Concern about health care lately has mostly focused on the Richardson administration's proposals for slowing the growth of the Medicaid portion of the state budget. But events in the last few weeks remind us that Medicaid is only one piece in the whole crumbling mosaic that is our health care financing system.
And in a state where public monies already pay for more than 70 percent of all health care, it is becoming obvious that market-driven solutions won't get us very far in solving the crisis.
At the same time, public concern over both the escalating cost of medical care and the proposals to reduce public sector spending on it are together producing a very anxious mood among voters, what Mel Brooks might term “high anxiety.”
Woe to any politician today who tries to ignore health care or who tries to finesse it with generic calls for fiscal responsibility and postponement of gratification. This was the message I got at two separate press conferences called by local advocacy groups. Neither group is in “gratification-
The folks who organized the conference on Jan. 14 at the Alamosa Community Center are from Imagen magazine. Their event was a discussion of a national study of Latino health and wellness issues.
Then one week later, maternal and child health advocates from around the state showed up at the Round House to draw attention to the proposed 50 percent cut in state funding for their programs.
For both groups, health care financing is clearly too serious a life and death issue to leave up to policy wonks and bean counters.
And remember the angry hailstorm called down on those in Congress who voted to restrict access to medicines purchased in Canada or Mexico, part of the compromise brokered by AARP in order to squeeze a pathetic, cowardly prescription benefit into the Medicare program.
The people are speaking out and they need to be heard: Health care is one of the things we expect our government to provide, along with education, police protection, good streets and dependable refuse removal.
If that strikes you as an unreasonable position, one tantamount to endorsing socialism and the Marxist world-view, you may be badly out of touch with the day-to-day reality for most Americans. There is no longer much public appreciation for “solutions” to health care crafted by the insurance and pharmaceutical companies that, by the way, fund the on-going propaganda campaigns that oppose universal health care solutions.
I am not describing a philosophical distinction for clever people to observe and comment on. I am talking about what Joe and Jill Average Citizen feel in their bones when they discuss health issues. Government-provided health care has crossed over from being a matter to debate over brandies at the club into being a deeply felt citizens' right that must be recognized and protected.
I am not clear when Americans changed the way they feel about the government's role in medicine.
It was certainly not a sudden or a quantum shift, but one that gradually grew from many small, painful experiences with accessing care for elderly family members, paying for COBRA coverage, being denied services by HMOs, being unable to afford to fill prescriptions and similar disheartening events.
Against that background, both the recommendations of the Imagen study and the plea for continued full-funding of Community Maternal and Child Health Councils seem remarkably restrained and worthy of support.
Linda Armas, publisher of Imagen, went over the most important recommendations. Every legislator will get the full report. It needs to be read and implemented. In the long-run its recommendations could actually reduce public expenditures for medical treatment.
Providing competent, trained medical interpreters and culturally competent health professionals for non-English speaking patients at hospitals and clinics saves money by assuring that appropriate care and diagnoses are given.
Promoting better nutrition for Hispanic children, eliminating junk food and soft drinks from school vending machines and expanding physical education participation will pay dividends in reduced rates of diabetes, obesity and other expensive-to-treat conditions.
Assuring access to health care, including studying the possibility of a single-payer health plan for all New Mexicans, is also on the Imagen list. This, too, when it is eventually put in place, can produce cost savings to the public treasury over the current wasteful and administratively burdensome system.
Restoring full funding for County Maternal and Child Health Councils, the network of 28 such bodies across the state, will enable their productive work to continue. It would be a major step in the wrong direction (and would send the absolutely wrong message) for the state Department of Health to reduce its commitment to these councils and their efforts.
The amount of money that would be saved by cutting the program is miniscule compared to the far greater loss in new programs and improved avenues of access that the councils have leveraged over the years.
Public financing of our health care system is no longer an issue. Now the debate should be focused on how best to shape that system, without muddying reform efforts with marketplace semantics. Let your legislator and the governor know how you feel about it.