Yes, it is true that during our budget hearings, there was a “combative” debate between members of the Board of Supervisors and the chief executive officer of the Community Health Centers.
It centered not only on the amount of funding the county can provide to CHC to meet our obligations for indigent health care, but also on the public relations campaign conducted by CHC that included postcards from patients and radio ads urging the board to make health care a priority, threatening dire cuts. A few of us felt the campaign was not only inaccurate, but pandering to patient panic.
It is also true that the clinics run by CHC do a very good job of providing health care to citizens in our county who otherwise have few or no options to access needed medical services, whether those services are in response to illness or are preventative in nature. Without such care, thousands of citizens would suffer. We should all be concerned about the suffering of our fellow citizens, whether they be children or the elderly or the many who work jobs that provide no health insurance.
And, sadly, it is also true that the county’s ability to provide funding for all who need subsidized health care has been severely curtailed by our own financial limitations — from $3 million in the 2010-11 budget to a proposed $2.2 million in 2011-12. Historically, we have been able to backfill funding while state and federal funding has spiraled down and costs have spiraled up. The growing need and shrinking resources have led to increasingly frustrating negotiations between the county and the management of CHC.
But let’s set aside the particulars of this specific debate — though it should be noted what was lost in the heat of argument was the light — the Board of Supervisors did direct our staff to see how we might be able to increase the funding of the grant with CHC.
The larger debate has to do with whether we can come to some agreement about our obligations to others, and how the generation-long divestiture in public services at state and federal levels hurts all of us.
There’s no need to rehash the health care debate. Still, it’s not difficult, when one looks closely at the system we have set up in our country, to see the excessive waste and cruelty that continue to be defended by the insurance companies responsible for the distribution of services that I believe should be basic rights of all our citizens, not just those with the resources to pay for them. I wish we could avoid the combativeness that does arise around this discussion and embrace a more virtuous and decent debate about how best to help the helpless and buttress the backsliding.
But unfortunately, we Americans — both local voters and decision makers — are nowhere near any such agreement on a more inclusive vision of duties and responsibilities of our country. We are not even near agreeing to the terms of such a needed debate. Rather, we are more frequently and more fervently engaged in zero-sum debates about the nature of individual rights and the role of government in responding to the adversity of many, even when sometimes that adversity has been caused by the most powerful few.
Despite the cynicism that can infect our larger public discourse, it remains my hope that in our community, all of our civic leaders can better appeal to our ideals and do better in stoking the moral energies that are essential to a vital society. I include myself in committing to do better in this regard.
So let me close by stating what should now be obvious by these remarks. With all my heart, I wish our county government could provide the health and social services needed in our community, and do so in a manner that would help stabilize and secure the greatest number of our citizens.
But when I read over our budget, and I meet with our departments and listen to our citizens, my head tells me we simply cannot do all that we would like to. This is not an exercise (excuse the pun) in passing the buck.
It’s operating and making effective decisions in the reality that exists as opposed to the one many of us wish we could create.
Adam Hill is chairman of the San Luis Obispo County Board of Supervisors.