Health Care Forum is a hit. So is the Public Option

This is one of the sure ways to draw an energized crowd: talk about health care reform.

The Miami-Dade Democratic Party has done it now twice recently, first back in December when we had to split into five groups to have manageable talk sessions on personal problems with the health care providing system. And again Monday evening when over 50 people came to hear a great roster of experts on public health describe our local problems and possible solutions.

The national health-care environment, of course, is what the U.S. Congress is at work on now. It seems certain that this summer there will be legislation to expand health coverage. What will its content be? “We don’t know yet,” said Dr. Olveen Carrasquillo, chief of general internal medicine at the University of Miami. He was the panelist charged with outlining the progress of legislation in Washington, where it can be said that it’s all still in committee. It’s clear that the big lobbying interests have a lot of influence, and they are fighting to retain as much of the status quo as possible.

“How we get our message to Washington is going to be our concern,” Carrasquillo said.

From the public comments after the panelists spoke, it was clear that our crowd, anyway, wants something like Medicare for all, at least a strong public option to compete against the entrenched insurance industry.

Former state Rep. Elaine Bloom: “Let the insurance companies try to compete against the public option. … If we can have Medicare for everyone, why not?”

This short video shows Elaine Bloom, followed by Paris Walker, of the AFSCME union.



Participants were given a list of suggestions for action, starting with lobbying their members of Congress on behalf of the public option. Also, use the Facebook group set up for the forum (search for Miami-Dade Health Forum) as a resource and sounding board. Best may be to use Organizing for America as the tool to set up events and campaigns to influence Congress.

State Rep. Ron Brise of Miami-Dade outlined what’s going on in Tallahassee, and Lillian Rivera, administrator of the Miami-Dade County Health Department, focused on local needs, pointing out that Florida has 3.6 million uninsured among its 18 million people and public health facilities are being hit hard by budget cuts in this hard economy.

She and others described how the public health sector is streamlining its act in useful ways including more public health clinics. Marisel Losa of the Health Council of South Florida told of the Miami-Dade Health Action Network, a new partnership of public and free providers that is increasing access to primary health care for the uninsured.

Mental health needs are, in some ways, being cared for as in the 19th century, said Dr. Janetta Dominic Cureton, forensic psychiatry fellow at Jackson Memorial Hospital. Good ideas abound but legislators repeatedly haven't funded them, she said, and described how the jails are crowded with people suffering from mental illness. “I can’t believe that in 2009 we want to look like 1809. We can’t leave these people in jail,” she said.

Dr. Carrasquillo also covered the needs of the undocumented, a big issue in Florida. Half of the undocumented in the United States are in four states, California, Texas, New York and Florida.

He said there were four main reasons to cover the health needs of the undocumented: humanitarian, egalitarian, businesses will save money with healthy workers, and it’s not expensive. One argument on the other side, he said, was that “some people do not listen to common sense.” Another is that some on the far right are so mean that they will pay more than health care would cost to screw them – the undocumented.

A late addition to the panel was the topic of oral health, covered by Thomas H. Ward, a retired dentist and trustee of the Florida Dental Association. He said one fascinating thing after another, starting with our ratio of 2,400 people per active dentist in Miami-Dade -- rather high. The key to good oral health is preventive care, he said, starting with prenatal care so that women do not pass dental problems to their newborn.

Dr. Ward said Miami-Dade County has several good programs to improve dental health among school children. But the state and federal levels have “zero solutions” for dental needs, he said.