Rally Protests Proposed Calif. Health Care Cuts

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SACRAMENTO, Calif. - Several American Indian health groups staged a rally
at the state capitol on June 2 to protest proposed budget cuts to Indian
health programs.

Approximately 1,000 people from various American Indian organizations
attended the rally that featured speakers from not only Indian health
organizations but from state politics as well.

"Say no to more cuts," prompted California Rural Indian Health Board
Executive Director Jim Crouch to a crowd that quickly picked up the chant.

Prompting the rally were proposed budget cuts by Gov. Arnold Schwarzenegger
to state health programs, many of which Indian people rely on for health
care.

Among the proposed cuts are $2.7 million to 36 of the state's Rural Indian
Health clinics that fund "culturally appropriate" mental health and
substance abuse programs; a $30 million reduction to tribal Temporary
Assistance to Needy Families (TANF) programs; and a total of $1 billion
from a "redesign" of state health care assistance known as MediCal.

Gov. Schwarzenegger's budget proposal will have to be hammered out with the
Democrat-controlled state legislature before a state budget is due in the
next month and it is possible that some of the proposed cuts will not be as
deep as proposed by the governor.

Crouch and health policy analyst Mark LeBeau both claim that the proposed
cuts in MediCal will disproportionately affect American Indians. In fact
Crouch estimates that about one-third of the patients seen in California
Rural Indian Health Board clinics are MediCal recipients.

In a press release issued to members of the media at the rally, Jerome J.
Simone, chief executive officer of United Indian Health Services in Arcata
claimed the cuts would be more than offset by shrinking "the size and
strength of a vital safety net that now exists ..."

LeBeau backed Simone's claim by pointing out that although the state would
save $2.7 million by cutting out the cultural substance abuse problems, the
state would have to pick up the tab in several other areas. Currently since
the money is divided among 36 clinics, it comes out to a cost of about
$60,000 annually for the state to each specific clinic.

However, by cutting the program, LeBeau said the costs would be shifted to
a myriad of other governmental agencies.

"Just by cutting this literal ounce of prevention, suddenly the state and
local governments will have to pay for a number of peripheral costs. For
example, police will have to respond to increased domestic violence and
other problems. There are the costs of incarcerating more people. Public
medical assistance will be needed for fetal alcohol syndrome and alcohol
related accidents."

All of this, claimed LeBeau, will more than offset the $2.7 million in
savings to the state.

In a study done in 2000, shortly before the substance abuse program was
first funded, research conducted by Dr. Carol Korenblot showed that
American Indians had a 50 percent greater chance of "avoidable" hospital
trips than the general population.

During the rally a person who works for the California Nations Indian
Gaming Association (CNIGA) who asked not to be identified, felt that there
was an irony in the Gov. Schwarzenegger's budget plan.

The governor is currently in negotiations with some of the large casino
tribes of which he plans to wrest around $1 billion to help bridge the
budget shortfall. This is almost the same dollar amount that the governor
will be cutting from MediCal.

"It's like he wants [Indian people] to pay more to the state, for something
they did not create [the budget shortfall] and then get fewer services in
return."

The current MediCal "redesign" includes five state working groups. Among
the participants listed for the entire redesign not a single representative
from an Indian group is included among the dozens of members.

"You don't see an American Indian single mother included on this list,"
observed LeBeau.

The list of participants in the redesign is fairly broad with
representatives from labor unions to public interest groups. Though there
are other minority groups represented, particularly a few Latino groups and
some representation from social justice organizations, the list is still
weighted slightly toward the medical industry and other large corporations,
including but not limited to medical insurance companies and HMOs.

Calls to Gov. Schwarzenegger's press office were referred to H.D. Palmer in
the Department of Finance who did not return calls before press time.
Similarly calls to the MediCal redesign group were also not returned.

Part of the MediCal redesign includes the potential option of a co-payment
plan. In Oregon, where a similar plan was put in place, LeBeau claimed that
Indian health clinics in that state have seen a 40 percent reduction in
American Indian patients. He also pointed out that American Indians,
despite the successes of a few gaming tribes, are still the poorest ethnic
group in the United States and are therefore dependent on state medical
services.