Thursday, August 6, 2009

The Real Price We Pay

In the midst of a discussion about national healthcare reform, I remain stunned by the completely short-sighted, mind-numbing ignorance displayed in our recent public health cuts in California. As the details of what these funding cuts are going to mean in California become more evident, the phrase I hear most from public health experts is, “Stunningly stupid … heartless … and fiscally irresponsible.”

These cuts will increase disease and death rates. They will increase the risks to the general public. They will increase the costs of healthcare to the taxpayer. An unbelievable and devastating trifecta.

Again I sat in a meeting of the San Diego HIV Planning Council where 40 desperate consumers and healthcare providers -- who all volunteer to serve on the council -- struggled with their rage and tears as they began to try to balance a budget -- a budget that will contain the worst HIV cuts in a decade. These cuts were part of a larger slashing of public healthcare funds, including cuts to children’s healthcare, shelters that support victims of domestic violence, MediCal’s mental health programs and so much more. We are still sorting through the impact of the cuts, and the impact is already horrific. And it’s only going to get worse.

I’m usually not an alarmist, but the choices facing the HIV Planning Council were nothing more than the devil’s bargain. Because of Governor Schwarzenegger’s cuts, we must find dollars to cover the viral load test that informs physicians about whether or not the mix of medications is working. Because of the elimination of DentiCal, funds must also be added to dental care so rotting teeth can be removed before they cause profound health complications and cardiac problems. To meet these needs, funds must be eliminated from programs that help people living with HIV/AIDS with food, housing, legal assistance, bus passes and assisted transportation programs that help them get to their health-related appointments.

The bottom line is that the governor chose public park preservation over the lives of the people of our state.

And I’m left to wonder how it is that we are even tolerating this travesty that passes for public policy? One answer was clear today: no one sees the people who will pay the ultimate price.

Scores of them came to this meeting to beg for their lives.

They are people whose lives -- and whose children’s lives -- have been devastated by HIV and they now have limited access to any resource, including healthcare. They are people who do not have a healthcare insurance option, who are often too ill to work full time or at all, who are struggling to climb out of the grasp of poverty and disease. They are people whose lives depend upon the thin lifeline public health throws them. They face eviction or homelessness, have little food and less nutrition (even though they must take chemotherapy strength medications). They often cannot pay the electricity bill, or afford a taxi ride after medical treatments that leave them exhausted. These are the people who will pay the price.

I’m well aware of the lament “we have to be fiscally responsible.” I agree. I’m all for it!

I agree, let’s be fiscally smart and responsible. Let’s stop pretending taxpayers don’t end up footing the bill and start using every intervention we can to prevent the worsening of the disease and devastation that will ultimately cost us billions more. Let’s stop bankrupting people who have a serious illness. Let’s stop hiding the real cost of these cuts in both dollars and human suffering.

And let’s stop pretending “some people” deserve this. No one deserves the fear and humiliation of having to beg for a chance at life or their children’s lives.

We don’t have to settle for this and it doesn’t have to end up a shameful, hidden, horrible truth. Let’s make the tragedy and voices of the people heard.

Every elected official -- your U.S. Senators, the Governor of California, the California State Assembly members, the California State Senators, every member of the San Diego Board of Supervisors -- should find their call sheets and their e-mail boxes full. Full of the stories of lives dismantled because of disease, the costs of healthcare and the even larger costs of having no access to healthcare. There should be phone lines full of fierce healthcare advocates asking for appointments with elected officials to brief them about the “on the ground” impact of the governor’s actions, and painting the real life picture of the people who are really paying for this travesty that passes for public health policy.

Make those calls, write those e-mails and letters. Use your voice to help today.

Don’t let the Governor choose parks over people so easily.

Contact Your Elected Officials
U.S Senators:
U.S. House of Representatives:
California State Assembly:
California State Senate:
San Diego County Board of Supervisors: