Health Care Reform Can’t Wait — Outside Washington

Those telling President Barack Obama to ditch health reform and concentrate on employment are wrong. What’s missing in such advice is a basic understanding of the grim intersection of a failing health system and rising joblessness, especially in blue-collar America.

As the recession forces people out of work or into low-paid, no-benefit jobs, the connection is clear. No work equals no health insurance, increasing the chance of death for Americans in poor health.

This should be dominating policy and political debate. When the human toll of the Great Recession is added up and analyzed by future scholars, the long and lasting impact on working people will be a powerful part of their narrative. But it is not a key part of contemporary journalism, or central to the current debate about the situation.

It’s another illustration of the large gap between the real world and the media-political world of Washington. There, the debate has become a repetitive drama: The Republicans are oblivious to anything but their plan to oppose and unseat Obama. The frightened and splintered Democrats have become a perfect foil for the Republicans. The media chronicle this in their mindless sports page manner, featuring daily winners and losers. The entire process has little relation to what’s happening to most people.

I’ve come to dislike conventional political journalism. It labors to present more than one side but ends up with a safe slant shared by most of the journalists. They’re not crusaders. They don’t show a sense of social justice. And they’re too often dull. No wonder the San Francisco News hired John Steinbeck to cover the Dust Bowl refugees in 1936.

Feeling uninformed by much of what I had been reading and watching, I drove 15 miles from my house in West Los Angeles to South L.A., home of some of the city’s poorest and sickest people. A few years ago, the big public hospital in the area, Martin Luther King/Harbor, was closed because of patient deaths and staff incompetence, leaving a huge gap in regional health care. Unemployment is high in this area, as is the number of working poor. The total of uninsured, always high, is growing. The area is mostly African-American and Latino.

I parked in front of the county Hubert Humphrey Comprehensive Center, a two-story building with a simple, unimposing façade. It is named for the former vice president and 1968 Democratic presidential nominee, unknown today to most of the patients and even to many of the center’s employees. But Humphrey was a beloved figure in the area for his fervent advocacy of activist government when the center was built some 40 years ago.

I wanted to know how the health reform bill, now stalled in Congress, would help the center’s patients.

Administrator Floretta Taylor and Dr. Lakshmi Makam, who is in charge of the medical staff, met me at the entrance. Their center handles 130,000 visits by patients each year. This is a small percentage of the more than half million people living in South L.A. Other clinics are scattered through the area, but no matter how hard their staffs work, it is an uphill fight.

We walked by the pharmacy, which hands out 30,000 drug prescriptions a month. Anyone is eligible for care, no matter how poor he or she is. Those on Medicaid (called Medi-Cal in California) can pay with government funds, but the indigent are treated free.

The halls were clean and quiet. The examining rooms were well maintained. A few patients waited in one room for their appointments, but in the walk-in clinic the wait is sometimes hours long. We visited the dental clinic and lab. We also visited the HIV/AIDS clinic, where Dr. Stephen Puentes supervises the treatment of 325 patients.

“This is a blue-collar neighborhood,” said Puentes. “We see the once employed, now unemployed, who lost their insurance, day laborers now unemployed. It is a summary of what is going on in our world.”

I was surprised to learn how deeply government is already involved in health care.

Hubert Humphrey’s Healthy Way L.A. is a free program that provides health care coverage to low-income uninsured legal residents. With an ID card, they receive routine doctor’s care. It’s financed with state and other government funds. Families poor enough receive Medicaid health insurance. The pharmacy gives out 30,000 prescriptions a month. Government funds finance drugs in the HIV/AIDS clinic. The federal AIDS drug assistance program helps pay the cost of $1,400 to $1,600 a month for the single daily pill now used for treatment.

But it takes a certain amount of sophistication to hook up with these programs. For an unemployed, possibly homeless person, finding the clinic and rounding up documentation, such as a birth certificate, can be a tough job. For the working poor spending part of a day at a clinic, waiting for care, could mean loss of a day’s wages — or a job.

It’s worse if a Humphrey Center patient must be hospitalized. With King closed, patients are referred to distant county hospitals. One of them, Olive View, is 32 miles away from Humphrey, and it takes more than an hour and a half to get there during rush hours.

“Referring a patient to Olive View is like referring someone to China,” said Dr. Makam.

Even the limited health reform bill stalled in Congress would make a huge difference in the lives of the Hubert Humphrey Center patients and others around the country.

It would immediately extend Medicaid to more of the working poor, giving them government health insurance. Center administrator Taylor said the reform would also open up private insurance to many now kept out by the insurance companies. That would be a tremendous change in the lives of Humphrey patients, who could choose a doctor or a hospital near their home or continue at the center. Medical checkups would become part of their lives. Diabetes and high blood pressure, frequent killers in South L.A., could be prevented or caught early.

Medical care would be treated as a right, rather than something available at the end of a long line.

As unemployment continues and more people lose their insurance, pressure on the doctors at Humphrey and similar clinics will increase. Members of Congress and their faithful journalistic followers ought to visit them. Maybe that would stir federal lawmakers to pass both a jobs bill and health reform legislation.