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Ethnic Leaders Find Hope in Health Care Plan

Leaders in the medical community analyzed what the president's health care plan would mean for immigrants and minorities.
 
 
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Without mincing words, President Obama on Wednesday night told a joint session of Congress that he wanted every American to have health insurance of one kind or another, and that he was looking for a bipartisan compromise to achieve that. He told detractors to stop using “scare tactics” and thereby lose yet another chance of succeeding in a much needed overhaul of the nation’s health care system.

Under his plan, Americans could choose to have private insurance coverage or a government insurance plan. And he was willing to consider alternatives to the “public option,” a provision that has created controversy. Obama’s plan would prevent insurers from being able to drop sick people or deny them coverage for pre-existing conditions.

The president’s primetime speech drew mixed reviews from minority community leaders, the medical community, academics and representatives of non-profit health care groups. Overall, he scored well with most of them.

David Villarejo, the former executive director of the California Institute for Rural Studies and a staunch advocate of immigrant rights, said that even though he believed that Obama’s health care plan was “morally wrong” for denying subsidized health care to undocumented immigrants, he still approved of the plan.

“That’s a reasonable compromise, given the country’s economic situation and the very conservative views of so many Americans,” Villarejo said. “I don’t think we are going to get everything. Obama needs to find 60 votes in the Senate.”

Villarejo said he believes that was why Obama put off the issue of immigration reform and focused his energies on overhauling health care.

David E. Hayes-Bautista, professor of medicine at the David Geffen School of Medicine at UCLA, said that before any health care policy is drawn up, Congress should first clear the incorrect “syllogism” – two premises and a conclusion – around Latinos.

The two false premises are that all Latinos are immigrants and all immigrants are undocumented. That leads people to wrongly conclude that all Latinos are undocumented, he said.

“As soon as people mention health policy and Latinos, the very first response is the word, ‘undocumented,’” Bautista said, noting that if that misconception is not cleared up, “we’re going to have a very biased conversation on Latino participation.

“And just as the death panel thing almost derailed everything, the all-Latinos-are-undocumented image needs to be exposed,” said Bautista.

President Obama estimated the plan to cost $900 billion over 10 years and said it would include a provision that would allow the government to impose more spending cuts if the savings he predicts don’t materialize.

There are currently 46.3 million uninsured people in the United States, 18.5 percent of them in California alone.

Dr. Sandra Hernandez, president of The San Francisco Foundation and an assistant clinical professor at University of California San Francisco, pointed out that Obama’s “comment that this reform legislation can’t add to the deficit has a lot of implications for Latinos in terms of prevention and changing behavior, eating healthy foods and not smoking, as a way to bring costs down.”

This means “that we have to do reform in a way that keeps us healthy and well and uses all the prevention we can,” she said.

Hernandez went on to say that Obama’s comment about the discussion of a public plan and “whether you die on that sword or not, is a means to an end and we should look at examples of where affordability is possible in the public or private and nonprofit sectors because there are good examples across the country. And it’s an area where the divide could come together.”

Dr. Andre Campbell, professor of surgery at UC San Francisco’s School of Medicine and a trauma surgeon at San Francisco General Hospital, called Obama’s speech “excellent, well laid out and thoughtful.”

“He definitely hit a home run,” Campbell said.

He lauded the provision that makes it illegal for insurers to discriminate against anyone who seeks coverage with a pre-existing condition. Because there is “a higher burden of disease processes in people of color,” he said, the African-American community will benefit from this.

If people living in poor neighborhoods such as Bayview-Hunter’s Point in San Francisco had access to primary care physicians, Campbell said, “maybe we could get an understanding of why there is such a high incidence of asthma and other respiratory diseases” in those places.

While President Obama was addressing Congress, former U.S. Surgeon General Joycelyn Elders spoke before the New York Academy of Sciences on the subject of disparities in health care. Elders watched Obama’s nationally televised speech after hers was finished.

“I thought it was an excellent talk,” Elders said. “I thought he presented the things he wanted to get accomplished.”

Elders said she believed a health care reform bill would pass, one that has an option for the poor and underserved. “Part of it will be very much a semantical game -- do we call it Medicare for all or a public option?” Elders asked. “I think all of our congressional delegations know we can’t continue how we are, I’m sure he will have to compromise. That is the nature of the system.”

Dr. Marguerite Ro, deputy director of the San Francisco-based Asian and Pacific Islander American Health Forum, lauded the public option plan.

“A strong not-for-profit public option plan must be a key component in any reform that seeks to provide security and stability for all Americans,” she asserted.

Nationally, more than one in six Asian Americans is uninsured and more than one in four Native Hawaiians and Pacific Islanders is uninsured.

“The public plan would expand the options of coverage plans and assure an affordable option,” Ro said. “Simply put, if you like what you have, you can keep it. If you don’t, or if your employer doesn’t offer a plan, you will still have options – including the proposed public plan.”

Like most Americans, Asian Americans, Pacific Islanders and Native Hawaiians feel the pain of the nation’s broken health care system and are struggling to keep up with out-of-control medical costs, she said.

Ro criticized the existing health care policy that denies access to Medicaid to legal immigrants who have been in the country for less than five years.

“Telling legal immigrants who are sick that they should wait for five years before being able to see a doctor simply doesn’t make sense,” she said, noting that the nation should have a health care system that allows immigrants to buy insurance at a reasonable cost and “allowing all those who are the most poor to have access to Medicaid.”

 
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