Will President Obama Defend Healthcare Reform?


Posted on 05 August 2011

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By Jim Mangia and Dave Regan

Estela Chavez is like many mothers in California. Her two kids want new bikes and the latest Xbox video game. But what they need is healthcare.

She works more than 60 hours a week at two different jobs, but even so there is barely enough money for bare necessities. For healthcare for her two children she depends on a statewide program that covers preventive care for children.

“My son has autism and without healthcare assistance he has no access to a doctor,” Estela said recently. “I could never afford the medication and behavioral health care he needs to function without this program.”

While President Obama and Congress are jockeying over the federal budget in Washington, D.C. people like Estela and her family hang in the balance.

President Obama is talking about closing corporate loopholes, taxing private jets and requiring the upper echelon of society to pay its fair share, but he is also proposing significant cuts to programs like Medicaid that if enacted would eliminate basic healthcare for kids. Estela’s children depend on Medi-Cal, the California Medicaid program for children.

Funding for our nation’s healthcare safety net is most in danger in the recent round of hyperbolic debate. Republicans are wielding a sledgehammer – demanding to gut the program and move on.

President Obama can stand up for healthcare funding for millions of children and people with disabilities while protecting the success of his own historic healthcare law passed last year by looking at states like California that have responsible and efficient programs that have reduced costs while adding coverage to those in need.

The Affordable Care Act has already extended coverage to dependents up to age 26 and prevented health insurance companies from denying care to children with pre-existing conditions. In 2014 the law will dramatically expand coverage for most Americans. For low income people who have no health insurance now, the law calls for more than 16 million to become eligible for Medicaid.

The program serves 50 million people, the vast majority children and the rest people with disabilities. Cut the program at the knees now and future benefits will never come to pass and the effects now will also be catastrophic.

We already see more people delaying care until only a costly dramatic or emergency room intervention can save them. We see more and more Californians out of work or without good jobs with benefits. Cut more out of the safety net and we will see nonprofit community clinics, long the only bastion for low cost preventive care, closing their doors in record numbers.

Hospitals, community health centers and doctors serving low-income Americans would be disproportionately affected.

Additionally, California will suffer. If Medicaid is slashed, our state stands to lose as many as 28,440 more jobs, and up to $3.7 billion in related revenue according to a new report by the nonprofit health-advocacy group Families USA.

California just enacted enormous and extraordinarily painful spending cuts to almost every program, university, hospital, clinic and courthouse in our state and we cannot weather another round of slashing.

It’s no mystery how important the safety net is for children and families like Estela’s. We’ve become accustomed to the slow unraveling of the healthcare safety net, rising unemployment and revenue losses. President Obama can stop these phenomena. California has done a lot to control the cost of Medicaid and that should be recognized before implementing a blunt instrument.

Do not betray Estela Chavez and millions more like her. President Obama should take the lead now in protecting seniors, people with disabilities and children.

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Jim Mangia is president & CEO of St. John’s Well Child and Family Centers, a network of federally qualified health centers in South Los Angeles which serve more than 140,000 patient visits each year. Dave Regan is president United Healthcare Workers West, which represents 150,000 hospital, nursing home and in-home care workers in California.

It is public policy driven by the US Congress (Democrats and Republicans - both dis-serve the public interest) since 1965 that has resulted in the presence of these millions dependent on the state. Democrats legislate policy that will insure millions of poor in the quest for a patron-client state. Look it up. Republicans serve their corporate masters by insuring million willing to work for slave wages, with societal costs externalized and covered by the taxpayers. Look it up.
These policies will continue until the money runs out. What then? Well, the market gave us a preview this week.
William Greider, some years ago, provided a clear explanation of how government really works to serve, not the public interest, but the interests of a monied elite. Read him. Gretchen Morgenson, in Reckless Endangerment , quite recently, focused on the role of the executive branch and congress in creating a financial crisis in the US. Not in Canada. Not in Australia.
Feinstein and Boxer have been in Congress a long time. How have they served the public interest?

How about the unraveling of the pyramid scheme created by congress since 1960? S&P just downgraded the US from AAA. That is just the beginning.

These are becoming too expensive. We must look at other paridigms. Either universal, single-payer for all citizens; or drop present Medicaid and have the people affected get all their health care from public hospitals where doctors would be paid a fixed salary.