Healthcare is a Human Right NM

Is US Labor propping up Big Insurance...again?

2009-06-26T00:41:00.000-07:00

What a sad irony, an "historic mistake", but that's the $64 million question as US Labor opposes any taxation of employment-based health insurance benes in the current health reform debate.

The drive to continue excluding employer-based health insurance from taxes actually subsidizes our current corporate health coverage scheme and empowers Big Insurance profits and a non-system of care that is rationed by employment status. Is this what we really want out of health reform?

While perhaps historically correct, tying health insurance benes to employment may now be, ironically, the nail in the coffin of a real Public Health Plan - something that Labor also says it wants.

Can we have both a strong Public Plan and subsidized employment-based health insurance, or are they logically incompatible? A new Center for Budget and Policy Priorities report says we can, but only under certain conditions. Labor should listen, this time.

If not, we’re all in trouble.

And I mean ALL of us - not just those of us lucky enough to have union jobs . We’ll fail to reform health care in the US if we compromise away a strong universal public plan so that Big Insurance can get more tax-payer windfalls for the dwindling numbers of amply-employed but still painfully underserved by Big Insurance.

This time, the failure may be stamped with the Union Label unless we tax the health care rationers and the employers who feed them. Or we can kiss guaranteed, affordable care for all, goodbye. That appears to be our choice now.

It's time for a full-court press to detach health insurance from employment in the face of a changed economy.

Please consider these Health Econ & Labor History basics before screaming at me for Labor heresy:

1. Our current employment-based system of health insurance is considered by most health and labor economists to be a “historic mistake” – one that is not working for most of us, even those who are insured. It rations care by class, race and income level and offers the poorest quality of care in the industrialized world for those it miraculously "serves", and makes a huge profit for shareholders while doing so.

2. US Labor pushed for employment-based health insurance after WWII , and employers agreed in order to enable a healthy, productive industrialized workforce amidst labor shortages.

3. Our economy is no longer industrial nor is labor in short supply, and it ain’t gonna be any time soon, at least not in poor or diverse states like NM. This is not necessarily a bad thing in a pluralistic society; in fact, it’s considered a good thing by many. Either way, it’s what we got.

4. Insurers and other administrators have driven health care costs uncontrollably high, despite their consistent exclusion from taxation when offered through employment contracts.

5. As a result of the above four points, demand for a Public Health Plan for all of us has finally emerged in the US – the only industrialized country to NOT consider health care a basic human right in this way - to produce affordable, universal access to health care, backed by the government because that's what they're there for and do best. (Just ask your local government Fire Fighter.)

6. A functional and universal Public Health Plan requires demand, among other basics, to regulate costs and access. When Big Insurance is subsidized by being excluded from routine taxation like that of other employment benefits, it will drain demand away from a Public Health Plan and cause it to fail.

7. Spineless ConservaDems in Congress want a Devil’s Deal in health reform to appease their corporate backers, so we may get EITHER continued subsidies for Big Insurance via untaxed employment health benefit rations OR a strong Public Health Plan for all of us.

This health care fight is about our social values, and about making choices for the change we need.

Here’s our first big one…will Labor side with people or corporations in health reform? We can’t have both this time, in this economy and with our people getting expensively, unjustly sicker.

When will we stop making historic mistakes in US health care and finally enact a Public Health Plan that puts Big insurance on the sidelines where they belong... and puts Labor on the side of all workers?

An open letter to Sen. Bingaman about the shameful AMA and bait/switchy 'co-op" plans

2009-06-25T12:59:00.000-07:00

Dear Sen.Bingaman's DC Staff-

Thanks for making time for our NM Alliance for Retired Americans unscheduled visit last week in DC. Our 400+ statewide and 3.5 million national members appreciate yours and Senator Bingaman's hard work for real health reform.

We want him to keep it up, and know that we're doing our part out here. Especially as the ground is getting weak with corporate interests, including the AMA, who shamefully opposed the creation of Medicare in 1965. They made a historic mistake then and they are making one now by opposing a strong Public Health Plan. Our Senator must not follow their lead and enable this mistake again...we need a strong Public Health Plan now.

I'm an epidemiologist and former NM DOH worker, but I'm now helping to lead our local NM ARA because health reform can't wait any longer. New Mexicans are dying in discriminatory patterns, and it's nearly all preventable with a sound Public Health Plan.

I've made a career of analyzing local health access and financing trends here in NM and I can tell you, first hand, that the co-op option will have no teeth to place corporate health insurance interests where they belong for the health of the people: ultimately, in a supplemental role.

We don't trust fire fighting or policing to corporations, so why should we trust them with health care gate-keeping and disease prevention/management? There is no science to back this fatal error up, just money and smoke and mirrors. International comparative health systems research bears this out time and again - the US is the biggest rationer of the poorest quality of care of all our national peers.

Please tell the Senator to be strong for our people, and we'll do the same.

Love,
Terry

The Doctor did it.

2009-06-12T14:22:00.000-07:00

Making corporately-financed health care irrelevant requires us to accurately define our enemies - the enemies of health care access as a basic human right.

In addition to Big Insurance, Big Business and others who profit from illness and healthcare rations, one enemy especially stands out because he/she's also a needed friend and ally. Really...??

The American Medical Association opposes a public health plan because it would threaten their profits. They opposed the creation of Medicare in 1965, too. Shame, shame on them, as Medicare is the most effective public health plan of all time and is responsible for lifting our country out of unequal illness and poverty patterns, and prolonging the quantity and quality of life in the US in equitable ways. According to the NYTimes the other day,

"The A.M.A., with about 250,000 members, is America’s largest physician organization. While committed to the goal of affordable health insurance for all, the association had said in a general statement of principles that health services should be “provided through private markets, as they are currently.” It is now reacting, for the first time, to specific legislative proposals being drafted by Congress."

You bet they are.

That's nice, but the current market-based system doesn't work for anyone who is not a doc.

Let me be more specific....our absence of a primary care infrastructure - itself a product of "private markets, as they are currently" - makes people sick, at much profit to treatment providers like medical specialists and high-end medical technology designed for over-killing (literally).

Let's be clear about who the AMA serves - it ain't primary care docs, but specialists. And they don't want the change we need in health care reform.

Nothing is simple about the politics of US health care, and our docs shouldn't be contributing to this profitable confusion. Tell the AMA (1-800-621-8335) - and Sen. Bingaman - how you feel about the status quo "private market" system that fails us all in fixable ways.

Be strong,
Terry

My new gig

2009-06-07T00:06:00.001-07:00

Greetings from the depths of the pre-national health care reform fight, circa 2009.

Will we get the single-payer system we all need and want but are afraid to admit? Or will we have to settle for a leaky Massachusetts-like "public plan" that emboldens a bigger Corporate Takeover of Our Health Care than we have now (if that's even imaginable)?

Stay tuned...and don't believe these two options are mutually exclusive.

They'd better not be. Our movement for single-payer may depend on how (and why) to make them inclusive so as not to shatter like we did after 1993, enabling (albeit reluctantly) more pain and suffering under years of our failed Corporate Model.

Which is as unsustainable for health care as it was for credit-default swaps. The antidote to the Corporate Model, for now? A strong Public Health Plan that incents primary care and controls costs as an alternative to our healthcare credit default swaps..er, I mean system.

So, if you must moralize instead of strategize, keep an open mind for how to turn our single-payer loss this year into a stronger movement for it next time. Let's patch the cracks and fix the leaks in our own movements, get to know each other and educate ourselves (in the Freirian sense) about our need and design ideas for guaranteed health care for all - everyone in; no one out.

And pledge to make that time come very, very soon: a strong public plan will help get us there.

Yours - more truly than ever,
Terry Schleder

NM ARA ramps up for “health care reform for all”,

celebrates Older Americans Month with expanded

Field Staff & move in to AFSCME offices

Albuquerque, NM – FOR IMMEDIATE RELEASE May 1, 2009

The NM Alliance for Retired Americans kicks-off Older Americans Month with a focus on health reform, a move into the offices of Council 18 American Federation of State, County, Municipal Employees (AFSCME) offices and the hiring of long-time public health advocate, Terry Schleder, as NM Field Staff. Schleder holds a Masters in Public Health degree from UNM and joins the NM ARA as their new organizer with a directive to grow the statewide Senior movement into a force for economic and health care justice in collaboration with union and community health care advocates. Nationally, the ARA represents 3.5 million members in 30 statewide chapters.

With bolstered support, the NM ARA will mobilize its 300+-strong statewide constituency and affiliated organizations this month to call on our Congressional delegation to support real universal health care and fix Medicare in these ways: expand coverage for pre-retirees, eliminate the inflated costs of private Medicare Advantage programs, and fix Part D’s privatized prescription price-gouging by allowing Medicare to negotiate volume discounts directly from pharmaceutical suppliers.

Despite aggressive statewide efforts to push an insurance model of health care reform, over 20% of New Mexicans remain uninsured. And aging doesn’t save New Mexicans from our healthcare access crises: 250,000 New Mexicans age 65 and older are paying higher out-of-pocket costs for an increasingly privatized Medicare since 2003 in an insurance model of health care financing that is unsustainable and an expensive break from traditional Medicare “fee-for-service” financing.

According to the Center for Medicare Advocacy, a non-partisan group:

“Since 2003 the number and costs of private Medicare plans have increased exponentially as a result of the design of Medicare Part D and "Medicare Advantage". Unlike plans to privatize Social Security, which were debated and largely rejected by lay people and professionals alike, the privatization of Medicare is well underway and has occurred largely without public knowledge or discussion. Medicare privatization and the billions of dollars being spent to subsidize private plans threaten the future of Medicare and the health and economic security the Medicare public program has provided for America’s older and disabled people and their families.”

“Congress has an opportunity to enact health care reform legislation that can improve the quality of life for all Americans. New Mexico’s Seniors and retirees, too, have a large stake in these national health care reform efforts”, says Emil Shaw, President of NM ARA and NM AFT retiree member.

NM seniors know that you can’t talk about health reform without talking about Medicare, which established health care in the US as a human right for all Seniors and not a market commodity for the few. Look for health reform updates all month from the NM ARA website.

“We are thrilled about our move into the office space donated by AFSCME Council 18 and their support of our local and national health reform agenda. Seniors and government employees in NM understand the strength and efficiency of so-called “single-payer” systems for basic human needs like health care, education and fire or police departments. I look forward to combining my local training in public health policy with the ARA’s progressive national and statewide agenda for real health reform for all”, says Schleder.

Contact:

Emil Shaw, 505-321-4603

Terry Schleder, 505-401-1328, NMSeniors@gmail.com

Let the games begin.

2009-05-22T10:29:00.000-07:00

The corporate takeover of health reform is underway, so get your Myth-Busting chops on and jump in the pool! Your voice will drown out Frank Luntz' memo any day.

Step 1: Spread the truth about corporate-run health care - it rations care, costs more and has ratty quality-of-care

Step 2: Write a quick Letter to the Editor about it!

Step 3: Talk about the benes of a strong public health plan, including a single-payer plan like Medicare for All

Step 4: Swallow hard when you realize that Medicare for All has been pushed off the table this year, and pledge your solidarity to a strong public plan anyway.

Step 4.5: Know that Rome wasn't built in a day and the movement for Medicare for All begins with strengthening Medicare now

Step 5: Support a strong public plan as a historic first-step in stopping the Corporate takeover of our health care system.

Our drive for single-payer depends on this first step. Lives depend on it.

Terry

Health Reform Wars Heat Up in NM, US Labor

2009-01-29T16:48:00.000-08:00

Split tactics for health reform are taking shape once again in NM's health reform movement and the US Labor movement, with supporters of maintaining the private insurance scheme on one hand and proponents of overhauling healthcare financing toward a "single-payer" mechanism, like Medicare, on the other.

In NM, the Health Security Campaign once again introduced the Health Security Act yesterday, this time to a crowd of standing-room only supporters and reporters. NM's other health reform group, Health Action NM, does not support the HSA and instead is pushing an independent health authority bill, among others, that they say will move the debate forward toward increased access in NM.

Time will tell if their authority bill can stand up to Gov. Richardson's new idea, and if either authority structures will do what we need in NM: control costs and cover everyone NOW.

On the national scene, HR 676 - expanded Medicare for All - has been introduced and is gaining sponsorships without the support of the AFL-CIO or SEIU, who prefer a piecemeal approach that maintains a primary role for private insurers. Who knew our "progressive" unions would one day play this role? Wow. I feel old.

Diverse opinions about political strategy can be useful to social change movements. But is this parallel strategy in NM and nationally helpful to securing universal and affordable access to all, or is it a sign of disorganized non-consensual rolling-over to Big Insurance?

Maybe, if we're lucky, it's a sign of grassroots revolt from within each movement. Time will tell.

I heart Paul Krugman

2009-01-26T11:52:00.000-08:00

He's at it again. The Nobel Prize-winning economist always makes me teary-eyed. In a good way.

Today's NY Times sees Krugman waxing poetic about the failed conservative arguments against government spending to kick-start the economy. Which gets me thinking about health care financing, of course.

One of the core functions of any public health system is assurance - as in assuring a level of equitable, quality of care to the people. In the US where our public health system lies in tatters, this task has fallen to the states, and they struggle with it as we know all too well in NM.

Paul Krugman uses the example of the air traffic control system to assure safe flights, and they do a remarkably good job given the task, and when they don't, the force of the national people's voice assures that they have the science and technology to get it right and prevent all-out mid-air catastrophe. In health care, our states don't have the same assurance from the feds because we haven't demanded it well enough at the federal level. There's many reasons for that, but we'll stay on the economic one.

Q: Why don't we follow the air-traffic controller example and assure a level of primary and specialty care to all in the US when it clearly averts catastrophes in families every day by preventing unnecessary trips to the ER and related costs, suffering and deaths? A: Profits are made from sick people. (No one profits when a plane crashes.)

So, Krugman posits today that some governmental intervention is essential for safety and for stimulus. In our health care financing example, the safety argument is clear. On the stimulus side, the medical hi-tech industry profits when governmental programs shuttle customers... er, I mean, patients, their way via Medicare and Medicaid. They will always make a comfortable living and have money to reinvest in new technologies when people demand quality health care. So where's the reciprocity?

This sounds like a good deal to me: In return for a stable customer base, Big Medicine should back-off of the health policy ‘biz and let the people’s choice for real universal access take shape, complete with its inherent purchasing pool, quality control assurances and people-powered mandate.

National (and local) forum for my writing!

2009-01-25T20:35:00.000-08:00

Visit my new spaces and tell me what you think! (I get paid for the AC one when you do ;)

http://www.associatedcontent.com/user/188963/terry_schleder.html

http://www.dukecityfix.com/profile/TerrySchleder

Yours,
Terry

Black Power: What a week!

2009-01-25T20:18:00.000-08:00

I'm still in happy tears over the first Black leader of the free world. 'Bout time!

Pride for my country will trump all disappointment about his status-quo health policies...at least for another week ;)

Seems Jim Scarantino would feel otherwise about Obama's first-ness based on recent uppity comments of a "post-racial" NM that doesn't need Indian or Hispanic Affairs departments in state government. What planet is he on?

Certainly not the one where racial minorities in NM make-up the majority of the population...and also the majority of those most at risk for poor health, educational and economic outcomes and related life chances.

Trends like that are about systematic failures, not individual ones. Shame on you, Jim. I thought you were smart, but it seems you're also nouveau racist and that's pretty dumb.

We're not "post racial" until we're all healthy, housed and educated in a ratio that's sorta proportional to our demographics. We're light years from that in NM, as you know.

Take your sugar-coated right-wing racism somewhere else - this week of all weeks. One Black man in the White House won't erase years of white privilege and it's consequences in health, educational and $$ gaps.

Why Sanjay Gupta for Surgeon General?

2009-01-09T17:38:00.001-08:00

Because he's sexy and cool, according to Alfredo Vigil, MD, NM's Department of Health Secretary. Dr. Vigil also mentions his academic cred, but Dr. Quinten Young of Physicians for a National Health Plan isn't buying it.

PNHP calls for mass opposition against a possible Gupta appointment, as does Rep. John Conyers and Nobel-prize winning economist, Paul Krugman, even though it appears to be falling on deaf ears according to Sam Stein at the Huffington Post.

Dr. Vigil's star-struck cheerleading aside, is a TV-star Surgeon General really what our ailing health care non-system needs now? I can think of a few other qualifiers, but no surprise they don't carry much weight in our state where personality and corporate connections often trump critical public policy.

What do we know about Dr. Gupta's commercial interests in medicine given his prominent role in Accent Health, the adver-mercial for anti-depressants that fronts as health education on a continual loop to a captive and vulnerable audience in doc's offices nationwide, and how might this possible corporate coziness influence his health reform ideas should a president Obama call on him for advice?

Hmmm...guess we'll wait and see.

Terry

Richardson stays in NM

2009-01-06T23:00:00.000-08:00

He's ba-a-a-a-ck.

Bill Richardson's habit of taking significant campaign contributions from state contractors seems to have caught up with him, and as a result his Commerce Sect'y post will have to wait until the dust settles and his fingers are determined to be cookie-free. Until then, he'll remain our Guv and we can likely kiss real health care reform in NM goodbye.

It's all about keeping the insurers happy, according to Big Bill and his health policy guru, Pam Hyde, Sect'y of NM's Human Services Division. Too bad insurance isn't the solution to the uninsured crisis. It's actually the problem, but never mind. Insurers make good cookies - and fundraising parties.

Greg Palast comes to mind today, since he has been investigating NM's special way of conducting the business of government via cookie-jar for over a decade and has been following Bill Richardson's nasty little pattern of siding with right-wingers from voting rights to immigrant rights to insurers rights.

Seems Newt Gingrich - astute health policy analyst that he is - saw nothing wrong with ValueOptions in 2006 despite the fact that they, too, seemed to be a cookie jar for a Richardson campaign. This from the man who brought us the K Street pig trough known as the "Contract with America".

We'll see what the new year - and a new state behavioral health contractor - brings us in NM. My guess: more of the same.

Terry

“I ask how can we afford not to?”

2008-12-17T11:43:00.000-08:00

President-elect Obama sees the connections between our economic crises and the de-regulation of the US health care industry, but can he muster the political strength to make lasting reforms for universal access to affordable care?

If he follows the lead of all other industrialized nations and reduces the role of the health insurance industry to a supplemental one at most, he just might. But the fight against Big Insurance money will be ugly, and the Dems aren't clean from industry-backed campaigning.

If they don't sort out their allegiances to people vs. profits soon, then we'll lost time circa 1993. Only now, our system is more broken.

Fortunately we have a mounting evidence-basis for universal access to care at our fingertips.

Only one question remains: How much longer can we afford to ignore the facts?

Yours - with my arm in a sling, surviving the Bush years one line at a time,
Terry

Health reform 2009 heats up in NM

2008-12-12T17:31:00.000-08:00

Greetings from the pre-session political games a.k.a. as the final weeks before the NM State Legislature convenes for a month or so to serve our public needs and plan for a healthier state amidst competing demands and economic worries. Yup, hundreds of bills will be pored over in the blink of an eye, very soon.

Can a system with a digestion rate of appox. 100 bills per week really produce good public policy? That's a question for another day (or we can ask our perpetually uninsured/uninsurable, for a quicker answer.)

Back to health reform dot. 2009...
The NM Independent offers a good read on the condition of the local health reform movement, including it's challenges, divisions, and elephants pooping in the living room. Once again, it all goes back to money in our drive to privatize a public need for basic access to healthcare. Oy vey. As if the science of epidemiology, global health systems, political economy of health, etc. etc. doesn't exist and point a clear way for NM.

But it does.

Our log-jam in passing real reform in NM is about fear and greed, not science. Can we unify to transcend it? Perhaps, but only if we slay our dragons (and elephants) before January, 2009. Can we do it, NM?

Tic, toc, tic...

Terry

Si se puede!

2008-11-11T12:47:00.000-08:00

Yes, we can...and did!

Beautiful Black, Hispanic, young and poor voters came out and made history. 'Bout time.

More on our health care reform issues later...

Savoring the moment,
Terry

Why healthcare is not on the Dems plate

2008-05-27T19:55:00.000-07:00

Summer's here, Obama's ahead and a vicious convention floor Dem smackdown may be averted. So why don't we hear the Dems talking about universal healthcare?

The time and demographics are perfect, unless you're too busy cutting expenses or crying over your Wall Street woes as your stock price dives, as our overpaid managed-care CEO's have been doing recently. So maybe there's far less than a 6-degree separation between the Dems and MCO's, and this is producing the deafening silence for reform over lip service.

Here's the economic skinny (Be sure to read it while standing on your head; it makes more sense that way): as Medicaid HMO moguls exec earnings climb, their stock prices fall. Their answer? Knock members off of the roles!

If the Dems seriously cared about working class voters, they'd hop on this like my ass on a motorcycle this Spring. Instead, we get the veneer-like joys of analysis paralysis. According to a Columbia Journalism report this week, Senate hearings will be held, money will be "looked for", and...nothing will change in the healthcare reform dept.

Ah well, I guess it's time for that ride to the mountains today. Hope I don't crash.

Terry

Forbes: Medicaid managed-care makes up for other private insurance losses

2008-04-22T12:59:00.000-07:00

Quick...imagine you're a US health insurance exec and one of your (expensively) sick and festering customers asks you this:

John Q. Public: How do you stop hemorraghing (profits) when your body (politic) begins eating you alive from the inside-out but you can't afford the premiums for medicines or expensive tests and all that fancy stuff?

Shameless Insurance Exec: You feed-off of what's left and enjoy the ride (to the bank)...Yeeeee-haaa!!

A similar yet metaphoric conversation has been uncharacteristically chronicled by Forbes today in a revealing piece about health insurer stock losses, likely due to their persistence in privatizing a basic human right despite vast public outrage and skyrocketing costs that normally line their CEO's pockets with profits.

Interestingly, the only health insurance stock winners in today's casino (known as Wall Street to those in higher-income brackets) was the Medicaid managed-care private venture, Centene, who's stock jumped 16%. How 'bout that? Ahhh, the joys of sickness and absent preventive/primary care access on the wallet. "Makes my piggy-bank jiggle with joy!", screams the giddy middle-man a.k.a. privatized Medicaid insurer.

But could the jig be up soon?

Yes, if the crack in support for managed-care-as-our-Savior continues to erode the public's confidence in their government to see past politics and create public health policies that work for us all, like a national health plan, or NM's Health Security Act. These single-payer models have the evidence to support their effective and efficient use when applied universally, as every other modern nation has managed to do to the benefit of their people's health.

Must we wait to fix it 'till investors in the health insurance sham feel the pain that uninsured folks feel every day? And if so, will we bail those investors out but leave the rest of us to rot some more?

What do you think?

Terry

"...Goldman Sachs (nyse: GS - news - people ) analyst Matthew Borsch said the key takeaway from UnitedHealth's earnings miss and lowered outlook is that the multi-year commercial underwriting cycle has worsened significantly, and investors should expect downward pressure on margins for the next two to three years - chiefly in the commercial risk segment that makes up most earnings for major insurers ...Meanwhile, Centene surged after the Medicaid health insurer reported better-than-expected quarterly results and its revised full-year profit outlook still topped the average Wall Street estimate. Shares of the St. Louis-based company spiked $2.19, or 16 percent, to $16.14."

Unnatural Causes: Is Inequality making us sick?

2008-04-10T17:39:00.000-07:00

How's that for a NM movie project?

It wasn't filmed here, but don't miss a second of the new six-part film series on racial health inequalities. It's a public health primer for the masses...as if we didn't already know.

Nevertheless, it's great to see epidemiology & data about our health crises made understandable and human on the big screen. And on the little screen: tune in to KNME this month to catch it!

NM's rich get richer and the rest of us get...sick

2008-04-09T22:14:00.000-07:00

Kids' enrollment in Medicaid in NM slows despite enormous need and a widening of the income gap between high- and low-income New Mexicans, according to local headlines, heartbreaks and purse strings.

But, wait...NM's Business Community has a plan! "Spread the pain around", they say. Translation por la gente: tax the poor! Talk about a Reverse Robin Hood. These are the same people who brought us healthcare as a market commodity (a.k.a. "managed care") and not a human right.

According to recent ABQ Journal reports, NM can't afford to enroll all our kids-in-need in Salud Medicaid Managed Care programs despite Gov. Richardson's stated commitment to universal healthcare in the recent legislative session. NM business leaders would skimp even more.

Perhaps the Guv (and Big Business) forgot to read the report he commissioned in 2007 which noted preventable 18% administrative waste (a.k.a. "nonmedical costs") inherent in private insurance models (including Medicaid), and how a single-payer system like the Health Security Act would curtail costs relative to other market-driven models the Gov's commission studied thanks to eliminating the profiteering insurance middle-man.

No wonder Big Business, like NM' s Association of Commerce and Industry, according to the ABQ Journal, opposes universal healthcare unless we raise the Gross Receipts Tax ...it's a regressive tax which lands on our poor like a bulls-eye. Besides, Bernalillo County DID raise the GRT in 2007 under the visionary leadership of County Commissioner Deanna Archuleta. It worked, and it hits our poor harder than the rest. So, if we want to spread the pain around, we'll come up with a rational tax plan to proportionally pay for healthcare as a basic human right like every other modern nation has managed to do. Enough of the insanity, already.

Speaking of insanity, if you attended tonight's speak-out against poverty at the South Broadway Cultural Center and across the nation, you heard 300 low-income 'Burquenos dissing the privatized healthcare industry and demanding their basic human rights to medical care AND housing, food for their families, public transportation, a living wage and fair immigration reform. More on this important event later....

"Something is rotten in Denmark."

2008-03-31T21:16:00.000-07:00

But you already knew that.

The political economy of healthcare is a funny thing in its predictability.

Like a tourniquet applied to the wrong vein, a defunded public health infrastructure in NM - where many say we need it to function the most- is sure to stop the flow of fresh & vigorous ideas into the body politic...and take the life out of our healthcare systems which are responsible for assuring care to the masses. We hurt it; it hurts us. "What goes around comes around", "Actions speak louder than words". Etc.

Our public hospitals and clinics and our State Department of Health perform vital functions, but tax-cuts to the wealthy in NM have been granted by a "progressive" Dem Gov amidst a state budget surplus at the expense of ample funding for these institutions, and the result has been sick people, cities and villages and disconnected public healthcare administrators. And fat cat healthcare and insurance profits - who can forget them?

Democratic, public discussions of healthcare needs in our communities are few and far between in a health system like ours, but things are starting to change in 'Burque, at least. Here's a quick local example, below. (For a detailed report, check out our Community Health Promotion presentation at the upcoming Head 2 Toe: A Conference on School Health in ABQ, April, 17.)

What kinds of healthcare do we need, and at what level of access in NM? Low-income folks in Albuquerque have been telling their public health leaders the answers to that question in an organized way since 2002. They weren't satisfied with a public trauma-care and teaching hospital that ignored the call for primary care clinics under its nose. And, voila, after years of community pressure UNMH plans two new clinics in ABQ's low-income neighborhoods, though they are still a good year away from door-opening.

The political economy of health will have the final say about whether or not we can staff those clinics with docs, nurse practitioners, PA's and social workers amidst a primary care provider pool in complete disarray. If recent history's any clue, we'll still need to be brought to the ER in a privatized medi-copter, first, before we can get a medical home at one of these shiny new clinics.

But the genie's out of the bottle in Albuquerque, and people are demanding justice and the elimination of health access inequities from their public health institutions. Slowly but surely, some of those institutions are responding. One day, they'll catch up and offer that justice first, because it's the healthy and right thing to do.

Until then...onward!
Terry

A public-service back-alley abortion

2008-03-28T12:39:00.000-07:00

That was fast!

My head's still spinning from a fruitful yet aborted 7 month stint on the inside of the NM Department of Health and, yowza, was it fun. I had much support from knowledgable public health professionals inside DOH and my community partners while there, and got some sharp new glasses and medical benefits for a while. Thx for that, NM taxpayers ;). I truly appreciated it and am so sad that our regional DOH public health executive branch can't seem to retain all of their well-trained public health practitioners.

Oh well. Been told by many - including public officials - that it's another badge of honor in a long and shameful line of highly skilled community health workers who've rotated through the NM DOH Region 3 Health Promotion Team, like flies in a fan: Veronica Plaza, MD, MPH; Francisco Ronquillo, PA; Lorenzo Garcia; Miguel Acosta; Michelle Melendez; Enrique Cardiel and others, con carino y amor. Talk about a public service brain-drain....

Seems I'm in great company for being "not a good fit" -but (y)our tax dollars are being mysteriously wasted by this local revolving door.

Questions? Ask your Regional DOH PH Division Director, Margy Wienbar, and HPT manager, Jerry Montoya, about it. Then let me know. (You have my permission to access my DOH personnel file.)

And our public health crises march on.

During my DOH tenure I was honored & able to co-produce some important public data reports on UNMH healthcare access (en englais y espanol) and teen pregnancy outcomes in Bernalillo County, and clean-up one very big mess of a county report on teen pregnancy (originally called a "gap analysis" but resembling nothing of the sort) in Bernalillo County. More about that later when the dust settles. Rest assured the BC Community Health Council did the right thing, eventually. In the spirit of disclosure, I chair their Health Access subcommittee.

The plot thickens...

Fondly yours,
Terry

Good-bye for now...

2007-08-31T08:23:00.000-07:00

Greetings & Goodbye!
I am retiring this blog for now - but keeping it and it's links available for public use - as I settle in to my new job as a Health Promotion Specialist with the NM Dept. of Health in ABQ's SE Heights Public Health Office. I'll be fortunate to be working with the amazing community groups in the region who are working for real universal access and the elimination of health gaps and disparities. Preventable public health problems like these require the attention of us all, both insiders and outsiders to the system.

For fear of a conflict of interest with my new job, I won't be blogging about the policy issues related to universal access in NM anymore. But I have always been in good community company, so I rest assured knowing the movement for truth and a rational, humane solution to our human/healthcare rights political problems will continue to grow.

Hit me up at my new email if I can help you with evidence-based data requests, public health or community organizing best practices, strategic planning assistance or other technical assistance from the inside...
terry.schleder@state.nm.us

Fondly,
Terry

Do The Right Thing, NM.

2007-06-21T11:44:00.000-07:00

Greetings from The NM Roundhouse!

We're coming to you live from the final report on 3 models of Universal Healthcare for NM and, guess what? The Health Security Act (HSA) wins again for our low-income families. Check the link to the right, Insure NM, for the complete report.

Here's the mid-day wrap. More to come!:
1. Multi-payer models of healthcare financing - like we have now- subsidize our private insurance industry to create administrative waste and broker/sales jobs at the expense of clinical care,
2. A centralized-payer for healthcare financing - like the HSA, your local fire deparment, police department and public school - concentrates our precious resources on actual services and away from marketing, spin and staff who specialize in excluding people from care,.
3. Rural and Metro NM will see an increase in jobs, tax-base and primary/preventive clinical services under the HSA model, vs the other two models, and,
4. A real universal model will reduce the inefficient "churning" effect of people coming and going in an "enrollment" process.

More later. Check out "What if you knew?": Terry Riley's new blog and analyses of these models at the link to the right.

In solidarity,
Terry

Cool, Animated Single Payer 101 Video!

2007-05-24T18:35:00.000-07:00

Confusion about our basic rights is a bummer!
So check out my latest favorite find here for a quick & easy look at single-payer healthcare financing...with NO BIG WORDS and lotsa FUN PICTURES.

If more docs were like this guy, we'd have a working healthcare system already!
http://www.grahamazon.com/sp/whatissinglepayer.php

Terry

Mathematica Cost Analysis: Confusion is Good for Private Healthcare Biz!

2007-05-18T14:29:00.000-07:00

Surprise, surprise. "Reducing multiple payers reduces non-medical costs", said Dr. Deborah Chollett, lead study author for Mathematica Policy Research, Inc., to a panel of Richardson Cabinet members, legislators and health policy experts this week in ABQ when describing the benefits of the Health Security Act model of universal coverage. How? The overhead, health benefits (!!) and salaries of the people who kick you off coverage & programs, or fail to tell you about coverage & programs, are all "non-medical costs".

This astute scientific finding on the inefficiencies of administrative waste passing for healthcare policy should come as no surprise to anyone living with the consequences of our current failure of a privatized multi-payer "mis-managed care" healthcare funding system. If you are one of the many who has been rationed out of coverage or forced to enroll in one of a zillion health coverage programs or market products, this economic analysis is not news to you: You feel it every time you need to see a doc or a nurse practitioner, or fill your monthly 'scrips, and can't find, access or afford them.

What exactly is the connection between how we as a society pay for healthcare and whether or not we receive it, individually? As the State's Health Care Coverage for New Mexicans Committee heard this week, that connection is mass confusion! As too-many-to-count members of the HCNM Committee put it this week, in exasperated response to this report, "I understand 50% of this...at most!"

Since disempowerment breeds the status quo, and since the status quo has left most of us uninsured or underinsured, let's fix this condition of intentional ignorance and demand healthcare as a basic human right for all in our state. Check out the links to the right - the Mathematica Report, news, how other countries do it, etc - and decide for yourself.

Are you willing to pay $.17-.28 out of every $1.00 to administrators, brokers or billing coders that are the back-bone of a multiple-payer system like we now have, or would you rather centralize your healthcare dollars into one payer, publicly managed, at $.02-.05 per $1.00 administrative cost? Every other industrialized nation has decided...when will we?

2007-05-16T22:41:00.000-07:00

Hello and welcome to Healthcare is a Human Right NM, where we slay sacred & corporate cows in the service of healthcare justice for all in New Mexico!

I hope to offer a public forum to share information about participatory movements for access to healthcare as a basic human right in Central New Mexico, USA. Along the way we'll think critically about how our privatized healthcare system has failed low-income New Mexicans. We'll share & learn about our state's specific healthcare needs, about countries and states with similar issues, and solutions that are working elsewhere and may work here in the struggle for healthcare justice.

Demystifying healthcare access, policy and funding in NM is an important part of the deal, but, rest easy: when healthcare is recognized as a basic human right, it is easier to fund & provide in a fair, rational and non-political way. Join in on the discussions! Share your stories, knowledge and opinions and take control of your healthcare system!

If we don't do it the "free"-market will, and we all know there is nothing free about that - just ask one of NM's 450,000+ uninsured.

Some basic NM health and social tidbits:
- NM is the poorest state in the US with a high uninsured rate and huge racial health disparities in many chronic and preventable diseases and conditions like diabetes, accidents, suicides, low birth weight, unintended teen pregnancy, mental illness and developmental disabilities.
- Our state is home to the largest concentrated stockpile of nuclear weapons in the world, and the atomic bomb was built and tested here first. These WMD's aren't cheap to make/keep.
- Despite these grim facts NM also boasts strong civic, cultural and multi-generational pride in its status as a "majority minority" state. Most New Mexicans, like growing numbers of the US, are mestizo or mixed race/ethnicity. Over 50% of Census-countable New Mexicans call themselves racial minorities; this makes us one of the most diverse states in the US! Native Americans have lived in what was Mexico 100 years ago, and what is now known as NM, for centuries. NM Hispanios (or Hispanics) claim ancestry from Spanish colonial settlers 400 years ago and have lived here ever since. African Americans first came to NM seeking freedom from slavery and to fight for its eradication in the Civil War. Anglos migrated to NM from the Midwest and East Coast en masse in waves, some to seek a healthy climate for recovery from tuberculosis in the early 1900's. Mexican and Latin American immigrants come to NM from points South and West seeking jobs and political stability.

Visit the links to the right and let me know what else you'd like to see here.
What information do you need to be better prepared to demand healthcare justice for your family?

Please share your comments, stories and questions with the world and each other on this blog...talking with and to each other is the only way we'll succeed in shaping a healthcare system that works for all who live in New Mexico. United we stand, divided we fall.

In solidarity,
Terry Schleder, MPH