American Forum Op-Ed

NEW MEXICO EDITORIAL FORUM

By Lilia Diaz

When hundreds of private investors came together at the 2010 Investor Summit on Climate Risk (INCR) in New York this past January, they weren’t there to debate the existence of global climate change or humans’ role in causing it.

They were there to talk about how to address the negative environmental impacts of the current climate crisis, while at the same time turning it into an opportunity for creating jobs and making money.

The private investors who belong to the INCR are increasingly embracing a reality that seems to elude Washington D.C. – investing in renewable and clean energy industries is the next crucial step towards digging ourselves out of this economic abyss and building a sustainable world economy.

The “2010 Investor Statement on Catalyzing Investment in a Low-Carbon Economy” demonstrates that what these investors are demanding is nothing short of bold leadership and clear policy decisions which pave the way for their investment in these industries.

Washington’s inexplicable failure to act on this issue by enacting comprehensive climate change legislation has placed New Mexico in the position of needing to advocate for itself. If New Mexico doesn’t take proactive steps to address the statewide spectre of carbon emissions now, then we run the risk of missing out on millions of investment dollars which could flow into our struggling economy. Other governments around the world are jockeying to take advantage of these opportunities, so New Mexico must act quickly to establish itself as a leader in the clean, renewable energy market.

Predictably, the measures needed to address climate change and jump-start economic revival have met fierce resistance from the oil, gas, and coal industries, and their army of lobbyists who have resorted to fear tactics to mislead and confuse consumers.

A local energy industry spokesperson and other opponents testified against New Energy Economy’s (NEE) petition to cap greenhouse gases at the August 16th Environmental Improvement Board hearing in Santa Fe. They issued dire warnings that NEE’s proposal will cost too much to implement and will lose the state money. No statement could be more disingenuous.

Contrast the industry’s alarmist arguments with the fact-based assessment of Brendan McDonagh, CEO of HSBC-North American Holdings, Inc. McDonagh reported that the climate business sector now generates annual global revenues in excess of $500 billion, which is already larger than the global aerospace and defense industries. Moreover, these revenues are expected to rise to $2 trillion by 2020.

Now that’s the kind of “green” that should be going into the pockets of consumers and businesses in New Mexico.

New Mexico must pave the way for companies who want to invest in renewable energy and who want to do it here. Our state ranks 2nd in the nation for solar potential, 12th for wind potential, and boasts vast untapped geothermal and biomass resources. With all of this raw potential, we could lead the nation in clean, affordable, renewable energy production.

Capping carbon will benefit New Mexico by expanding and diversifying our energy resources. Sandia National Labs recently released a report which estimates that the cost of inaction will be much higher than that of implementing carbon cap measures.

Study co-author George Backus, an energy engineer and technical expert at Sandia, says the take-away is that “the uncertainty associated with climate change validates the need to act protectively and proactively.”

Regulation is a policy signal, which acts as an economic stimulus by spurring investment, research and development in renewable energy and energy efficiency. Mindy Lubber, President of Ceres and Director of INCR (the group has more than 90 members and $13 trillion in assets), highlighted that the financial industry has a huge role to play in closing the climate investment gap, and that there is a great need for policy change beyond financing the transition to a low-carbon economy.

NEE’s petition has rallied strong support from the business community and advocacy organizations around the state, many who are co-petitioners, and offered compelling testimony at the August 16th hearings. The New Mexico Pediatric Society, League of Women Voters NM, Amigos Bravos, Positive Energy, San Juan Citizen’s Alliance, and Rocky Mountain Youth Corps, to name a few, demonstrate the broad range of organizations that support a carbon cap as part of what is nothing less than an energy paradigm shift.

According to the world’s top investors, the switch to a clean energy economy is not a matter of if, but when.
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Diaz is the education and outreach director for New Energy Economy. The hearings resumed on October 4th in Santa Fe. The 2010 Summit Final Report can be found at http://www.incr.com/summit and the Sandia report at https://cfwebprod.sandia.gov/cfdocs/CCIM/docs/Climate_Risk_Assessment.pdf
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Copyright (C) 2010 by American Forum. 10/10

NEW MEXICO EDITORIAL FORUM

By Margarita Mercure Hibbs

Living in rural regions supports a lifestyle that many families, small businesses and retirees appreciate. However, securing access to affordable, quality health care -- especially during a recession -- can be a challenge. With roughly one-third of its 2 million residents living in rural areas, New Mexico has an especially severe challenge.

According to studies by the Rural Health Research & Policy Center, the Flex Monitoring Team, and Kaiser, there are 42 hospitals in New Mexico, only 29 of which are located in rural areas, and six of which are critical access hospitals.

What does this mean for rural New Mexicans? These numbers show that although they occupy the largest geographical territory in the state, folks in rural New Mexico only get about half the medical resources. These statistics are devastating to our state and are completely unsustainable.

Adding to the special challenges facing New Mexicans is the fact that our state has some of the highest unemployment and uninsured rates in the nation. The rural-urban disparity in insurance coverage is exacerbated by the fact that incomes are generally lower and fewer rural companies offer private health insurance.

These special challenges are why the changes brought about by the Patient Protection and Affordable Care Act are so important to New Mexicans. The Act addresses many of the health care issues that so many rural Americans face and ensures that they will now have affordable access to necessary health care that was once unavailable to them.

Historically, rural New Mexicans faced with catastrophic injuries or illnesses have had a greatly diminished chance of survival due to the lack of emergency, urgent care, and first responder resources.

The Patient Protection and Affordable Care Act creates a system that is fair for rural communities -- one that will grow rural health care workforces by making necessary investments in training, recruitment and facilities, so that rural populations have greater access to doctors, nurses, dentists and paramedics.

Health care reform sets important guidelines which address the care of our most vulnerable members of society. Under the Act, people with pre-existing conditions, children and youth, small businesses and seniors will be the first groups to directly benefit.

Beginning in 2104, insurance companies will finally be held accountable and may no longer refuse coverage to a person simply because he or she has a medical history. Until then, a pre-existing condition insurance plan serves as a bridge to meet the needs of those individuals who have already been denied insurance coverage and have been uninsured for at least 6 months.

Children can’t be denied coverage for any reason and family coverage will be extended for young adults through the age of 26.

Seniors, who have fallen into the prescription coverage gap (the “donut hole”) since 2007, will receive assistance with paying for medications, and will also have access to cheaper ones.

Most importantly, everyone will also have greater access to preventive care, which will help avoid expensive and unnecessary treatments later.

Establishing a fair playing field for small and independent businesses is a key component of reform. In New Mexico, agriculture and tourism are cornerstone industries – related small businesses contribute greatly to the economy. But typically, in rural areas, one large insurance company dominates the market, so there is no guarantee of choice or competitive pricing.

To remain viable, these small businesses must be able to attract and keep good employees by being given the opportunity to provide health insurance (large corporate businesses currently pay, on average, 18 percent less for comparable insurance plans). In the past, only 35 percent of small business owners were able to offer health insurance to their employees, but this year, more than 88.9 percent of New Mexico small businesses (24,800) with fewer than 25 employees will be eligible for tax credits to help pay the cost of necessary employee health insurance coverage.

Many New Mexicans are already benefiting from reform. Health Action New Mexico, a statewide health advocacy organization, provides information to folks in order to better explain what the health care plan does and doesn’t do. Access to this information is an important piece of reform, so we strongly encourage you to contact them directly at www.healthactionnm.org or (505) 867-1095.
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Hibbs is a rural advocacy specialist and former first lady of Estancia.
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Copyright (C) 2010 by New Mexico Editorial Forum. 10/10

NEW MEXICO EDITORIAL FORUM

By Lydia Pendley and Kathryn C. Sherlock

The working families of New Mexico and the nation are the backbone of our economic and cultural identity. Working families are so essential that our city, state and nation have created public policies and programs designed to help them to survive.

The Earned Income Tax Credit (EITC) and Child Tax Credit (CTC) are just such tools. Both programs encourage low and middle-income people to work, even when their jobs pay too little to live on. These tax-credit programs also keep millions of children out of poverty each year, building a stronger future for our next generation.

The EITC for low-income working individuals and families is a refundable federal income tax credit. It has received bipartisan support since Congress passed it in 1975. The EITC is designed to "make work pay" by decreasing the impact of taxes that low-wage workers pay on their earnings by supplementing their wages. The intention is to move a family with a full-time minimum-wage worker above the poverty line. The EITC is the largest poverty-reduction program in the U.S., and, in 2009, it was expanded as part of the American Recovery and Reinvestment Act (ARRA) to provide more help to married couples and low-income families with three or more children. In 2009, the EITC lifted 6.6 million people out of poverty, half of them children.

The CTC is designed to lessen the impact of income taxes for families raising children. Again, as part of the ARRA, the CTC was improved to allow families earning between $3,000 and $13,000 the chance to claim the credit. Previously, these working families were not allowed to claim the CTC. This change alone has helped 13 million low-income children and their families.

As a nation, we are right to invest in tax credits for working families. The EITC and CTC (and the improvements to them enacted last year) have been essential in helping families get back on their feet, especially in these tough economic times.

Beyond helping individual families, EITC dollars are helping to get our economy moving again. In 2007, across New Mexico, over 319,000 households claimed the EITC and/or the CTC, thus bringing over $470 million into New Mexico’s economy. As many of us know, the dollars received by working families go right back into New Mexico’s economy.

The 2009 improvements to the EITC and CTC are due to expire at the end of 2010. If these long-overdue changes are allowed to end, thousands of working families in New Mexico will be put in financial jeopardy. In our state, 177,000 children would receive a smaller CTC and 78,000 people would receive less EITC.

At a time when New Mexico’s economy needs positive improvement, removing these benefits to our working families makes no sense at all.

It’s time to reaffirm our commitment to real family values and make the 2009 improvements to the EITC and CTC permanent.
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Pendley and Sherlock are Co-Group Leaders of RESULTS-Santa Fe.
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Copyright (C) 2010 by the American Forum. 9/10

NEW MEXICO EDITORIAL FORUM

By Max Bartlett and Jose Aguilar

One issue has generated little discussion during the heated health care reform debate: whether states should have the right to develop their own approaches to universal coverage.

The Health Security for New Mexicans Campaign wants to see language included in the national proposal that gives states flexibility to develop their own approaches to solving rising health care costs and growing numbers of uninsured.
The focus of current health care reform proposals is to create “insurance market exchanges.” These one-stop-shopping insurance exchanges must offer consumers -- primarily the uninsured -- choices of different insurance products, including some type of public option. A less than robust public option is in the proposal passed by the House of Representatives. The Senate is in the process of negotiating an alternative to the House version.

Unfortunately, the health care reform debate has skirted the issue of whether states can take a different path that reaches the same goals. States always have been laboratories for innovation. Women’s suffrage, civil rights, child labor and minimum-wage laws were developed in the states first and then became federal law. Why shouldn’t states be allowed to continue that role in health care reform?

If a state can develop an approach that is not based on the insurance market exchange model, an approach that still provides comprehensive health coverage for its residents and contains rising health care costs, why shouldn’t it be encouraged to do so?

The recently passed House bill contains no language enabling states to develop anything other than an insurance market exchange. The merged Senate bill now under consideration mandates that by 2014, states must set up an insurance market exchange and experiment with it for three years before requesting any waivers.

Why should states be forced to go through a long, expensive, complex and time-consuming process when they already may be working on approaches more appropriate to their circumstances?

In New Mexico, the Health Security Act offers a different solution from that based on an insurance market exchange. It is a “home-grown” solution that has earned enormous public support -- 146 diverse organizations are part of our coalition, and 32 New Mexico counties and municipalities have passed resolutions endorsing it.

The Health Security Act would enable New Mexico to set up its own health care plan that automatically covers most New Mexicans, provides comprehensive benefits and guarantees freedom of choice of doctor even across state lines.

Instead of creating a system of competing insurance plans, each with different provider networks, this proposal would shift the role of private insurance companies to provide supplementary coverage – as they do with the original Medicare program. Any individual, employer or group wishing to purchase additional coverage could do so. A non-governmental, geographically representative citizens’ board would be in charge of the plan.

Two separate studies have concluded that if such a health plan were established in New Mexico, health care costs would be reduced by hundreds of millions, if not billions, of dollars within five years.

Why is this so? Because this approach simplifies a very complex private insurance system with its hundreds of policies, different benefits, co-pays and deductibles, all of which affect administrative overhead of doctors, hospitals and clinics – and which, in turn, negatively affect health care costs.

In a state such as ours, with a small population, it makes economic sense for most residents to be covered under one health risk pool.

Coalitions in other states -- California, Minnesota, New York, Pennsylvania, Washington and Oregon, to name a few -- have been working on proposals that are not based on an insurance market exchange and are adapted to the particular needs of those states.

Acknowledging these developments, the National Conference of State Legislators recently passed a resolution containing a provision asking that states be allowed to create solutions that go beyond any federal requirements. New Mexico was counted as one of the resolution’s supporters.

In addition, New Mexico State Sen. Dede Feldman and others from the House and Senate sent a letter to our five-member congressional delegation, which included a request that states be given flexibility to develop their own comprehensive plans.

Health care reform should clearly encourage state experimentation. Aside from the need for state flexibility language in the national legislation, the Health Security for New Mexican Campaign believes states deciding to develop their own health plans also should have the right to access the same federal dollars as those states choosing to set up their own insurance market exchanges.

At this critical juncture, Congress needs to tackle this issue.

NEW MEXICO EDITORIAL FORUM
By Rev. Dr. Holly Beaumont

NEW MEXICO EDITORIAL FORUM
By Ona Porter

KRWG - Newsmakers in Las Cruces, New Mexico recently aired a program about the multitudes of doctors that are speaking out about healthcare reform. They interviewed New Mexico Editorial Forum author Dr. Sandra Penn, who recently penned an op-ed "Stop Negotiating Away the Public Health Insurance Model" about her views that Congress is letting real reform slip away. You can see her interview for yourself, which occurs at the 5 minute mark.

NEW MEXICO EDITORIAL FORUM
By Jason Marks

NEW MEXICO EDITORIAL FORUM
By Miriam Komaromy, MD

When I walked into the exam room, a thin, pale, middle aged man was sitting patiently in a chair waiting for me. Mr. Richards (not his real name) politely explained that he needed medicine for his heart, and gave me a list of the medications he was supposed to be taking. I asked about his living situation, and he told me he had been living in shelters for the past two years.

As he responded to my questions I learned this man was an engineer who had been employed by a prominent technology firm. When he had developed diabetes in his late 30s he quickly developed severe complications, including damage to his vision, and later heart trouble. He could no longer perform his work duties. He lost his job and then his health insurance. He became depressed and withdrawn, and eventually his wife left him. His health care bills bankrupted him and he lost his home. He had applied for disability benefits, but was turned down.

As this man’s story unfolded I felt my stomach clench with anxiety for what would happen to him. Unfortunately I had very little to offer. As a physician who has worked all of my adult life caring for low-income and uninsured patients, I have so often been in a position to apply a band-aid—in this case, arranging for him to receive a month’s worth of his medicine free of charge—but not a solution to the huge problems that face my patients on a daily basis. In order to get in to see a health care provider at my clinic he had stood in line for over an hour in the heat on two successive days, waiting to find out if we would have an available appointment. Tonight he would walk a long distance alone on the street, vulnerable because of his poor eyesight, and would sleep on a cot in a shelter.

I was struck all over again by the cruelty of a so-called health care “system” that offers health insurance only to those who are employed. For this man, illness had caused the loss of his health insurance, and now lack of health insurance and adequate medical care was allowing his disease to progress unchecked. It was undoubtedly shortening his lifespan, and was creating a situation in which we as taxpayers will all pay the enormous costs of providing care for him as he becomes so severely disabled that he requires hospitalization, heart surgery, and perhaps dialysis. Yet, we as a nation have not been willing to pay the upfront costs that could help this man and so many others to get the care that could help prevent or slow disease complications and extend functional years of life.

Who are we as a people? How have we allowed it to become the norm that our citizens go hungry, sleep on the street, and do not have access to basic medical care? Nations vastly poorer than ours choose to treat health care as a basic human right and thus provide health care for all citizens.

We each know deep down that a sudden twist of fate could land us in a devastating situation like my patient Mr. Richards. The Reverend Martin Luther King, Jr., once said, "Of all forms of inequality, injustice in health care is the most shocking and inhumane." Paradoxically, in our country health insurance seems largely to be reserved for the healthy.

We are coming to an historic moment, when we finally have a president who is willing to put all of his weight behind passing comprehensive health care reform. The outcome though, is not guaranteed. Most worrisome is the backlash against the option of a public health care plan. The so-called “public option” would help to loosen the stranglehold that the private insurance industry has on our health care system. It would offer meaningful competition to for-profit insurers, would help to reduce costs for medical care, and would provide comprehensive insurance similar to Medicare.

Now is the time to let our voices be heard: Comprehensive health care reform with a public health insurance option is not just what we want, but what we demand.
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Dr. Komaromy is a former medical director of Albuquerque Health Care for the Homeless.
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Copyright © 2009 by the New Mexico Editorial Forum. 9/09

NEW MEXICO EDITORIAL FORUM
By Sandra Penn, MD, FAAFP

I believe in evidence. As a Western-trained physician, I was taught that half of what I learned in medicine would be proved wrong and that I would have to continue to study, learn and seek evidence that what I was doing continued to be appropriate.

When I came into medicine in 1973, Medicare had already proved itself. Seniors were able to get care as they never had before. By the time I started practicing in the 1980’s, Diagnostic Related Groups was changing the payment system for hospital care because physicians had cleverly moved some diagnostics into in-patient procedures and thus kept patients in hospital longer. Changing the payment system, it was clear, would change the amount that was charged.

During my eight years in private practice, I often wrestled with insurance companies about how they paid. Each company had a different requirement and I would be encouraged to see a person many times for a lesser rate rather than allowing me to charge more and have a longer visit. The insurance companies delayed payment because a single block was not checked on their form, driving up my office expenses because I had to hire more staff to service their forms. Medicare, at least, remained the insurer of all my patients over 65, thus reducing the number of changes I had to make when my patients were forced to switch insurances. That experience has driven me for the last 20 years to be an advocate for health payment reform (I am no longer in family practice although I still do primary care).

The last eight years have seen the deterioration of our health care and our safety net. A safety net is essential because our country has not provided us with the universal, accessible, accountable and affordable health care that is enjoyed by the rest of the developed world.

Now, here we are with a Democrat in the White House, a Democratic majority in the Senate and the House and I listen and cringe as they give away, not even “Medicare for All,” but just a public plan option! What, pray tell, is wrong with us?

Insurance companies claim they can’t make a profit if there is a public plan. President Obama shot back that UPS and FEDEX are doing well despite the competition of the U.S. Post Office. Why should anyone be concerned that some insurance company is not making a profit when their profit is often floated on denying people care?

Evidence shows that a majority of physicians support a national health plan. Research data over the past few years finds that Americans would pay more in taxes so that everyone would have health insurance. Yet, the few screaming people disrupting town hall meetings are being attended to more than the majority.

Our elected officials are negotiating away our well-earned chance to join the rest of the civilized world by offering our citizens at least the chance of being insured.
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Dr. Penn is a primary care physician in Albuquerque.
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Copyright © 2009 by the New Mexico Editorial Forum. 9/09

NEW MEXICO EDITORIAL FORUM