Dueling diagnoses

About two weeks ago, driven by pain, David Smith climbed to the top of a light tower at Chico State University’s soccer field intending to kill himself by jumping off. Once there, though, he fixated on the thought that the fall might not kill him. So he sat there, looking down.

That’s when “the miracle” happened.

Later, Smith, 54, explained that for two years he had lived with a serious medical condition. His scrotum had swollen to six times its normal size and engulfed his penis, he said, but no doctors in the area would treat him. They said he needed to see a urologist. But Smith had no health insurance and no money to pay a urologist.

Eventually the swelling became so painful he was ready to take his own life.

“The brain is powerful, and it’s hard to trick it into letting you kill yourself,” Smith said at the Torres Community Shelter, where he has been staying since February. “I’m just thankful for the miracle that happened that day.”

The miracle, ironically, was getting arrested. Police and firefighters, responding to calls of a man atop a light pole, took him into custody and transported him to Enloe Medical Center.

That day a local doctor, while being walked through the procedure over the phone by a UC Davis urologist, drained Smith’s scrotum and relieved him of the pain.

Smith is one of approximately 6.5 million Californians—20 percent of the population—without health insurance—and by virtue of that dismal fact is at the center of a growing debate over how best to provide insurance to everyone.

Both sides in the debate were present Monday morning at Little Chico Creek Elementary School, where members of OneCareNow, a statewide campaign for universal Medicare-style health insurance, were the first to greet attendees of Gov. Arnold Schwarznegger’s “town hall meeting,” hosted by the Chico Chamber of Commerce, the American Association of Retired Persons (AARP) and the California State PTA.

While the governor was scheduled to discuss a wide array of issues facing the state, the topic at the forefront of most attendees’ minds was the health-care crisis facing California.

As guests filed past the protesters, they were offered information by the group on SB 840, a bill that passed in the state Senate and Assembly this past August but was vetoed by Schwarzenegger in September. And despite the presence of the heads of several state departments—Corrections and Rehabilitation, Food and Agriculture, CalEPA, and Education, among others—it was evident almost immediately that, while health care may not have been center stage for Schwarzenegger, it certainly was for his constituents.

“We were there to challenge the governor’s position on health care,” said Jeanne Ertle, committee member of Chico’s OneCareNow organization. Ertle said that the members of her organization were not allowed to go inside because they were not invited, but she thought it was important to inform those who did attend about SB 840.

The bill, titled the California Universal Healthcare Act, aims to establish a Medicare-style health insurance system in California that would cover all residents and be administered by a government agency. Sponsored by Sen. Sheila Kuehl (D-Santa Monica), the bill recently passed in the state senate. It is strongly opposed by the health insurance industry, which stands to lose its huge profits.

Two other bills, both similar to Schwarzenegger’s plan, have been introduced, one in each house of the Legislature. Both AB 8, by Assembly Speaker Fabian Nuñez, and SB 48, by Senate President pro tem Don Perata, attempt to provide much more extensive coverage using private health insurance, though both would leave as many as a million people uninsured. Both passed in their houses despite strong Republican opposition.

Ertle said what she found most disturbing about Monday’s “meeting” was the fact that it was co-sponsored by AARP. While AARP purports to be a nonprofit membership advocacy group for seniors, it also makes a lot of money with its business enterprises, including AARP Health Care Options, an insurance program.

With his usual enthusiasm, Schwarzenegger addressed the health-care issue straight on, saying he recognized the daunting task that he faces in the upcoming months and adding that he “loves tackling big problems.”

Despite having “great hospitals and great doctors,” the governor said, the “system itself is failing people.”

Citing overcrowded emergency rooms and the phenomenon of insured individuals paying for the medical costs of uninsured individuals in a “hidden tax,” Schwarzenegger highlighted the need to reform health care through his own three-part plan, rather than SB 840. The plan has yet to be written, however, and no bill has been presented to the Legislature.

Expounding on this so-called plan was Health and Human Services Agency Secretary Kim Belshé, who said California’s current state of health-care coverage is “unacceptable” and “unsustainable.”

The governor’s plan includes three parts, Belshé said: prevention and wellness, coverage and affordability. The plan’s objectives include continuing with fighting diabetes and obesity to reduce future medical costs, making medical insurance coverage mandatory for all Californians, and making health information available online to reduce the costs associated with paperwork in medical facilities.

“Everyone benefits and everyone contributes,” Belshé said.

Still, at the conclusion of the presentation, attendees seemed uneasy about the governor’s proposal, with three of the six questions posed by the audience related to the issue of health care.

One question came from William Todd-Mancillas, who asked Schwarzenegger what his objections to SB 840 were. Schwarzenegger turned the question around, asking Todd-Mancillas what he thought the governor’s objections were.

“I would guess that you would say it costs small businesses too much money.”

Schwarzenegger agreed, saying he wanted to protect small business, and then moved on to the next question.

Todd-Mancillas, a professor of communication studies at Chico State University, later said he was taken aback by the governor’s response and disappointed that he did not receive a “more informed” answer.

He did credit the governor with being “pleasant and accessible” to the public, however.

This accessibility is the very reason why the governor said he conducted the meeting, saying that events such as these are important to inform the public and have the public respond to him.

The next day, Tuesday, Ertle and others from the OneCareNow campaign joined filmmaker Michael Moore and more than a thousand nurses at the west steps of the Capitol in support of SB 840.

Over Ertle’s phone, Moore could be heard in the background calling for “health care for everyone” and for the regulation of pharmaceutical companies in the manner that utility companies are regulated.

Moore’s booming voice was applauded by supporters marching from the Capitol to Sacramento’s Crest Theatre, where an afternoon screening of his new documentary, Sicko, was scheduled.

Ertle and OneCareNow were joined by members of the California Nurses Association, who organized the event, and a group of Massachusetts nurses.

“The group from Massachusetts wants the same thing as us—for everyone to have health care,” Ertle said during the rally. “They’re out here in hopes that California will pass this bill and be the model for the rest of the country to follow.”