Oct. 30, 2009

Oct 30, 2009

Sen. Joe Lieberman served notice this week that he'll be shilling for insurance companies headquartered in Connecticut by joining the GOP in filibustering any bill that has a public option. A public option is a nonstarter for Lieberman, and keeping him in the Democratic fold is one of the many challenges facing Majority Leader Harry Reid as he moves the health-care-reform bill toward the Senate floor. Amid the birth pangs of health-care legislation will be wails about how we're destroying the best health care in the world. This is a myth that critics of reform perpetuate, that government-run health care will be the equivalent of turning doctors' offices into the Department of Motor Vehicles. (Click here to follow Eleanor Clift).

It's true we have the best care for people who can afford it, but we also have large populations that are underserved in urban and rural America. For example, there is just one hospital in South-Central Los Angeles, home to 1.6 million people. South L.A.'s available medical care is more comparable to Bangladesh, a Third World country, than to the rest of California, which has five times as many primary-care doctors per 100,000 people as this densely populated and poor section of Los Angeles. In some suburbs, not 10 miles away, there are hundreds of physicians per 100,000 people. "The differences are appalling," says Susan Kelly, former president of Charles Drew University of Medicine and Science, which is located in the heart of the South-Central L.A. community.

Kelly came to CDU with fresh eyes. She is from Australia (and is now a dual citizen), and when she took the job, she was the first female, the first non-physician (she has a Ph.D. in psychology), and the first non-African-American to lead Charles Drew, the nation's only dually designated Historically Black Graduate Institution and Hispanic Serving Health Professions School. CDU was chartered as a private, nonprofit institution in 1966, one of the good things to come out of the Watts riots that awakened the country to the disparity of services in South-Central L.A. and seeded social reform. She remains shocked at the conditions that prevail in the community, where education, housing, and transportation are all subpar.

In her three years at the helm of Charles Drew, Kelly established the only nursing school in the nation focused on addressing health inequities. With the legislature and Gov. Arnold Schwarzenegger she secured $43 million in state bonds for a new research and nursing-education facility despite California's wrenching budget crunch. Kelly remembers her first meeting with the governor. He asked to see her green card, which she readily showed him, and then, she says, "he asked me for my wish list." She said she needed $10 million for a new nursing building, and money for telemedicine. Schwarzenegger didn't blink. He asked what else she needed. "I'm a big fan of his," she says, adding that when the governor spoke at Charles Drew's commencement this year, he shook the hand of every student with evident pride at what they—and he—had accomplished.

Before Kelly came to America she was an on-air television and radio psychologist and commentator, president of the Australian Psychological Society, and the author of three bestselling books on family relations and stress. She's interested in culling the best ideas from all over the world; for instance, she's made two trips to the Cuba to research how it delivers such high-quality care with so few resources, and how it manages to graduate several thousand doctors every year, enough to export many to underserved areas around the world. Most U.S. medical schools graduate between 80 and 150 students annually, says Kelly. "The Cubans think that's a small tutorial group." Cuba is near No. 1 in the world in maternal health, according to the World Health Organization, and its infant mortality is much lower than most industrialized nations, and less than half that of Mississippi. One answer is the consultorio, a small clinic, located in nearly every high-rise residential building to dispense basic health care, from teaching people to take their own blood pressure and manage their diabetes to prepregnancy care with a lot of contraception education. Cuba has a very low unplanned-pregnancy rate, a result of all the proactive care. It is a model that Kelly thinks would work well in rural and underserved areas in America.

While Kelly was in Cuba, she met several U.S. students, mainly African-Americans from the South, attending medical school there, drawn by the free tuition. "If you can get yourself to Cuba, and you learn Spanish and work hard, they will turn you into a doctor if you agree to work in an underserved area anywhere in the world, including the United States," Kelly explains. Some of the first graduates of this Cuban program are doing their residency training in New York. That will provide more health care than a bunch of politicians railing against a public option.

Eleanor Clift is also the author of Two Weeks of Life: A Memoir of Love, Death, and Politics and Woman, Child for Sale: The New Slave Trade in the 21st Century .

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