Thumbs up. That's the overwhelming reaction in and out of the Caribbean immigrant community in New York, especially among professionals and administrators, to President Barack Obama's health care reform plan, which he outlined in detail in a recent address to the nation.
While some people and their institutions weren't quite clear on the specifics of the White House plan before the speech, the unanswered questions were eliminated during what most considered an "excellent address" that may have mobilized nationwide support for a plan that seeks to satisfy the needs of the uninsured, poor and the middle class across the country.
"Before the President's presentation to Congress and to the American people last week, I was 95 percent in his corner. Now, I am fully on board, 100 per cent," said Dr. Milton Haynes, a former president of the 5,000 member New York County Medical Society. "Before he spoke I wasn't sure about what he planned to do about the much-needed tort reform, but the President dealt with it in his excellent speech and in so doing he eliminated that worry. I know there is still a lot of opposition to his proposal, particularly coming from conservatives, but I am optimistic that he would be able to get significant changes through the Congress that would make a major difference in the way health care is delivered in this country. We do need comprehensive reform."
Like Dr. Haynes, Yvonne Graham, Brooklyn's deputy borough president and the office's chief spokesperson on health care, is confident that "some kind of reform would be approved by Congress this year," one that would provide access to services to many of the uninsured.
"I think what's happening now is that almost everyone agrees that there must be reform, but the specifics would have to be worked out, of what it should look like, what it would cost and how it is going to be paid for," said Graham. "We spend about a sixth of our budget on health care and we are not seeing the benefits from that allocation. That's because our system performs poorly. Secondly, with almost 47 million people who are either under-insured or without insurance, we must do something about it. Thirdly, action has to be taken to lower cost, to improve quality and to expand coverage. They are the three over-arching goals. The President made a good pitch but one speech isn't going to do it."
U.S. Congresswoman Yvette Clarke, who before the speech had vowed to return to Washington fight for comprehensive reform was "excited and re-energized" after it was delivered to a packed joint session of Congress, and she hailed the President's decision "to guarantee that a health care reform bill will cover the nearly 47 million uninsured Americans across our nation."
As the lawmaker saw it, such a plan would reduce the number of deaths caused by a lack of care.
"No longer will we stand idle as our fellow Americans die from preventable disease or suffer silently in the shadows because they can not afford a checkup," she asserted. "We need real health care reform that guarantees that no American will be denied coverage. Affordable, high-quality health care is not a privileged but a right."
The issue of cost was pivotal to the debate and the movement towards reform, she said. "The growing cost of health care is one of the biggest drags on our economy," Clarke insisted. "In 2006, our economy lost as much as $200 billion because of the poor health and the shorter life span of the uninsured. Without any change, by 2018 health care spending would rise to $4.4 trillion – more than one fifth of the economy. It is clear that our nation can no longer accept the status quo. We need comprehensive health care reform if America is to move successfully forward into the 21st century."
Dr. Pat Hazlewood, a health educator and a retired public health professor at Kingsborough Community College of the City University of New York, thinks reducing current cost is a crucial factor in the reform plan. For one thing, if implemented, the President's proposal would help bring Medicare and Medicaid expenses under control, specifically the "abuses" in the two federal- and state-funded medical programs for the elderly and the poor.
"The over-charging and the unnecessary testing and other factors related to Medicare and Medicaid would be reduced," she said. "Those abuses are causing the bill for care to be higher than it ought to be. All the things the President is proposing would work together to improve the system. A single element wouldn't do it. It's the overall plan that's important. The cost of medical procedures should be reduced, thus providing relief to patients when they go to a doctor. It's not a perfect plan, but it is far better than what we have now."
Like Dr. Haynes, a former president of the New York Gynecological Association, Dr. Hazelwood thinks the present system must be reformed, no questions asked. With skyrocketing costs and the tens of millions of people without ready access to quality care, the demand for change was clear.
"Things just can't be allowed to continue the way they are now," Dr. Hazlewood said.
Congressman Ed Towns, whose Brooklyn and Queens Congressional District is home for thousands of Caribbean immigrants, readily agreed.
"We have a once-in-a-generation opportunity to fix our broken health care system," he said, after the President's address. "Currently, the House of Representatives is considering a plan that would provide greater access to high quality, affordable health care that will drive down costs and put patients and doctors back in charge, not the insurance companies. Through this comprehensive plan, we can focus on preventive medicine; guarantee doctor preference; create a mechanism for people to keep their insurance, regardless of unemployment or job changes; and remove a combative obstacle to coverage."
As in the case of the Brooklyn Deputy Borough President, Towns, who once held that position a quarter of a century ago, feels accessibility and affordability are vital questions "that will touch every American at some point in his or her life, directly and indirectly," and the matter should be resolved now. "In the past several weeks, the problems with our health care system have been clouded by rhetoric and political maneuvering, designed to distract our attention from the painstaking matter at hand," was the way he put it. "America needs comprehensive reform now."
As for the thorny matter of access to care for undocumented immigrants, neither Graham nor Dr. Haynes would predict the outcome.
"I believe access to health care for all in America is a right and no a privilege," said Graham. "But the unanswered question when it comes to undocumented immigrants is who is going to pay for it? I am not sure how this is going to play out."
For his part, Dr. Haynes, an associate professor of medicine at New York University, backs the provision of universal access for everyone but it raises questions of cost when providing care to persons who are not in the country legally.
"The real issue is who's going to pay for it for illegal immigrants," he said. "Morally and professionally, they should have access to care but we have to decide who's going to finance it."
But the New York Immigration Coalition, an aggressive advocacy organization said it was "deeply dismayed at how opponents of health care reform" were diverting people's attention from the key question of care by using immigration as a scapegoat to derail the drive to change the current system.
"Opponents are making false attacks and offering no solution to the real problems of working families not having access to quality, affordable health care," the Coalition stated after Obama's speech. "Immigrants in the United States are three times less likely than citizens to have health insurance, and they are less likely to use health care, including emergency services. Like everyone, immigrants want to be healthy and to keep their families healthy, and they deserve the opportunity to buy affordable health insurance."
Interestingly, Colin Powell, retired U.S. Army General who served as Chairman of the Joint Chiefs of Staff and later as U.S. Secretary of State under President George W. Bush, called for health coverage for immigrants. He issued his call in a short address at the West Indian-American Day Carnival Association's kick-off breakfast on Labor Day, in Brooklyn. Powell was one of the carnival parade's Grand Marshals. At the state and local government levels, the call for reform was a common theme.
New York Governor David Paterson, State Senators John Sampson (D-Brooklyn), Kevin Parker (D-Brooklyn) and Eric Adams (D-District 20), Assemblyman Nick Perry (D-District 58), and [Democratic] City Council members Letitia James, Dr. Kendal Stewart, Leroy Comrie, Charles Barron, and Dr. Mathieu Eugene had all endorsed the demand for access to care by all.
