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 V.18 No.51 | December 17 - 23, 2009 

Talking Points

Heinrich on Health Care

Alibi's nurse columnist quizzes a congressman on reform efforts

Whitny Doyle, RN, asks Heinrich health care reform questions based on her professional experience.
Eric Williams ericwphoto.com
Whitny Doyle, RN, asks Heinrich health care reform questions based on her professional experience.

Rep. Martin Heinrich’s constituents gathered beneath the outdoor tent, warming up with posole and hot chocolate, while the old guard South Valley residents sat on folding chairs discussing grandbabies and holiday recipes with one another. Saturday, Dec. 12, marked the grand opening of Heinrich's district office in the South Valley, an area in which he saw “great needs” during his campaign, he said in a news release.

“Welcome to your congressional office,” he told the shivering crowd. After the speech, the Atrisco Heritage Academy High School Jaguar Cheer Squad performed a special cheer for the congressman, energetically chanting, “Heinrich got the beat!” with goose bumps covering their bare legs.

Heinrich began his first term in Congress in January after serving four years on Albuquerque’s City Council. Heinrich is the first democrat to represent New Mexico’s 1st Congressional District since the district was created in 1969. Since winning the position vacated by Heather Wilson, Heinrich has sponsored legislation to promote land conservation, and he authored a portion of a defense bill that prevents retirement of the Fighting Tacos, the 150th Fighter Wing of Kirtland Air Force Base.

Eric Williams ericwphoto.com

When it comes to health care, Heinrich has been a vocal supporter of the public option and a visible figure in the reform debate, especially back home in the district. He’s hosted town hall meetings and opened other public forums for New Mexicans to voice concerns.

Heinrich sat down with the Alibi to speak about health reform. His two children ran around the South Valley office, buzzing with endless energy. In the middle of the interview, the lights suddenly went out, plunging the room into utter darkness.

“I’m going to guess that my children are responsible for that,” Heinrich deadpanned. An adult eventually found the light switch.

How did your health reform listening tour inform your understanding of what the public needs?

Eric Williams ericwphoto.com

New Mexico is not like every other state. One of the things that I think is at the root of a lot our problems is that ... we [medical providers] get reimbursed at such a low rate as compared to other places in the country. I tried to focus on getting some language in to begin to fix that. I’m pretty happy with the language that came in the House bill, and we’ll have to see what eventually gets included in the Senate bill.

I also heard a lot about primary care ... the lack of primary care both rural and urban. There have been a number of primary care bills around for awhile, in particular one sponsored by [Rep.] Allyson Schwartz that I thought was really good that we were able to get into the overall health reform. The primary care provisions in the House bill set the bar, and the Senate’s not quite there yet.

So that will be one of the things that I’m trying to—as we go into the final negotiations between the House and the Senate—really make clear to our House members who are negotiating that. We really need to do a good job on primary care.

Many people, like those here in the South Valley, lack access to care. Tell me more about what the bill actually does to address the primary care and nursing shortages.

There are a number of financial provisions that deal with things like scholarships for primary care providers, and not just primary care docs but a whole suite of primary care providers. Also, increasing the reimbursement rates for primary care providers in both rural settings and underserved settings.

As a nurse, I want to hear your sense of how resonant the voices of nurses, doctors and other providers were in shaping this legislation as compared to big industry stakeholders like hospitals and insurance companies.

At the end of the day, I was really impressed with the strength of providers, of people who are actually on the front lines of medicine. There are so many fairly organized organizations that represent those different groups.

I would hear from nurses ... through the lens of whatever their work situation was. And that was really helpful because it wasn’t at 20,000 feet being described to me by some insurance company or hospital executive who is all about the big picture and not about, OK, this person’s working way too many hours and ... is pushed beyond the point of giving the quality that they’d like to give to people.

I also think that most members of Congress were fairly skeptical of the insurance industry through this process, and that’s why you saw such a strong bill come out of the House.

What’s your sense of the Senate’s alternative to the public option, the Medicare buy-in option that’s been endorsed by House Speaker Nancy Pelosi?

I’ve never had a problem with Medicare buy-in, and I think it’s a good way to get people in the program in a deficit-neutral way. But at the same time, it doesn’t change the fact that I think we need a public option for the 30-somethings and the 40-somethings.

Around 30 percent of young adults aged 19 to 29 lack coverage, which represents a disproportionate share of the uninsured. Alibi readers tend to be young, so how do you anticipate the individual mandate will affect this demographic?

I went through a number of years in my 20s, when I was reading the Alibi, where I was skiing, spending time in the backcountry by myself, doing things that were fairly high risk. I had no insurance! And, when one of these people finds themselves in a position where they develop something serious, it’s really hard to ever get them in a decent economic setting again because they’re not allowed into the system.

It’s going to mean much better health care for those people long-term. And the bill we passed said that if your parents have health insurance, and you’re on that plan, you can stay on that plan all the way up until age 27.

What’s your sense of what this bill is going to look like in its final version when it comes back from conference committee?

I think it’s still in the process of a number of, within the Senate, of a lot of negotiations. What I don’t want to see is three senators who represent 2 percent of the population of the nation dictating policy for 60 senators who represent 90 percent of the population.

Most of the major concessions have been made to win the votes of fellow democrats. What’s the implication for your party?

We’ve got to come up with a bill that works for all of America ... and not let a very narrow set of interests dictate policy for everybody else. That’s a hard challenge, and it means there’s going to be a lot of negotiations between the House and the Senate because we’re not in the same place on some of these things.

 
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