of a protectionist thing and it’s natural. So, it’s not an evil thing.

Rachel: Right.

Mike Shirkey: But first, when somebody comes along and wants to challenge status quo, you know that there’s going to be inertia. The second thing that got my interest is that I think the best we can do for healthcare long term is ensure that everybody can practice at their highest level of training. Maximum level of training.

JJ: That’s right.

Mike Shirkey: And there should be no contemplation of restricting what they’ve been trained to be able to do. Many of the limitations that have been established are artificial or protecting somebody’s sandbox. And then you couple that with the fact that anesthesiologist, they’re very important, very and very expensive.

JJ: Very.

Mike Shirkey: And so, it’s hard for many rural hospitals to be able to afford to carry and have somebody of that nature full time. And so CRNAs are a very good example of how to fill that void without sacrifice of safety. During the time period in which I was learning about what they were facing, I learned that they were very passionate about what they can do and very proud of the work they can do. And again, to me, it’s a shame to not let people do the work that they’ve been trained to do.

Rachel: Right.

JJ: And we heard that testimony. You were very clear in making sure that that came out of committee and it passed. And I will tell our listeners today, you may not understand the complexities that Michigan went through in fighting this for eight years. You may be a state that already has this practice privilege or you may be a state that really do not want it. But I’m going to tell you the impact for our hospital has been starting programs that generate revenue, such as our pain clinic. To the senators point, to hire an anesthesiologist to come in would be impossible for any profitability or any margin of profitability because we would have to pay it. So, practicing, which they can do very well independently, they administer our anesthesia here at this hospital. And the law now allows them, which they have been doing for a while, just practicing under the name or the auspices or supervision of an AESTHESIOLOGIST, but doing all the work. And we have been able to demonstrate here in the state of Michigan that the return on our investment is patient outcomes were not impacted negatively by this at all. And number two, the economies were positively impacted of small rural hospitals like ours who could not afford to go out and recruit anesthesiologist. So that’s the economic side of it, Rachel. And for the clinical side of it, patient outcomes, no difference, not one beat was missed after this legislation passed in providing excellent patient care.

Rachel: Right. And if you want to really follow that thread, I think this legislation probably had an impact on the long-term sustainability of some of our or will of some of our rural hospitals.

JJ: Sure.

Rachel: Because if you can’t hire an anesthesiologist, you can’t do surgery. And if you can’t do surgery, your rural hospital has no way to stay afloat.

JJ: Absolutely.

Rachel: Because of our payer mix and all of the issues that we talk about. And then when your hospital is closed, then there goes your community and your economy. So terrible, right. So, it’s an access to care issue as well because it makes those specific procedures available in the community but also sustains the healthcare organization as a whole because of the service they provide being so critical.

JJ: Agree to that.

Mike Shirkey: Precisely.

Rachel: Now, also talking about access to care, Medicaid expansion was a major issue for rural hospitals and health care providers in general across the country. And JJ, I want to ask you because you were here at Hillsdale Hospital when that debate was raging and the subsequent vote was happening, what do you remember about that time? How did it feel to be at a rural hospital not knowing whether Medicaid expansion would pass?

JJ: Well, and you have to remember, so I started here and I’ll just be very candid as a very conservative Republican official from a county government who did not believe in the encroachment of government. And so, I had to learn a quick lesson. You know, access was needed in our community of poor individuals who did not have health care, who needed to receive health care. And I at first, when I heard that the legislation was being considered and discussed, truly thought it would not pass. In fact, we were hearing a tremendous amount of ground swelling that it wasn’t going to happen. Not enough votes. You know, no one’s going to its election year. No one’s going to be pushing this forward. They don’t want to increase the burden on individuals with Medicaid expansion, etc., etc. E. And so at first, we really anticipated that this would be shut down.

Rachel: What were you thinking then was going to happen? And what were you trying to prepare for? Assuming that it wouldn’t pass, the hospital would close. And I’m not being dramatic in its entirety. Yeah, the hospital eventually would close because access to care is going to happen two ways. The individuals are either going to be covered under an insurance plan, whether it’s a government or a private or those individuals are coming into the hospital without any insurances, and therefore they will present at the emergency department, which will then cost us more of uncompensated care. So, we knew that with the decrease of jobs, with the closure of some factories in Hillsdale, that these individuals typically would then seek out either government payers or they would have no insurance. And we were starting to see a significant increase in non-insurance. In other words, uncovered they had no insurance. So, these were individuals that we would need to take care of as a small, non, for profit hospital. You don’t kick someone out of your emergency department by virtue of law anyway under I’m Tala. But second of all, we have a mission. We’re mission oriented. So, it’s difficult in a practice to say, well, you don’t have the money. So, we were starting to see a lot of uncompensated care. That led to a reduction in our cash on hand, which, if you were to follow that, a long period of time would result in closure. And so, I changed my tune quickly on the role of government as it relates to issues like this. It is not the seven-year old’s fault that the factory closed and the parents had to seek government insurance, but it needed to be accessible to them, and so it needed to expand out of the categories in which it originally was created for.

Rachel: So, from there, you changed your tune. You had a new understanding of this. What happened next?

JJ: So, what happened next was something very remarkable. We were hearing at the time that it wasn’t going to pass. But then we heard of a name of a conservative who was actually promoting it. Who we were told in the inner circles was going to get the vote. Which we thought never going to happen. Never going to happen. Never going to lead this initiative as a conservative. Of all things in a conservative state at the time. With a conservative legislature. Not going to happen. And to the chagrin of many, it happened. And to the surprise and delight of most, it happened because as a result of senator Mike Shirkey, which was the name that was introduced to us at the time, we just heard representative Shirkey, and at the time we were told that he would get the votes for us that we needed out of the legislature. And then what happened is the MHA caught wind of his support, and I believe there was a great relationship that was formed from all right, here’s the bottom line. You spent ten years in healthcare, Mike turkey, but here’s what we’re facing today, and here’s what this would mean to Michiganders if it could expand. And this is what the pickup would be for individuals who do not have health insurance, who could in fact, their lives could be changed. And how were their lives changed? Because they can seek medical care. Many people during this period before Medicaid expanded did not meet the criteria, and these individuals were not seeking treatment. They were passing up their health care to buy groceries, right, and to pay bills. And that’s a true story. And so, without support or help and the resources to do it, they were foregoing their medical needs. And then what was happening is that individuals that did that waited longer for their health care. They came and they presented sicker, right? Or up to a point where we could not take care of them any longer. We send them to a tertiary center where the costs are ten times what it would have cost to take care of the patient at the primary care level. So, for all of those reasons, we started to learn of this name. And I’m like, I know that guy. He sang once around me. We served Ruby floats together with Tim Walter. I know that guy. And through a series of contacting, his office, I don’t even I think there was a few times we talked about it personally, but really working with his staff and Mike giving them direction, something miraculously happened, and Medicaid expanded Michigan, and that was incredible. So with that knowledge, obviously, I know that the Medicaid vote was hard for you, Mike.

Mike Shirkey: That’s putting it lightly. So, here’s the story behind the story. Rachel, again, I’ve already spoken about Speaker Boger, who I was serving under at that time, and I was dead set against expanding Medicaid eligibility. And James called me in his office one day. He said, I got a favorite asked of you. And I said, okay, what is it? He says, I need you to really study this and then come back and give me a recommendation. Well, that’s easy. I just said that’s easy. We’re going to restart it. He said, no, I need you to study it, and then after you’ve done that, come back and give me a recommendation. All right? I was kind of flipping about it because I knew the outcome was going to be but I rolled my sleeves up and digitally, precisely, which would he ask for? And the more I learned and the more I investigated, it became abundantly clear that the best economic equation included this is not just economic equation for health care. The best economic equation for Michigan, for all businesses, was, of course, because these folks who were being under or not served were never going to be let alone I mean, we were going to pay for it one way or the other.

Rachel: Right.

Mike Shirkey: And at that time, if you remember, and maybe I don’t think it’s the case as much today, but Michigan was a net taxpayer to the federal government. That’s really one of the things I hung my head on with my colleagues and legislators said, listen, this is an opportunity for us to get our tax money back and do it in a way in which we’re really providing. A real service. I still got scars on my arms.

JJ: And arm without a doubt no harmful.

Mike Shirkey: Healed I understand it was my favorite. I mean we’ll talk about maybe a little bit later of labor, freedom, right to work, but it was my favorite for speech because this one was completely and totally from the heart. There was no politics involved in this force speech and I got a standing ovation from the democratic side about a dozen of my colleagues in a republican side evil looks but it was the right thing to do then it remains today the right thing to do and very few people would argue about that today.

JJ: So how far in the process did you realize again, you come into it with a little health care knowledge from the board level but when did you realize this is good for Michigan? Was it after specific conversations with economic development MHA or was it, was it.

Rachel: Like one or two points that really stood out?

Mike Shirkey: It’s kind of like my journey of faith. There isn’t a day when it happened where all of a sudden, I became a believer. I’m an engineer. It’s a process for me and that’s what this was. It was a process. I’ll say though that if I had to identify one specific item, it was this notion of wait a minute, we can get much of our own tax money back into the state and deploy it in a way that can be very useful, very helpful. And it was my primary point to be made in my caucus. Another story that is related to this is that you know, Chase with his help and a bunch of other colleagues, we were able to figure out we probably had enough votes in the House but there was no interest in voting in the House unless we knew we had enough votes in the Senate. So now I want you to picture this. I’m a second year fresh, you know, basically a sophomore in the House of Representatives and we’re working on something that’s very complex like Medicaid expansion. We have a lot of emotions, a lot of hard people dug in on their positions but I was pretty sure we had the votes in the House. It was going to be close. So, Jay knocks on the door and says, hey, I need you to go over to the senate caucus, republican caucus and sell them because they don’t have enough votes. Oh my gosh, I had gray hair but I was still a rookie and I don’t get intimidated really easy. But that was one of those days where I thought, oh man, this is.

JJ: Seriously have to be.

Mike Shirkey: Yeah, it was fun and so mutual friend of ours that was responsible for the studio that we’re sitting in here now and a number of his colleagues were not happy that this sophomore house member was walking into the upper chamber senate caucus and making a pitch for expansion of Medicaid. But we stood there and we answered every single question. And the only questions that I couldn’t prevail on were those that were principles beyond the contemplation. The government just shouldn’t be doing that. I can’t help either. No, healthcare is not a free market driven entity in the United States of America, mostly because of the intelliglas it is. And so, we all love to make our decisions through that filter of free markets. But not everything is a free market.

JJ: I agree.

Rachel: You can’t fairly apply it to an industry like health care because like you said of things like in talent, also, we don’t get to set our prices. So that makes a big difference too.

JJ: You got the votes in the Senate and in part because you gave an impassioned plea to them as a scared, brand new, almost representative.

JJ: And there were some there were some moments of pushback for you and that has really, I think, defined your character because you moved right along and continued working and it led to the fact that others recognize that. And you’re then appointed a leader in the Senate. And I think that’s incredible story because there you’re championing something that’s not popular, but you’re known by your character. And I can’t stress it enough to our listeners who may be listening outside of Michigan about the critical importance of having someone like a Mike Shirkey in the House or in the Senate working for you. It’s been incredible. And you’ve tackled a lot of other issues. And I want to ask you this question. If you were to look at all the issues spanning your career, name one or two of those that when you get ready to depart in two months, what do you just say? You know what? Well done, good and faithful servant. I feel really good about that. I know a couple you regret not being able to do, but I’m proud of those. But we like our certificate and needs editor but what would you say is one of the things that you just.

Mike Shirkey: Go, okay, it’s simple, it’s only one.

JJ: Okay.

Mike Shirkey: And it’s very simple. And that is that when I ran for office, I was hellbent on doing everything I could to make sure that to help Michigan become, some call it right to work state, I call it labor freedom, where unions are as free to make their case as workers are to make their choice. And that was the sales pitch. Right to work is a very incendiary topic and a title and issue that causes people to go to their corners fighting. But when you frame like this, okay, unions, you should have the opportunity to make your case. Absolutely. And workers, you should have the opportunity to make your choice. And that was the breakthrough. And now I’m not going to take credit for Michigan becoming a right to work labor freedom state. But the role I played, I believe, helped give my colleagues the confidence to follow through with the vote. And I was the only legislator. This is before your time in Michigan, Rachel, so you will remember this, but the labor unions and across the state of Michigan were very riled up over this because it was Michigan. Michigan was this was ground zero for labor unions.

Rachel: Right.

Mike Shirkey: And by the way, I’m not antiunion. Just make it free. Make it, make it I was the only legislator that went to union halls for about a year and a half and debated in union halls against union members. He’s a brave guy, and there were a few threatening time periods there, but that gave my colleagues confidence to know that, well, if he can stand up and do that and I had many union people say, okay, so we see. You’re not crazy and you’re not antiunion. You just want your pro freedom. I said, absolutely. And so, right to work. Labor freedom, where unions are free to make their cases, workers are to make their choice, is the thing that I will forever be grateful that I had just a small part of.

JJ: Yes. Incredible. Incredible. Well, that work and other work that you’ve done, we cannot minimize it, but certainly has impacted healthcare in general. So, is there anything that you want to convey as you get ready to wrap up here? And again, if you don’t, that’s fine. We’ve covered a lot of the areas, but is there anything you want to encouragement? Whatever it is, sure. Okay.

Mike Shirkey: So many of the people listening to this podcast are in one way or another related to healthcare. In many cases, its rural healthcare, right. And that’s one of the beautiful things about America that we hold precious. This notion of maintaining rural America as we all have envisioned it in our minds and read about it in our books and so forth. We have the technology to be able to sustain both, both in urban and in rural health care. But healthcare, just like any other industry, is not immune to having to evolve, not immune to having to reinvent yourself. Our tour that we took of your facility today, JJ and Rachel, it’s a perfect example of how you guys have faced, made the hard decisions and reinvented yourself over and over and over. And by the way, I got bad news for you. You’re going to have to continue to do that the rest of your career in health care. And that’s my message to healthcare in general is that I made mentioned earlier about people creating sandboxes that they don’t like anybody in. No, forget the sandboxes. We’re all in this together. It’s a great big sandbox. And we have to figure out how to continue to evolve to make sure that we not only are prepared to serve the needs of the community. But we are also examples of how they can best own their health and what they can do to make sure that they minimize the need for health care. But at some point, in time we all are going to need some help. I told you I’m going to have my second knee replaced here in a couple of three weeks. So, these things wear out. They did. But it’s a high privilege to serve and work in the healthcare community across this nation and be proud of that. All of you who are listening. But also, don’t be afraid to reinvent yourself when the opportunities present themselves.

JJ: Thank you so much for your time today, Senator Shirkey, and we wish you the best on your journey. You have many years ahead of you. It’s time for a little respite because you’ve worked hard and you’ve labored hard. So, on behalf of health care, we thank you.

Mike Shirkey: Thank you very much.

JJ: And before we close, we’d like to do a fun segment with each of our guests. So we want to know Senator Mike Shirkey, what is your most unique rural experience or one of your favorite memories from rural life?

Mike Shirkey: So, I didn’t grow up in rural, I grew up in a suburban area, but my heart was always rural. I’m a big avid hunter and fisher, an outdoorsman. My wife had none of those experiences or none of those interests. So, we’ve moved back from Flint to Jackson to start the business and I had this hankering to want to build a timber frame home. And I was only going to build a new home if it was going to be timber frame, and it was only going to be if it’s in a very rural setting. And so, we looked for like four years for places to build a house. And every time we showed I found one that I was somewhat interested in. So would say not going to do that for a long list of reasons. But one day I’m out literally on a bicycle ride after work, just distressing myself and I’m driving down this recognizable gravel road. I think, when was I down this road? I remember it, I can recall it. And I got to this two track that went off the road and I took that two track back to a little lake called Grand Lake. And I remember then when I was 16, I just got my driver’s license and my brother and little brother was 15. We had gone there to do rabbit hunting.

JJ: Oh wow.

Mike Shirkey: And as we left there that morning or that afternoon rabbit hunting, I pointed up to the top of the hill, it was this gorgeous view of the lake and I said to my brother Mark, I said, wouldn’t it be awesome to build a house up there someday? I was 16.

Rachel: Wow.

Mike Shirkey: I drove my bike back on these two tracks and there was a house that was built not on the hill that I wanted, but right next door. And so, I just went over, this is half a mile off the main road. I knocked on the door, and I introduced myself to the guy that lived there. And I said, my name is Mike. Do you happen to know if that hill is available for sale? And he goes, well, you know, it’s funny you ask. He says, it was my wife’s sister and her husband. They were going to build their retirement home, but he unfortunately died recently, and they’re getting ready to sell it.

JJ: No.

Mike Shirkey: So, I got on my bike. I don’t think my wheels, every time I brown, went home, grabbed sue, put her in a truck, brought her over now and we park, and we have to walk up to the top of this hill. Walk around the top of the hill, you can’t see the lake because it’s just all overgrown. And this is after she turned me down, I don’t know, eight or ten times other different locations for building. And we got back in the truck, and I’m really excited, but I know that there’s no way she’s going to do it. Just too remote. I brought halfway home. I go, so what do you think? She said, buy it. No, she never asked how much, even. She just said, just buy it.

JJ: That’s an incredible story.

Mike Shirkey: Door opening to true rural living. And now this morning, before I came here, I spent 2 hours out chopping wood.

JJ: Is that right?

Mike Shirkey: Yes. Preparing for the winter.

JJ: That’s amazing. Welcome to rural Michigan.

Mike Shirkey: Amen.

JJ: All right.

Mike Shirkey: Amen.

JJ: Next time on Rule Health Rising, we’ve another great conversation with another great guest, so be sure to tune in.

Rachel: And with that, don’t forget to subscribe wherever you get your podcasts. And if you like what you hear, leave us a five-star review on Apple podcasts and tell others why they should listen to your feedback helps more listeners find Rural health Rising.

JJ: And you can now find us on Twitter. I’m at HillsdaleCEOJJ Rachel is at ruralhealthRach. And you can also follow the podcast at rural health pod. Until next time, stay safe, stay healthy, and stay strong.

Rachel: Rural Health Rising is a production of Hillsville Hospital in Hillsdale, Michigan, and a proud member of the Health Podcast Network, hosted by JJ Hodshire and Rachel Lott. Audio engineering and original music by Omer. For more episodes, interviews, and more information, visit rural health rising.com.