California CapitolWeek – Health Counts 2000 –  Health Insurance

 

October 27, 2000

 

((JACK)) THIS WEEK, A HEALTH ISSUE THAT AFFECTS ALL OF US ONE WAY OR ANOTHER.  DESPITE A STRONG ECONOMY AND LOW UNEMPLOYMENT, ONE IN FIVE CALIFORNIANS DO NOT HAVE HEALTH COVERAGE.

 

((MELISSA)) WE’LL USE INTERACTIVE TECHNOLOGY TO CONNECT COMMUNITIES WHO ARE BRIDGING THE GAP BETWEEN THOSE WITH COVERAGE AND THOSE WITHOUT. INCLUDING A COMMUNITY CLINIC IN FRESNO.  IN LOS ANGELES COUNTY . . . VOLUNTEERS HELP MAKE HEALTHCARE A REALITY. 

 

HELLO, I’M MELISSA CROWLEY.  AND I’M JACK KAVANAGH.    GET CONNECTED IN THIS SPECIAL EDITION, NEXT .

 

((JACK)) THANKS FOR JOINING US FOR PART TWO OF OUR SERIES ON HEALTH IN THE 2000 ELECTION

 

((MELISSA)) IT’S PART OF A PROJECT CALLED HEALTH COUNTS 2000, A MULTI MEDIA PARTNERSHIP INVOLVING SOME OF THE MOST RESPECTED MEDIA OUTLETS IN THE STATE.  WE’LL TELL YOU MORE ABOUT THE PARTNERSHIP LATER IN THE PROGRAM.

 

((JACK)) LAST WEEK WE TACKLED PRESCRIPTION DRUG COVERAGE, THIS WEEK IT’S THE PROBLEM OF THE UNINSURED.  CALIFORNIA HAS MORE THAN 7 MILLION UNINSURED RESIDENTS, THE MOST OF ANY STATE. 

WITHOUT COVERAGE, MANY OF THESE PEOPLE TIE UP EMERGENCY ROOMS . . . . AND SOME EVEN GO WITHOUT CARE, UNLESS ABSOLUTELY NECESSARY.

 

((MELISSA)) TO TELL THEIR STORIES, WE ARE USING INTERACTIVE TECHNOLOGY TO TAKE YOU TO TWO COMMUNITY CLINICS, ONE IN FRESNO, THE OTHER IN VENICE, CALIFORNIA. THERE WILL BE A DOCTOR AND A PATIENT AT EACH SITE, AND THEY WILL PARTICIPATE IN OUR DISCUSSION. LET’S CHECK IN WITH OUR REMOTE LOCATIONS.

 

((ALL))HELLO.

 

((JACK)) YOU WILL MEET THEM IN A MOMENT.  BUT FIRST LET’S MEET OUR IN STUDIO EXPERTS. CRYSTAL HAYLING OF THE CALIFORNIA HEALTH CARE FOUNDATION. AND GRANTLAND JOHNSON, SECRETARY OF HEALTH AND HUMAN SERVICES.

 

((JACK)) CRYSTAL, THAT’S A PROBLEM, SEVEN MILLION PEOPLE IN CALIFORNIA WITHOUT HEALTH COVERAGE.  IS THERE A FIX FOR IT?

 

((CRYSTAL HAYLING, CA HEALTH CARE FOUNDATION))

THERE IS INDEED A FIX FOR IT.  I THINK THAT WE KNOW THAT MANY PEOPLE WHO ARE UNINSURED FALL INTO A COUPLE OF DIFFERENT CATEGORIES.  THERE ARE THOSE THAT ARE WORKING POOR FAMILIES, PEOPLE WHO ARE WORKING FOR A LIVING, MANY OF THEM FULL TIME WORKERS, PEOPLE WHO CANNOT AFFORD TO PURCHASE INSURANCE IF IT IS OFFERED BY THEIR EMPLOYER, OR INSURANCE SIMPLY ISN’T OFFERED BY THEIR EMPLOYER.  WE KNOW THAT THERE ARE MANY FAMILIES OF PEOPLE WHO ARE LEAVING WELFARE, AND THOSE FOLKS THAT ARE FIRST ENTERING THE JOB MARKET, I KNOW THAT MANY OF THEM CANNOT AFFORD INSURANCE AS WELL, BUT THERE ARE PROGRAMS OUT THERE TO ADDRESS THOSE PROBLEMS.  FOR EXAMPLE, THERE IS THE MEDICAL PROGRAM, WHICH SERVES THE PEOPLE THAT ARE IN THE LOWEST RUNG OF THE INCOME BRACKET, AND SOME EXPANSIONS IN THAT PROGRAM COULD REALLY HELP US TO ADDRESS SOME OF THE PROBLEMS.

 

((MELISSA)) CRYSTAL, WE’RE GOING TO HAVE THE ABILITY TO DISCUSS THOSE MORE IN A MOMENT, THANK YOU VERY MUCH.  GRANTLAND, WE WANT TO TOUCH ON, FIRST, HOW WIDESPREAD IS THIS PROBLEM?  DO-DO WE, FOLKS IN THIS STATE WHO HAVE INSURANCE, DO WE FULLY UNDERSTAND THE MAGNITUDE OF THIS PROBLEM?

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES))

NO, AND THE FIX IS REALLY A FINANCIAL ONE, ULTIMATELY, BECAUSE IF YOU WANT TO EXPAND PUBLICLY-FINANCED HEALTH COVERAGE PROGRAMS, IT WILL TAKE ADDITIONAL MONEY.  IN THE PRIVATE SECTOR, EMPLOYERS WILL TELL YOU THAT THEIR PROFIT MARGIN IS NOT SUFFICIENT FOR THEM TO PROVIDE, IN MANY CASES, HEALTH CARE COVERAGE FOR THE EMPLOYEES AND THEIR DEPENDENTS.  IN BOTH CASES, IN THE ABSENCE OF A NATIONAL, FEDERAL COMMITMENT WITH UNIVERSAL COVERAGE, IT FALLS TO THE PRIVATE SECTOR, MAINLY, AND STATES IN TERMS OF PUBLICLY FINANCED HEALTH PROGRAMS

 

((JACK)) LET’S GET OUR REMOTE LOCATIONS INVOLVED, STARTING WITH FRESNO. ABOUT ONE THIRD OF CALIFORNIA’S UNINSURED POPULATION ARE CHILDREN, THAT ADDS UP TO ABOUT 2 MILLION KIDS. AS WE FOUND OUT IN ONE FRESNO CLINIC, IT’S AN UPHILL BATTLE REACHING OUT TO PARENTS AND CHILDREN.

 

 

((JACK)) JOINING US NOW FROM FRESNO . . . .

DR. PATRICIA QUINTANA OF THE SEQUOIA COMMUNITY HEALTH FOUNDATION…

 

AND ROSA BROCKAMONTE, A PATIENT AT THAT CLINIC…

 

((JACK)) ROSA, CAN I ASK YOU, WHAT’S AT STAKE WHEN PEOPLE DON’T HAVE HEALTH INSURANCE?  WHAT HAPPENS IN YOUR COMMUNITY WITH YOUR NEIGHBORS?  DO THEY JUST REMAIN SICK OR DO THEY GO WITHOUT OR WHAT HAPPENS.

 

((ROSA BROCKAMONTE, PATIENT)) MOST OF THEM DO REMAIN SICK BECAUSE THEY CAN’T AFFORD TO GO TO THE DOCTOR.  I USED TO GO TO A DOCTOR WHO I HAD TO PAY EVERY TIME THAT I WENT.  I’M A DIABETIC.  I COULDN’T AFFORD TO PAY FOR MOST OF THE MEDICATION THAT I WAS GETTING, AND I WAS SKIPPING APPOINTMENTS BECAUSE I COULDN’T AFFORD TO PAY FOR THEM.  MY HUSBAND HAS A STEADY JOB AND WORKS EIGHT HOURS [A DAY], BUT THEY DON’T SUPPLY MEDICAL OR ANYTHING.

 

((JACK)) CAN I ASK DR. QUINTANA, ALSO IN FRESNO, IF I MAY, AS A PHYSICIAN, HOW DO TREAT A PATIENT WITH LIMITED RESOURCES, AND HOW DO YOU PRESCRIBE SOMEONE A DRUG YOU KNOW WOULD FIX THE PROBLEM, BUT THEY CAN’T AFFORD?

 

((DR. PATRICIA QUINTANA)) WELL, THAT A QUESTION WE FACE EVERY DAY.  IT’S REALLY DIFFICULT WHEN A PATIENT COMES TO SEE YOU EVERY YEAR WHEN YOU’D ACTUALLY PREFER TO SEE THEM EVERY THREE TO FOUR MONTHS FOR DIABETES, HIGH BLOOD PRESSURE, THINGS THAT NEED TO HAVE STEADY TREATMENT.  THEY SHOW UP AND THEY’VE RUN OUT OF ALL THE SAMPLES YOU’VE GIVEN THEM.  THEY HAVE TAKEN ANY MEDICATIONS FOR A NUMBER OF MONTHS, AND YOU FEEL LIKE YOU’RE STARTING BACK AT GROUND ZERO IN TERMS OF TREATMENT.  A LOT OF TIMES, A PATIENT COMES TO SEE YOU, AND YOU HAVEN’T SEEN HIM OR HER IN A LONG TIME, AND YOU’LL END UP DOING EVERYTHING YOU CAN, IMMUNIZATIONS, LABORATORIES, STARTING THEM BACK ON MEDICATIONS, BUT, REALLY, YOU HAVE NO GUARANTEE THAT THEY’LL COME BACK—

 

((JACK)) DO YOU—

 

((DR. PATRICIA QUINTANA))

ON THE SAME MEDICATIONS.

 

((JACK)) DO YOU, IN THE BACK OF YOUR MIND, WHEN YOU SEE A PATIENT WITH SOMETHING LIKE DIABETES, FOR EXAMPLE—CAN YOU ALMOST PREDICT THE OTHER COMPLICATIONS DOWN THE ROAD IF IT’S NOT TREATED PROPERLY?

 

((DR. PATRICIA QUINTANA)) ESPECIALLY WITH DIABETES AND HIGH BLOOD PRESSURE BECAUSE PATIENTS FEEL WELL.  IT’S DIFFICULT TO GET ACROSS THE POINT THAT YOU’RE GOING TO FEEL WELL NOW, BUT IN TEN TO FIFTEEN YEARS, WE’RE GOING TO BE LOOKING AT PROBLEMS WITH YOUR EYESIGHT, WITH YOUR KIDNEYS, WITH YOUR CIRCULATION, AND TRYING TO SELL THAT WHEN THEIR ATTENTION IS ON DINNER THAT NIGHT OR PAYING FOR THE MEDICATION THAT YOU’RE TRYING TO PRESCRIBE THEM, IT’S SOMETIMES DIFFICULT.

 

((MELISSA)) ROSA, WHAT KIND OF DIFFERENCE HAS THIS MADE, HAVING ACCESS TO THIS HEALTH CARE AND, HOPEFULLY, NOT HAVING TO MAKE DIFFICULT DECISIONS BETWEEN PUTTING FOOD ON THE TABLE AND AFFORDING MEDICINE?  HOW HAS IT AFFECTED YOUR LIFE?

 

((ROSA BROCKAMONTE, PATIENT)) OH, IT’S BEEN WONDERFUL BECAUSE I WAS ABLE TO—I WAS TAKING MEDICATION, AND NOW I AM OFF THE MEDICATION BECAUSE I’VE BEEN GOING TO THE DIABETIC CLINIC CLASSES WHERE THEY’VE BEEN TEACHING ME HOW TO EAT AND EXERCISE AND DO THE RIGHT THINGS TO CONTROL MY DIABETES, SO I’M OFF THE MEDICATION.

 

((MELISSA)) WONDERFUL, ROSA, AND WE’LL BE HEARING MORE FROM FRESNO IN JUST A MINUTE, BUT NOW WE’D LIKE TO INTRODUCE YOU TO OUR PARTICIPANTS IN LOS ANGELES COUNTY.

END DISCUSSION PT. 2

 

((MELISSA)) THE VENICE FAMILY CLINIC IS ONE OF THE LARGEST FREE CLINICS IN THE COUNTRY, AND HELPS MORE THAN 100 PEOPLE A DAY. THE CLINIC HAS BEEN AROUND FOR 30 YEARS AND NOW WITH 4 LOCATIONS, THE CLINIC RELIES ON GRANTS AND VOLUNTEERS TO MAKE ITS SERVICES POSSIBLE.

 

 

((JACK)) GRANTLAND, LET ME ASK YOU, IN 1994, WE SAW THE CLINTON ADMINISTRATION TRY TO GET A UNIVERSAL HEALTH CARE SYSTEM INSTALLED IN THE UNITED STATES.  THAT DIDN’T WORK.  DOES THAT MEAN THAT WE WILL NEVER SEE THAT IN THE FUTURE OR THAT WHAT WE WILL SEE WILL SOME SORT OF A COMPROMISE BETWEEN THE SYSTEM THAT WE HAVE NOW AND UNIVERSAL COVERAGE?

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES)) I THINK WE WILL SEE.  I THINK THE REFORM EFFORT IS A PROGRESSIVE INCREMENTALISM.  WE ALREADY SEE A GROWING CONSENSUS AROUND INSURING CHILDREN.  THE STATE CHILDREN’S HEALTH INSURANCE PROGRAM, WHICH WE CALL THE HEALTHY FAMILIES PROGRAM, WAS PASSED IN 1997 AT THE FEDERAL LEVEL AS PART OF THE BALANCED BUDGET ACT.  NOW YOU SEE A STATE LIKE CALIFORNIA AND OTHER STATES BEING GIVEN FLEXIBILITY BY THE FEDERAL GOVERNMENT TO PURSUE A WAIVER TO ENROLL THE PARENTS OF KIDS WHO ARE IN THE HEALTHY FAMILIES PROGRAM.  I THINK YOU’LL SEE—

 

((JACK)) AN EXTENSION OF THAT?

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES))  AN EXTENSION OF THAT. 

 

((JACK)) THEY WANT YOU TO GET A FOOTHOLD AND THEN BUILD ON IT.  IS THAT WHAT YOU’RE SAYING?

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES))  I THINK THE REALITY IS THAT IT’S SUCH A LARGE PROBLEM, SUCH A COMPLICATED PROBLEM, JUST THE VISION OF OPINION POLITICALLY AT THE NATIONAL AND STATE LEVEL THAT PROGRESSIVE INCREMENTALISM REALLY BECOMES THE MOST PRAGMATIC APPROACH.

 

((JACK)) RIGHT.  FORGET ABOUT A SWEEPING SOLUTION.

 

((MELISSA)) LET’S ASK DOCTOR FLEISCHMAN IN VENICE A QUESTION.  WHEN WE TALKED EARLIER, YOU HAD TALKED ABOUT A POSSIBLE COMBINATION THAT COULD BE A SOLUTION, MAYBE A STATE/LOCAL PARTNERSHIP OR PERHAPS ONE THAT USES GRANTS AND VOLUNTEERS,AS THEY DO AT THE VENICE FAMILY CLINIC, TO MEET THE NEEDS OF THE UNINSURED.

 

((DR. SUSAN FLEISCHMAN)) WELL, I THINK THAT WE’RE A WONDERFUL MODEL IN THAT WE USE PUBLIC AND PRIVATE MONEY, WE USE THE LOCAL COMMUNITY, WE USE MEDICAL VOLUNTEERS, WE USE IN-KIND SERVICES FROM HOSPITALS, BUT I THINK THERE IS AN INHERENT LIMITATION IN OUR MODEL IN THAT OUR PATIENTS ARE STILL DEPENDENT ON CHARITY.  WE HAVEN’T COME OUT AND SAID, “YOU, AS A CALIFORNIAN, ARE ALWAYS GOING TO HAVE ACCESS TO HEALTH CARE,” SO AS MUCH AS I AM PROUD OF OUR MODEL, I AM LOOKING FOR A BIGGER PICTURE SOLUTION.

 

((JACK)) YOU KNOW, CRYSTAL, IN A WAY WHEN YOU THINK ABOUT IT, YOU HAVE THIS ENORMOUS BUDGET SURPLUS IN CALIFORNIA, TWO PRESIDENTIAL CANDIDATES WHO ARE TALKING ABOUT AN ENORMOUS BUDGET SURPLUS IN WASHINGTON, AND DOCTOR FLEISCHMAN TALKING ABOUT CHARITY, THAT DOESN’T MAKE SENSE.

 

((CRYSTAL HAYLING, CA HEALTH CARE FOUNDATION)) I THINK THAT’S RIGHT.  I THINK THAT’S ONE OF THE QUESTIONS WE NEED TO BEGIN ASKING OURSELVES IS, “HOW DO WE PUT THIS AT A HIGH PRIORITY IN TERMS OF PUBLIC POLICY?” BECAUSE MOST CALIFORNIANS ALREADY PUT IT AT A HIGH PRIORITY AT TO WHAT THEY CARE ABOUT.  EDUCATION, WE KNOW, THEY CARE ABOUT, BUT HEALTH CARE IS RIGHT UP THERE, AND SOLVING THE PROBLEM OF THE UNINSURED AT A TIME WHEN WE HAVE BUDGET SURPLUSES, I THINK, SHOULD BE AN EASY QUESTION THAN THE TIMES WHEN WE HAD BUDGET DEFICITS.

 

((JACK)) BUT YOU’VE BEEN IN WASHINGTON, GRANTLAND, AND YOU KNOW HOW IT WORKS.  WHY IS IT SO HARD?

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES)) BECAUSE MOST POLITICAL CYCLES ARE SHORT TERM CYCLES.  SECONDLY, WE CAN’T PREDICT NEXT QUARTERS INTEREST RATE, LET ALONE NEXT YEAR’S BUDGET OUTLOOK PICTURE.  PEOPLE ARE CONCERNED IN THE PUBLIC POLICY SECTOR ABOUT WHAT’S GOING TO HAPPEN TWO, THREE, FIVE YEARS DOWN THE ROAD.  THE BUDGET SURPLUS SITUATION TO DATE MAY BE A SEVERE DEFICIT PROBLEM TOMORROW, AND SO WHEN COMMITMENTS ARE MADE TO LARGE, ONGOING EXPENDITURES, THE CONSENSUS HAS TO BE BASED UPON A SENSE OF SECURITY AND CONFIDENCE THAT THAT CAN BE SUSTAINED.  IN THE ABSENCE OF THAT, IT’S VERY DIFFICULT TO GET THOSE TYPES OF COMMITMENT MADE.

 

((JACK)) SO BOTH THE FEDERAL GOVERNMENT AND THE STATE GOVERNMENT ARE AFRAID TO RISK IT?  IS THAT WHAT YOU’RE SAYING?

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES)) I THINK THAT IT IS THAT, AND, ALSO, TOO, WE HAVE FRAGMENTED OPINIONS.  EVEN THOUGH THE POLLING SHOWS THAT THERE IS A GREAT DEAL OF INTEREST, WHEN IT COMES DOWN TO THE DETAILS—WHEN IT COMES DOWN TO THE REAL BUDGETARY AND POLICY DISCUSSIONS, IT’S VERY DIFFICULT TO MAINTAIN A MAJORITY COALITION, A MAJORITY OPINION.

 

((MELISSA)) THANK YOU, GRANTLAND.  WELL, LET’S GET FRESNO BACK IN THIS DISCUSSION.  DOCTOR QUINTANA, WHAT KIND OF DIFFERENCE WOULD IT MAKE, FOR INSTANCE, IF THE MONEY FOR HEALTHY FAMILIES HAD BEEN ABLE TO BE SAVED?  HOW MANY MORE PEOPLE WOULD YOUR CLINIC HAVE BEEN ABLE TO HELP?

 

((DR. PATRICIA QUINTANA)) WELL, OUR CLINIC CURRENTLY SEES ABOUT THIRTY PERCENT UNINSURED.  THE REST OF OUR PATIENTS ARE COVERED BY SOME FORM OF INSURANCE.  I THINK IF HEALTHY FAMILIES WAS EXPANDED, IT WOULD DRAW IN WOMEN AND WOMEN WHO DON’T CURRENTLY HAVE INSURANCE.  I HESITATE TO SAY THAT THAT WOULD BE THE FULL THIRTY PERCENT, BUT I THINK IT WOULD BE AT LEAST TWENTY PERCENT AND A LOT OF YOUNG, WORKING FAMILIES.

 

((MELISSA)) THANK YOU VERY MUCH, DOCTOR QUINTANA.  GRANTLAND, IS THAT MONEY GONE FOR GOOD IN REGARDS TO HEALTHY FAMILIES OR IS THERE SOME WAY THAT CONGRESS COULD REALLOCATE OR GIVE AN EXTENSION TO USE THOSE FUNDS?

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES)) YOU’RE TALKING ABOUT THE 1998 ALLOCATION UNDER THE HEALTHY FAMILIES PROGRAM.  UNLESS CONGRESS ACTS, THAT MONEY WILL GO BACK TO OTHER STATES.  WE’RE HOPING THAT CONGRESS WILL ACT BEFORE IT ADJOURNS TO GIVE STATES LIKE CALIFORNIA [A REALLOCATION OF THOSE FUNDS].  THIRTY-NINE OTHER IN ADDITION TO CALIFORNIA AND THE DISTRICT OF COLUMBIA FACE THE LOSS OF THAT MONEY IF CONGRESS DOESN’T ACT BEFORE IT ADJOURNS.  THERE ARE OTHER ALLOCATIONS THAT FACE SIMILAR DEADLINES.  THERE’S A THREE YEAR DEADLINE THAT WAS ESTABLISHED IN 1997.  IT DIDN’T TAKE INTO ACCOUNT THE DIFFICULT LEGALITIES OF BRINGING UP A COMPLICATED, LARGE SCALE PROGRAM LIKE HEALTHY FAMILIES.  WE WOULD HOPE THAT WHEN WE ARE NOW AT A PACE WHERE WE ARE RAPIDLY ENROLLING KIDS—WE’VE INCREASED THE ENROLLMENT BY FIVE HUNDRED PERCENT SINCE WE’VE BEEN IN OFFICE SINCE JANUARY 1999—IT’D BE A TRAGEDY TO LOSE THOSE MONIES FOR GOOD SINCE THEY CAN GO INTO INVESTMENTS TO COVER KIDS AND THEIR PARENTS.

 

((JACK)) LET ME GO TO FRESNO FOR A SECOND AND TALK TO ROSA, ROSA BROCKAMONTE.  ROSA, DO YOU KNOW PEOPLE IN THE NEIGHBORHOOD WHO ARE RELUCTANT TO GET INVOLVED IN MEDICAL OR HEALTHY FAMILIES BECAUSE THEY’RE PROUD PEOPLE AND THEY KIND OF CONSIDER THAT WELFARE IN A WAY?

 

((ROSA BROCKAMONTE, PATIENT)) YES, THERE IS A LOT OF PEOPLE.  A LOT OF MY NEIGHBORS DON’T GO BECAUSE THEY DON’T WANT [PEOPLE] TO THINK THAT THEY CAN’T TAKE CARE OF THEMSELVES, BUT IF THEY WOULD GET BRAVE ENOUGH AND GO AND ASK FOR HELP.  SOMETIMES THEY GET TURNED DOWN, THOUGH.

 

((JACK)) WOULD IT HELP IF THEY UNDERSTOOD THAT THIS IS A BENEFIT THAT THEY ACTUALLY PAY FOR WITH THE TAXES THAT THEY PAY?  I MEAN, THEY’RE ENTITLED TO IT.  WOULD THAT HELP IF THEY UNDERSTOOD THAT IN THAT WAY?

 

((ROSA BROCKAMONTE, PATIENT)) I THINK SO.

 

((MELISSA)) THANK YOU VERY MUCH.  DR. FLEISCHMAN, DO YOU THINK WE’VE LEARNED ANYTHING IN REGARDS TO HOW TO REACH OUT TO PEOPLE?  IT’S A SURPRISE THAT A LOT OF PEOPLE THAT MAKE TOO MUCH, SAY TO QUALIFY FOR MEDICAL OR MEDICAID, DON’T REALIZE THAT THERE ARE OTHER OPTIONS OUT THERE TO GET HEALTH CARE.  HOW DO WE REACH THOSE PEOPLE?

 

((DR. SUSAN FLEISCHMAN) WELL, I ACTUALLY THINK THAT THE STATE IS DOING A PRETTY GOOD JOB ON HEALTHY FAMILIES ADVERTISING.  I THINK SOME OF THE ISSUES OF NOT WANTING TO BE A PUBLIC BURDEN THAT ROSA MENTIONED ARE REALLY IMPORTANT.  I THINK THAT WE’VE ONLY RECENTLY HAD CLARIFICATION ABOUT THE IMPACT OF APPLYING FOR HEALTHY FAMILIES AND MEDICAL ON PEOPLE’S IMMIGRATION STATUS.  THAT’S BEEN VERY HELPFUL IN CALIFORNIA.  I THINK THAT WE JUST HAVE TO GET THE WORD OUT, AND I THINK, ACTUALLY, THAT JUST COVERING ADULTS, THE PARENTS OF THOSE CHILDREN, IS REALLY HELPFUL BECAUSE THEN WE ARE REALLY OFFERING COVERAGE FOR A FAMILY.

 

(( JACK)) WE HAVE A FEW MINUTES LEFT.  LET’S TOUCH ON WHAT THE PRESIDENTIAL CANDIDATES ARE PROPOSING TO DO ABOUT THE UNINSURED. EACH CANDIDATE HAS CRITICIZED EACH OTHER FOR THEIR RECORD ON HELPING THE UNINSURED . . . ESPECIALLY CHILDREN.

 

BUSH/GORE CLIPS

 

((MELISSA)) GENERALLY SPEAKING, BOTH CANDIDATES SUPPORT TAX CREDITS TO ENCOURAGE PEOPLE TO BUY PRIVATE INSURANCE.  THEY WOULD ALSO INCREASE FUNDING FOR SAFETY NET PROVIDERS, LIKE TEACHING HOSPITALS AND COMMUNITY CLINICS.

 

((MELISSA)) CRYSTAL, IS THIS THE DIRECTION THAT WE NEED TO BE HEADING?  AT LEAST BOTH PARTIES ARE LOOKING AT HEALTH CARE.

 

((CRYSTAL HAYLING, CA HEALTH CARE FOUNDATION)) I THINK IT’S ABSOLUTELY THE RIGHT DIRECTION.  CERTAINLY THE CANDIDATES DIFFER, BUT I THINK THE IMPORTANT THING IS TO RECOGNIZE THAT WE NEED TO HAVE A PUBLIC/PRIVATE PARTNERSHIP, TO RECOGNIZE THAT WE REALLY NEED TO EMPHASIZE THIS, TO RECOGNIZE THAT WE NEED TO, I THINK, MOVE BEYOND JUST INSURANCE AND COVERAGE FOR CHILDREN BUT AS FAMILIES.  MOST FAMILIES THINK OF THEIR HEALTH CARE AS A FAMILY UNIT, NOT JUST THEIR CHILDREN, AND REALLY PLACE AN EMPHASIS ON IT AND MAKE IT A PUBLIC POLICY PRIORITY.

 

((JACK)) KATHERINE, HOW DO YOU RESPOND TO WHAT AL GORE AND GEORGE BUSH ARE SAYING?  DO YOU FEEL THAT, REGARDLESS OF WHO GETS ELECTED, THAT HEALTH INSURANCE WILL BE A TOP PRIORITY AND SOMETHING MIGHT GET DONE NEXT YEAR?

 

((KATHERINE JONES, PATIENT)) WELL, I WOULD HOPE SO.  THE HEALTH CARE IS A TOP PRIORITY FOR THEM.  ESPECIALLY FOR KIDS, TOO, BUT ALSO, FOR UNEMPLOYED MENS [SIC] AND WOMENS [SIC] THAT DON’T HAVE NO [SIC] INSURANCE LIKE MYSELF.

 

((JACK)) DO YOU FEEL, PERHAPS, THAT THERE WILL BE A SOLUTION?  THAT THERE’S GOING TO BE A SOLUTION DOWN THE ROAD SOMEWHERE?  DO YOU FEEL CONFIDENT ABOUT THAT?

 

((KATHERINE JONES, PATIENT)) I’M JUST HOPING THAT THERE WILL BE A SOLUTION FOR IT.

 

((MELISSA)) AND, ROSA, HOW DO YOU FEEL ABOUT WHAT THE CANDIDATES ARE SAYING ABOUT HEALTH CARE?  DO YOU THINK THEY REALIZE HOW IMPORTANT IT IS AND HOW DIFFICULT IT CAN BE WHEN YOU DO NOT HAVE ACCESS TO HEALTH CARE?

 

((ROSA BROCKAMONTE, PATIENT)) WELL, THEY PROBABLY REALIZE, BUT I DON’T KNOW IF THEY CAN DO ANYTHING ABOUT IT, THOUGH.

 

((MELISSA)) WHAT DO YOU THINK THAT THEY SHOULD DO, OR WHAT WOULD YOU LIKE TO TELL THEM?

 

((ROSA BROCKAMONTE, PATIENT)) WELL, THERE’S A LOT OF SICK PEOPLE THAT ARE AFRAID BECAUSE THEY’RE NOT IMMIGRANTS, SO THEY’RE AFRAID TO GO TO THE CLINICS ANYWHERE AND TAKE CARE OF WHAT’S WRONG WITH THEM.

 

((JACK)) GRANTLAND, ORIGINALLY THE HEALTHY FAMILIES APPLICATION WAS TWENTY-SIX PAGES LONG.  IT’S BEEN REDUCE TO FOUR PAGES.  IS THERE ANYTHING THAT WE CAN DO WITH THE EXISTING RESOURCES TO TAKE AWAY THE STIGMA OF WELFARE FROM MEDICAL AND HEALTHY FAMILIES?  OBVIOUSLY, THAT WOULD HELP AN AWFUL LOT.

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES)) THE REAL STIGMA, THE PERCEIVED STIGMA IS ASSOCIATED WITH MEDICAL, AND THERE’S GOOD REASON FOR THAT BECAUSE WE RUN IT AS IF IT’S STILL ATTACHED TO WELFARE.  IT’S A VERY COMPLICATED PROGRAM.  WE MAKE IT MUCH TOO COMPLICATED, MUCH TOO CONFUSING.  THE QUESTIONS THAT WE ASK ARE TOO INTRUSIVE.  I WOULDN’T WANT TO GO THROUGH IT.  ONE OF OUR MISSIONS IS TO MAKE MEDICAL AS MUCH LIKE A PRIVATE HEALTH INSURANCE PROGRAM AS WE POSSIBLY CAN.

 

((JACK)) ALL RIGHT, CRYSTAL, IT SOUNDS LIKE WE’RE ALREADY WORKING ON THIS PROBLEM.  HOW IMPORTANT IS THAT?

 

((CRYSTAL HAYLING, CA HEALTH CARE FOUNDATION)) WELL, I THINK IT’S INCREDIBLY IMPORTANT.  MOST PEOPLE REALLY PERCEIVE THAT THE DIFFICULTY THAT THEY WILL HAVE MAKES THE PROGRAM.  WHAT WE FIND WHEN WE SURVEY PEOPLE THAT ARE ACTUALLY IN THE PROGRAMS IS THAT THEY SAY IT’S WORTH THE EFFORT TO GET INTO IT, BUT IT’S THOSE PEOPLE WHO FIRMLY BELIEVE THAT THE EFFORT IS NOT WORTH IT THAT WE REALLY GOT TO REACH OUT TO.  ONE OF THE PROJECTS THAT WE’VE BEEN WORKING ON IS TRYING TO BUILD A WEB-BASED, WHAT WE’RE CALLING A “HEALTHY@” WEB-BASED APPLICATION TO ALLOW PEOPLE TO ENROLL MUCH MORE QUICKLY IN THE MEDICAL AND HEALTHY FAMILES PROGRAMS.

 

((JACK)) IT SOUNDS LIKE YOU BOTH FEEL THAT THAT IS DEFINITELY THE DIRECTION TO GO IN.

 

((MELISSA)) ALL RIGHT, LET’S JUMP BACK IN OUR FINAL MOMENTS BACK TO VENICE.  DR. FLEISCHMAN, YOU HAVE SEVERAL SUGGESTIONS AND SEVERAL IDEAS FOR HOW WE CAN STREAMLINE THIS PROCESS?

 

((DR. SUSAN FLEISCHMAN)) UH, THE MEDICAL PROCESS?

 

((MELISSA)) AND JUST GETTING HEALTH CARE TO THOSE THAT NEED IT, AND I KNOW THAT YOU HAD SOME QUESTIONS FOR THE GOVERNMENT OFFICIALS HERE TODAY.

 

((DR. SUSAN FLEISCHMAN)) WELL, I THINK STREAMLINING MEDICAL AND HEALTHY FAMILIES APPLICATIONS IS VERY HELPFUL.  I’D LIKE US TO MOVE TOWARDS PRESUMPTIVE ELIGIBILITY.  I MEAN, IF A KID AT SCHOOL IS GETTING A FREE LUNCH, SIGN THEM UP RIGHT THERE ON THE SPOT.  I THINK WE NEED TO INTEGRATE PROGRAMS, AND, AGAIN, I THINK WE NEED TO BRING THE PRIVATE SECTOR IN, WHICH WE REALLY HAVEN’T HAD TIME TO TALK ABOUT TODAY.  I DO HAVE A COUPLE QUESTIONS FOR THE SECRETARY IF THAT’S ALL RIGHT.

 

((MELISSA)) IF TIME PERMITS, WE’LL HAVE TO KEEP THEM VERY BRIEF AND PROBABLY JUST ONE QUICKLY.

 

((DR. SUSAN FLEISCHMAN)) OKAY.  THE CHANCE OF INCREMENTAL REFORM GETTING TO WORKING ADULTS, THE KIND OF PEOPLE THAT KATHERINE MENTIONED?

 

((GRANTLAND JOHNSON, SECRETARY OF HEALTH & HUMAN SERVICES)) YES, I THINK THAT’S POSSIBLE.  WE MADE ONE STEP, WHICH YOU RECALL, LAST YEAR WHEN WE INCREASED THE ELIGIBILITY ON MEDICAL FROM ABOUT EIGHTY PERCENT OF THE FEDERAL POVERTY LEVEL UP TO ONE HUNDRED PERCENT OF THE FEDERAL POVERTY LEVEL.  SECONDLY, WE ARE PREPARING AN APPLICATION IN THE FORM OF A WAIVER REQUEST TO THE FEDERAL GOVERNMENT IN ORDER TO ENABLE US TO ENROLL THE PARENTS OF KIDS WHO ARE ENROLLED IN OUR HEALTHY FAMILIES PROGRAM.

 

((JACK)) ALL RIGHT, ON THAT NOTE WE HAVE TO LEAVE.  THANK YOU BOTH, CRYSTAL HAYLING AND GRANTLAND JOHNSON. FOR JOINING US.

 

((MELISSA)) AND THANK YOU TO OUR GUESTS FROM FRESNO AND FROM VENICE, THANKS FOR SHARING YOUR STORIES.

 

((ALL)) THANK YOU.

 

((JACK)) AS WE MENTIONED EARLIER, THIS IS THE SECOND PART OF A PROJECT CALLED HEALTH COUNTS 2000. OUR PARTNERS HAVE GENERATED CONTENT THAT WE WOULD LIKE YOU TO HAVE BEFORE NOVEMBER 7TH.

 

((MELISSA)) WITH THE HELP OF RESEARCH FROM THE CALIFORNIA HEALTHCARE FOUNDATION, THE SACRAMENTO BEE DEVOTED THIS RECENT WEEKEND FORUM SECTION TO HEALTH.  AND THE CALIFORNIA JOURNAL PUBLISHED THIS OCTOBER SUPPLEMENT OUTLINING CANDIDATE POSITIONS ON HEALTH.

 

((JACK))  YOU CAN GET THESE MATERIALS TWO WAYS.  FIRST LOG ON THE PARTNER WEBSITE.  THE ADDRESS IS:  HEALTH COUNTS 2000 DOT ORG OR CALL THIS TOLL FREE NUMBER 1-888-430-CHCF.  AGAIN . . .  888-430-CHCF

 

((MELISSA)) NEXT WEEK . . .  WE PREVIEW THE 2000 ELECTION.  FROM THE PRESIDENTIAL RACE, TO THE BALLOT INITIATIVES.

 

((JACK)) WE’LL HAVE IN DEPTH INFORMATION YOU’LL NEED BEFORE YOU CAST YOUR VOTE. I’M JACK KAVANAGH, THANKS FOR JOINING US.

 

((MELISSA)) I’M MELISSA CROWLEY. . .  SEE YOU NEXT TIME.