Yesterday the Progressive Women of New Mexico (they sounded like Democrats to me) sponsored a briefing on health legislation to be considered in the upcoming session of the New Mexico Legislature. I was there and came away very impressed by….well, first let me tell you a little about the panelists and the subject matter.
Warning – I usually critique the news, but here I am about to commit some journalism myself. This means you are about to read lots of words on the nuts-and-bolts of improving health care in New Mexico, which may bore you to tears. Sorry
Lt. Governor Diane Denish spoke first. The State has a huge problem of uninsured citizens. In that context, she said the Administration would attempt to get more small employers into the General Services Administration insurance pool. She mentioned efforts to educate younger people to the value of health insurance. And she signaled an attempt to tax smokeless tobacco the way cigarettes are taxed.
Rep. Danice Picraux of Albuquerque said earlier efforts aimed at making health care more affordable are beginning to pay off; the insurance pool, for example, has slowed price increases. It’s not all rosy, she said, and the state will have to do more to keep doctors. She saw insuring more residents as part of that effort. She said she hopes the Legislature will extend existing regulations to cover more part-time workers.
Picraux said she will work for:
o Full funding of Medicaid ($98 million)
o Expansion of the existing Tele-Health program (bringing specialized medical expertise, including psychiatric, all over the state)
o Broadening the prescription drug discount program for the 65+ crowd (Senior RX) to all citizens.
Secretary of Health Michelle Lujan Grisham defined the goal as getting more dollars for health care from a finite pie. She talked about defining Medicaid narrowly and neatly to get the federal matching funds.
She also described programs aimed at adolescents. Doubling the number of school-based clinics to better address problems like obesity (a predictor of diabetes) and pregnancies, Taking control of school vending machines – not easily accomplished. Establishing a peer counseling hotline.
She talked about better auditing of institutions for the aged and disabled and more effective work against infectious diseases (HIV/AIDS, hepatitis C).
Sen. Dede Feldman of Albuquerque noted that past Medicaid tweaks have produced more case management and are slowing the rate of increase in the cost of prescription drugs. She noted the SALUD program (Medicaid handled by managed care companies) soon will have a "preferred drug" list.
And that the State has hired Presbyterian to manage prescription drugs.
On the broader question of health care in New Mexico, Feldman said a study of where the money comes from and where it goes has revealed:
1. 75% is public money
2. federal agencies (Medicare, Indian Health Service, VA) make 65% of all health purchases
Her conclusion: big government already plays a major role. The next question, Feldman suggested, is "Are we getting our money’s worth?" That because NM still has 400,000 uninsured.
Incidental note: Feldman said 23% of all NM jobs are in the health care sector.
The audience of some 75 had questions and statements. There was concern that the Tele-Health program not "crowd out" health care providers in small towns. Also, that the Administration plans should but do not include dental care. And that New Mexico continues to have too few beds for mental health and drug abuse patients.
Still other questions suggested that the Senior RX program, which compares favorably to Medicare’s efforts to help seniors cope with high drug prices, is a state secret. Many of the well-informed activists who attended the briefing at the UNM Law School didn’t know much about it.
Well, there you have it. My report would be longer, and better organized, if I were a beat reporter. (I attended, actually, to refresh my memory on health issues.) And if I could read all my notes. I suspect I have made small errors. I hope I have avoided biggies.
So what to make of all this?
First, Denish, Picraux, Grisham and Feldman are my heroes. Their knowledge is one reason. Their commitment is another.
Secondly, I was struck by how touch it is to tackle health care piece-meal. The State ought to have a health plan for all its citizens. So should the United States. By that, I mean universal health insurance, with doctors, groups, hospitals – all health providers - competing to provide services.
Which leads to politics.
Denish was Governor Richardson’s running mate and is his ally in the Executive Branch. Grisham is a member of his cabinet. Legislative leaders Picraux and Feldman are, like the Governor, Democrats. Richardson wants to be President of the United States. He calculates that he cannot win the nomination, no less the office, as a liberal. He must be a moderate, a la Bill Clinton.
(For purposes of this piece, let’s not argue with his perceptions.)
This is not just a matter of ideology; it’s about money. Any politician who favors a single-payer approach to rescuing our crumbling health care system will receive not a penny from the insurance or pharmaceutical industries. In fact, they will rush to the aid of his opponents in the primaries. (Ditto, some physicians’ organizations, though not all.)
This is one more reason to admire the four women at the briefing. They know this and they keep working for incremental progress.
Hat’s off.