By the statistics, requests from Shirley and other leaders make sense. American Indians continue to live sicker and die younger than other New Mexicans, a trend replicated throughout the United States. 2008 data from the New Mexico Department of Health shows that this population fares the worst amongst NM racial/ethnic groups in nine of the 20 health indicators measured, including homicide, motor vehicle deaths, and youth obesity. American Indians in our state are three times more likely to die from diabetes and alcohol than the best performing groups in these areas.

“We simply cannot take health care away from the most vulnerable. It is in all of our best interest to provide healthcare services to the level of the need for those services in our state,” Dr. Kristine Suozzi, Coordinator of the New Mexico Health Equity Working Group told The Independent.

Suozzi pointed to a recent letter from UNM economists to Governor Richardson, a warning that cutting income and services to those who need them will have a spiraling downward effect on our overall economy.

The funding of health care for American Indians continues to lag far behind the national average, roughly one-third of that spent per-capita by those with private insurance, and half of that spent on prisoners. While the Indian Health Service (IHS) provides much of the funds for on-reservation care, 17 percent of the IHS budget comes from third-party payers such as Medicaid. The majority of the Native population does not live on reservations, and for this group, Medicaid becomes an even larger source of healthcare coverage. In all, almost half of our state’s American Indians (43 percent) are on Medicaid, and 66 percent of this group are children.

Last September, when the MAD announced impending cuts to Medicaid, Tribal leaders and advocates, along with Medicaid supporters such as the New Mexico Center on Law and Poverty (NMCLP) began to strategize how to minimize these cuts, and more importantly, minimize the impact that such cuts would have on the vulnerable populations they serve.

“With the $4 to $1 match in federal funding, it would be fiscally irresponsible to forego funds that are critical to our economic recovery and thousands of jobs in the healthcare sector,” Sireesha Manne, a lawyer with the NMCLP told The Independent.

Manne is equally unimpressed with proposals to restructure Medicaid benefits.

”We’re looking at devastating cuts to healthcare coverage for people living in poverty. This will make the difference of whether a family member with a disability can continue to receive services at home, or whether a child can see the eye doctor or dentist,” Manne said.

One proposal, introduced in House and Senate Joint Memorials by Ray Begaye and John Pinto, respectively, requested the development of a program to establish Native Americans in a separate category of Medicaid eligibility with its own benefits package.

The bill invokes legal arguments, pointing out that under New Mexico’s State-Tribal Collaboration Act signed into law last year by Gov. Bill Richardson, Tribes must be given information regarding redesigns of programs such as Medicaid so that Tribal leaders an opportunity to give “important systemic input into the redesign.”

Regina Roanhorse of New Mexico Voices for Children said she saw these memorials as safeguards in a Medicaid restructuring process that has thus far not included Tribal leaders.

“These are important to ensure that when the state “re-designs” the services and coverage plans for Native Americans that we don’t see any drop in enrollment or cuts to services like prescription medication, transportation, dental, and vision,”  Roanhorse said.

Asked why there should be a separate category for American Indians, Roanhorse pointed out that New Mexico receives 100 percent of the funding for Medicaid services provided to tribal members at IHS facilities and the Tribe-run 638 programs.

“[It's] fiscally advantageous to the state, especially in this economic climate, to maximize Medicaid in the Native population,” she said.

The memorials also point out that the American Recovery and Reinvestment Act (ARRA) of 2009  requires states to consult with federally recognized tribes on any Medicaid plan amendments.

While there is no current consensus as to how to answer the Medicaid question, more Federal funds for the program would help both those trying to balance the budget and those advocating for the health of our Native communities.

Last week, Senator Bingaman announced he would join in introducing legislation on Capitol Hill that would help New Mexico and all other states pay for the increased costs of providing health care.

Since 1934 the U.S. has officially recognized Columbus Day, though not without contention. To our north, the annual Columbus Day parade in Denver draws counter-protests each year, and South Dakota voted in 1989 to rename the holiday Native American Day.

Monday’s noon event was hosted by the UNM Native American Studies Indigenous Research Group (NASIRG), now in their 6th year celebrating Indigenous Day with events throughout the day on campus. NASIRG Co-chair Wyndsor Yazzie was pleased with the turnout, which included students from diverse backgrounds. “Our goal is to use this petition calling for the observance of Indigenous Day to our administration to bring together all student groups, to make this an issue of our idenity and values as a community, not just a Native [American] issue,” he stated.

“I think having the name of the holiday changed is bigger than people realize – it is a step toward a more honest way of telling the story of our country, of giving the First Peoples of this land a place in that story,” said Eudora Claw, a Navajo student who attended the event.

Of those in attendance was Jozi DeLeon, UNM vice president of equity and inclusion. “I told the students that I thought it was really the right idea to declare the celebration of Columbus Day as the celebration of Indigenous Day instead,” DeLeon said. “I think celebrating Columbus Day just doesn’t make sense, given the fact that American Indians have existed in this country long before Columbus ever landed on the shores of what is now the United States.”

While there was no protests at the noon event, and no one I spoke to was opposed to changing the holiday’s name and focus it is clear that many people disagree with replacing the current holiday with Indigenous Day. Response to the Monday article in the Daily Lobo about Indigenous Day was contentious, bordering on abrasive (See blog comments to UNM Daily Lobo article here). In 2007, the proposal to change Columbus Day to Indigenous Day came before the NM Legislature, spearheaded by the efforts of a UNM law student, Suzanne Martinez. The legislation stalled at that time, with a variety of reasons for opposition. Rep. Paul Bandy, R – San Juan, said at the time, “I don’t think it’s appropriate…it would be a slap in the face to the relatives of Columbus – Hispanics and Italians.”

At the event, NASIRG leaders also stated their plan to re-approach the issue of Indigenous Day at the state level, with a goal to pass legislation in the near future.

UNM community members in conversation after Tuesday's Community Coalition for Healthcare Access meeting adjourned (Photo by Anthony Fleg)

ALBUQUERQUE — In a simple room at East Central Ministries, using a bed-sheet as a makeshift screen, the Community Coalition for Healthcare Access (CCHA) held a public discussion Tuesday night regarding changes they feel University of New Mexico Hospitals need to make to improve access to care.

“As a coalition and community, we are not asking for a free ride. We are asking for fair prices, access to care, high quality services, and an end to medical debt,” began CCHA coordinator Carol Anda.

Community members, health professionals and elected officials voiced concerns over UNM’s recent statement that it will not allow undocumented residents of Bernalillo County to register for UNM Care, its safety-net insurance program for the indigent. Prior to this, CCHA leaders said that UNM officials had left the door open regarding coverage of this population, with the coalition and the Community Affairs Advisory Committee (CAAC) advocating for inclusion of all indigent residents of the county in the UNM Care program.

First-term state Rep. Eleanor Chavez, an Albuquerque Democrat, reminded the group that “UNM Hospitals forget that it is a public hospital, that its mission is to serve the residents of this county regardless of their ability to pay, regardless of their citizenship status.”

Chavez, who has been a part of CCHA since its inception eight years ago, pointed out the urgency of the matter.

“UNM is the only option for many people, and instead fully accepting this mission, it seems that the hospital’s leadership wants to run UNM Hospitals as a business,” she said.

In the last week, both CCHA and CAAC have written letters to the UNM Board of Regents expressing their concerns that their recommendations for change are not being heard by the hospital’s CEO Steve McKernan and the vice president for the UNM Health Sciences Center, Paul Roth.

The CAAC has requested a meeting with the regents, while CCHA is asking that barriers to service at the university hospitals be removed.

CAAC, a committee formed in 2005 to serve as an adviser to the leadership at the UNM Health Sciences Center, is a liaison to the larger community, bringing concerns of citizens and grassroots groups like CCHA to the university’s attention. CAAC’s letter on August 28 to Raymond Sanchez, president of the Board of Regents, expresses the group’s current discontent:

We feel that the wishes of the community constituents we represent have not been given an adequate hearing, and have been denied without appropriate response.

In addition to the issue of the undocumented, both CCHA and CAAC are concerned about the large number of UNM patients being sent to collections, the threat of “up-front” payments being proposed by the hospital, and the lack of attention given to the university’s obligations to Native American patients.

The latter stems from a 1952 contract that allowed UNM to build a hospital on pueblo land in exchange for guaranteed services to Native Americans.

Alma Olivas, a community member who sits on CAAC and who also helps lead CCHA, expressed frustration with the process of negotiating with UNM.

“It has been eight years since the coalition has been negotiating, and we are still on the same page. Our message is very simple — health care is a right and must be accessible to all. Every program that a public hospital offers should be open to all residents who pay taxes toward the hospital,” Olivas said.

Family medicine resident physician Jesse Barnes can see the effects of turning people away quite clearly.

“Earlier today, I saw a patient with newly diagnosed diabetes, and even though the patient has been living and working in this county for seven years, paying taxes that go toward UNM Care and the other programs of the hospital, she cannot get UNM Care,” Barnes said. He added, “The options I have in treating her diabetes are quite limited, and it is a struggle to keep patients like this from severe, very much preventable complications of their illnesses.”

UNM Hospitals has not responded publicly to the CAAC or CCHA letters, but is expected to do so before the Board of Regents meets on Sept. 29 at UNM’s Family Practice Clinic.

Meanwhile, Bernalillo County and UNM continues to maintain emergency funds for undocumented residents with serious and life-threatening acute conditions, but nothing beyond that.

Photo by Napoléon et la bêtise/Flickr

ALBUQUERQUE — Forty-five years after the 1964 release of the Surgeon’s General Report on Smoking and Health that linked smoking to lung cancer, this week’s signing of the Family Smoking Prevention and Tobacco Control Act marks another milestone in the time line of commercial tobacco in the United States.

On Monday, President Obama signed the law, which will  allow the Food and Drug Administration (FDA) to reduce nicotine in tobacco products, ban candy flavorings and block labels such “low tar” and “light.”

The law does not let the FDA ban nicotine or tobacco outright, but the agency will be able to regulate what goes into tobacco products, make public the ingredients and prohibit some marketing campaigns, especially those geared toward children.

The bill is not without controversy, however, including in New Mexico, where smoking remains a primary public health concern. An estimated 40,000 New Mexicans are living with serious tobacco-related illnesses, including emphysema, lung cancer and cardiovascular problems.

Some have pointed to Philip Morris USA’s endorsement of the bill as a sign that it is too friendly toward the companies that sell commercial tobacco. Some analysts argue that Philip Morris, the largest tobacco company in the United States, was looking to solidify its market share by supporting the bill.

Following trends across the nation, today’s smokers are more likely to be poor and to have lower educational status, in part due to the disproportionate advertising by the tobacco industry among such communities. This has led to efforts such as STOMP — Stop Tobacco on My People — a statewide network dedicated to eliminating the health inequities related to smoking.

Dr. Dona Upson, a pulmonologist in Albuquerque and chair of the American Lung Association of New Mexico, is guardedly optimistic toward the new law.

“I do think this is a good step toward decreasing tobacco use and toward decreasing marketing of tobacco to youth,” Upson told NMI, noting that the primary goal of the tobacco industry is to get new, young people addicted.

She noted that there is controversy over menthol being permitted in the new law. This is a flavoring put into cigarettes that make them easier to tolerate, an attribute that is especially important to lure in new smokers. Mentholated cigarettes represent 25 percent of the cigarette market, and are smoked more by African Americans. According to the American Lung Association, 67 percent of African American smokers smoke menthol cigarettes, compared to 16 percent of white smokers. The exclusion of a ban on menthol in the law has drawn criticism from anti-tobacco organizers and educators in minority communities, with some organizations withdrawing their support for the bill.

Upson said she would have preferred that the bill banning menthol flavoring but thinks such a provision would have killed the bill, since these cigarettes represent a large part of the market.

Natalie Thomas, a member of Laguna Pueblo and the co-facilitator of the Southwest Tribal Tobacco Coalition, has a different perspective on the issue.

Thomas’ tribe, along with most American Indian tribes, hold tobacco as a sacred part of life and culture.

“We see how our images are misused to sell commercial tobacco, often sending signals that this is connected to ceremonial uses of tobacco that are thousands of years old.”

Natalie and others are educating local tribes on the traditional uses and importance of tobacco as a way to prevent smoking among youth and to encourage smoking cessation. For instance, a current campaign called “Breathe tradition, not addiction” looks to re-connect Native youth with the ceremonial, medicinal, and traditional uses of the various types of  traditional tobacco, which unlike the Nicotiana tabacum  used in commercial tobacco, range from sage to lavender.

Such efforts provide education about the harmful effects of smoking and commercial tobacco. “For Native people, the issue is not to get rid of tobacco, but to regain a sense of how it is to be used,” Thomas said.

She is skeptical that the new law will have much influence on tribes like hers.

“Looking at how the ban on smoking in public places in New Mexico excluded Native nations in the name of protecting our sovereignty, under the influence of heavy lobbying from casinos and the prospect of gaining tax revenue off tobacco products sold on tribal land, I am worried that my people will never see the positive effects of this law,” she added.

Furthermore, she has concerns that this law will over-burden the FDA and may give an inside path for tobacco companies to get ingredients approved for their products without adequate health data.

Dr. Terry Gerace is an epidemiologist who has devoted his career to creating and running the Toxic Tobacco Law Coalition, a national organization to end the sale of tobacco products in the U.S. while still allowing adults to import commercial tobacco from abroad.

“It is a red flag to all of us when Phillip Morris, the nation’s wealthiest tobacco company supports the legislation,” says  Gerace. “They are certainly not going to support something that will hurt their long-term profitability.”

Gerace’s criticism of the bill revolves around some provisions in which the role of industry and government are blurred.

“It is absolutely unprecedented for industry representatives to serve as advisors for an FDA panel, for industry to fund the national office meant to regulate that same industry (in this case, the Federal Office on Tobacco that will be created) and likewise ethically troublesome that this law will now legitimize the all-American image the tobacco industry wants to create, since they will be part of the government,” he said.

It remains to be seen how effectively the Family Smoking Prevention and Tobacco Control Act achieves its goal of reducing the number of smokers and the amount smoking-related sicknesses and premature deaths in the United States.

For now, local critics and supporters alike will have to wait until the smoke clears, see how well the act is funded, and hope that this new law of the land can do all it is promised to do.

The Obama administration came out with strong language suggesting that the president wants to see a health care bill in place by this summer in which government plays a large role to ensure that every American has health coverage.

The coming struggle over health care reform will bring to the forefront the seemingly age-old battle lines of government versus market-oriented solutions, but it’s a struggle that now takes place in a new climate compared with earlier efforts.

Surprisingly, the new climate is not necessarily due to the growing ranks of the uninsured, nor is it the result of the latest figures about just how much of our gross domestic product is now spent on health care.

Today, many symbols of free-market capitalism, including leading banks and car companies, are now partly owned by the U.S. government, and that sets up a different landscape for the debate on health care.

Specifically, there’s a sense that government will and must play a larger role in the delivery and financing of health care. Much less pronounced are those scary words (to some) like “socialized medicine” from critics as Obama wrote to Congress that now was the time to develop what he calls a “public health insurance option” to compete with private insurance companies.

We did not hear cries to keep the government out, but rather citizens and politicians alike listening quietly, even curiously, to what such a change in the foundation of health care in this country might look like.

No wonder unions and workers are worried when we start talking about doing away with tax incentives for companies to provide health insurance. No wonder hospitals, insurance and pharmaceutical companies are shaking when they hear that their profits may be determined by more than just the free market. No wonder health care providers and patients are unsure of what this means for them.

But after a moment of pause, this is not unfamiliar territory.

After all, we have already faced the frightening question: Government-aided banking or no banking at all? And another: Government-assisted auto industry or no more Detroit?

It makes sense then that we are willing to listen to a new approach for health care, from the halls of Congress to parades in Albuquerque and pubs in Alamogordo.

And remember that this is not suggesting as radical a change as it might seem. Estimates suggest that in our current health care system up to 60 percent of funds spent on health care are public funds, with that percentage continuing to rise as Medicare and Medicaid costs rise and state safety-net programs like UNM Care, SCHIP and SCI expand to meet the growing need.

What is notable about last week’s movement on health care reform — and even the president’s speech to the American Medical Association earlier today — is that the Obama administration has set down novel ground-rules for this year’s debate. His message is clear — those interested in working on a proposal for health care reform that involves a public health insurance option overseen by the federal government should let their voices be heard.

And until a contingent stronger than the president’s rewrites the rules, this will be the framework for discussion on the issue of health care reform in the coming months.

For New Mexicans, maybe all of this is good news. Despite attempts to change our state’s ailing health care woes — including the nation’s highest percentage of uninsured — the New Mexico Legislature has yet to enact any major pieces of health care reform legislation.

So, as the season begins, expect lots of drama, a few fights, and hopefully a more sane, more affordable, more just health care system for patients and providers when the dust finally settles.

Anthony Fleg, a regular NMI contributor, is a family medicine resident physician at the University of New Mexico and a coordinator for the Native Health Initiative.

Looking toward Mt. Taylor (Photo by grace tee/Flickr)

One month after being placed on the National Trust for Historic Preservation’s most endangered historic places list, New Mexico’s majestic Mt. Taylor looks to have a new lease on life.

This past Friday, the New Mexico Department of Cultural Affairs Cultural Properties Review Committee (CPRC) voted unanimously to give Mt. Taylor temporary Traditional Cultural Property (TCP) status. Once designated a TCP, a site is protected from new development.

The decision pitted uranium mining interests against local tribal nations that have considered the mountain a sacred site for millennia, and the new designation was seen by supporters as a confirmation of Mt. Taylor’s endangerment.

“I would like to thank the tribes for bringing the nomination forward, for sharing their closely held spiritual beliefs and making all of us more aware of the importance of Mount Taylor,” CPRC Chairman Alan “Mac” Watson said in a statement.

“In the same regard,” Watson continued, “the private property owners and others with rights to Mount Taylor who expressed their concerns deserve thanks for helping us achieve a balance that lets this committee help preserve the varied — and sometimes perceived as conflicting — interests of all the parties involved.”

Mt. Taylor is well known to most New Mexicans, situated in between Albuquerque and Gallup, with its 12,000-foot snow-capped peak visible for miles. Kaweshtima, as it is known to the people of neighboring Acoma Pueblo, is revered by more than 30 tribal nations as a sacred and ceremonial site.

Malcolm Bowekaty, former Zuni Pueblo governor and a associate director of the Sacred Alliance for Grassroots Equality (SAGE) council, describes Mt. Taylor in a recent interview with NMI as “a place that connects us to the spirit world. It is a source of life for Native people, a place where we go to gather materials for our ceremonies.”

But the threat to Mt. Taylor’s existence as an undisturbed sacred site is jeopardized by its value to another interest — uranium mining companies.

One of the richest known reserves of uranium ore in the United States, known as the Grants Uranium Belt, lies within the mountain, having been explored in mining booms during the 1950s and 1970s. As the prices for uranium have soared in the last decade, proposals for mining on Mt. Taylor have skyrocketed.

Bowekaty understands the arguments on both sides but objects to outsiders wanting to profit off Native land while excluding tribes from the process.

“These business interests never approach our Native people, asking what we feel about projects they are planning. And, to make it worse, we are often left out of the political process that makes final decisions about the future of our sacred sites. At least the latter we can change. We have to become involved in the political process in order to protect Mt. Taylor and our other ceremonial lands.”

Weighing both the spiritual and commercial value of Mt. Taylor is an issue that is not foreign to the southwest. In the recent years, construction plans in and around the Petroglyph Natural Monument, located on Albuquerque’s west side, and Flagstaff Arizona’s San Francisco Peaks, have pitted sacred and ceremonial values against commercial value of the sites to real estate developers and ski resort owners, respectively.

Among the historical concerns are the multitude of laws that largely protected recent commercial interests over the claims of cultural importance made by Native Americans.

Over a century ago, when Native peoples were not considered American citizens, the 1872 Mining Law was created, permitting mining regardless of its impact on cultural and natural resources.

Since then, laws have begun to move in the direction of recognizing the value of sacred sites from the perspective of tribes and as culturally important landmarks for America, including a resolution passed by the New Mexico Legislature earlier this year — HJM 50: Federal Protection of Native American Sites.

But there are other concerns with re-opening uranium mines of Mt. Taylor. In the times of the previous uranium mining booms at this site, the full health and environmental effects of such projects were not appreciated. Today, we know from the former workers and communities around such mines that exposure to uranium is associated with cancer and damage to the kidneys.

From an environmental vantage point, mines threaten local water sources, which in the case of Mt. Taylor includes Rio San Jose, the primary water source and another sacred element for Acoma Pueblo. The vast amount of waste from the mine, along the inevitable building of roads and infrastructure to support the mine, will also endanger the local environment.

“Mount Taylor is a significant part of the cultural history of the Acoma people and many other Native American tribes,” said Richard Moe, president of the National Trust for Historic Preservation. “We can’t allow an antiquated mining law — one that has no merit today — to forever scar a place that has tremendous historical and cultural significance to thousands of Americans.”

Will the decision by the CPRC to designate Mt. Taylor as a Traditional Cultural Property set a precedent for how New Mexico sees the sacred lands within our midst? It is hard to say at this point, but what is clear is the importance of the state in arbitrating such matters, which are sure to continue.

And for the moment, we can all have confidence, whether we view Mt. Taylor as a sacred site or a beautiful New Mexico landmark, that with Friday’s vote it has passed one hurdle toward protection and preservation.

If there is one thing I love about America, it is the Department of Homeland Security. I love hearing about colors I never knew existed each time I go to the airport, pretending to know the difference between “level fusia” and “level lemon-lime.” I love knowing that these Homeland Security experts are taping me everywhere I go to make sure I am not a terrorist, ’cause I have always been photogenic.

However, the small way that I differ from this department and its current philosophy is the way in which we achieve this meritorious goal of security. Last night, I envisioned myself as the leader of the Department of Homeland Security, making a mid-term speech to my team…

Good afternoon fellow leaders of Homeland Security, and thanks for attending this meeting in your uniforms. Sgt. Pguyen and Pvt. Lucero, I must say that you are wearing the red noses particularly well today! If anyone needs a spare clown suit, please feel free to contact Mable, our 78 year old “uniform organizer” and local hospital volunteer.

Before I start the meeting, I will just remind you that if the jacuzzi water gets too hot for you at anytime, please let me know and we can move the meeting to a new location, like that sandbox behind you.

Okay, down to business. I am happy to report that our beloved United States And world are safer now than when we began our work 18 months ago. Financially, I think our operating budget of $18,000 annually is proving to be a little hard to spend, especially with the reduced prices worldwide for juggling balls, slinkies and pink-colored wigs.

Going campaign by campaign, we will start with “Operation Laughter in Afghanistan.” As you will recall, our president directed us to follow the withdraw of troops from Afghanistan and Iraq by going in mass to the places we had previously demolished in those dark, misguided times of the past where we thought that inflicting violence was the way to protect our country. We rolled up our sleeves are started working to rebuild these cities complemented by our nightly comedy shows.

I think our strategic formation as we approached each town was an important part of our success, and of all people, it seemed like Lt. Quiones was the most effective person to be at the top of our 3-level human pyramid, in terms of the laughter we received when reaching the town.

I know we were worried about the land mines we would encounter, those stone-faced older men who refuse to laugh even at our ridiculous skits about how badly Americans sound when they try to speak Arabic, but it seemed like this was actually a false premise, a kind-of… how would you say it… weapons of mass destruction that were not really there at all!!!! (jacuzzi erupts in laughter).

Our second campaign in Cuba, “Campaign Warm War (of laughing clowns)”where we changed focus to put more emphasis on magic tricks, increasing our arsenal to include pulling rabbits out of hats, having handkerchiefs disappear, and the ole’ “Who let one out” skit were a huge part of our military success.

Now, I will say in hindsight, that our loss in the Battle of West Havana, is due to some bad planning on my part. The funeral for one of the community’s elders made the area’s men much less receptive to a bunch of clowns, bouncing on Pogo sticks down the narrow streets, shouting amor para todos, nuestros hermanos y hermanas cubanas (love for all, our Cuban brothers and sisters.)

However, even though our yellow military handbooks (Clowning for Dummies) say that those you have lost in battle are gone forever, I do remember that after this incident, crying obnoxiously loud to poke fun at the American stereotype of being completely culturally inappropriate in foreign lands, we did have same mourners, along with hundreds of kids come over and laugh hysterically with us into the night.

And then there was our meeting with good ole’ Fidel. Here, it was a planned “in and out” mission, knowing how busy he must be trying to feed his people in the midst of embargoes. I think our juggling of Cuban cigars to the music of Buena Vista Social Club was a good opening act, but I was amazed when he then responded with tears, describing how sad it is that our countries see the other as an enemy, to the citizen’s detriment, simply because we hold tight to past transgressions and 21st century McCarthyism.

We cried together, prayed a lot that night, and skipped home to prepare for the following day’s battle at the nearby women’s salon and taqueria.

(A collective nostalgic sigh passes around the jacuzzi.)

Finally, the Taiwan Surge, a very effective three-day campaign in a small land far away, somewhere in Europe as I remember from my school days. We cannot talk about our time in Taiwan without bringing up the gun fight out in their capital of Taipai. I think we all remember that tense moment, our troops lined up face to face with theirs. Who would fire first? Silence… more silence, and the BOOM! A large burst of water hit our front line, coming from all directions.

We tried to come back, but just as we started unloading the U.S. military’s top weapon, the 446.23 Water Blaster (by Toys R’ Us, made in Taiwan) they started launching their military style water balloons.

Yes, we lost quite a few men in that one, mostly due to slipping on the wet, soppy ground. Fortunately for our men, the Taiwanese who dragged off our men were not taking P.O.Ws but instead were rushing the wounded to the nearest hospital. Because Taiwan, a country musch less wealthy than our own, provides universal health care, our comrades scraps and cuts were offset by the fact that their medical bills were taken care of Taiwan’s government.

In any case, from our failures we learn, and next time a similar situation comes our way, we will make our opponent is the one soaking wet at the end of the day.

(Gasp of disbelief spreads clockwise around the jacuzzi.)

I will simply say it is a pleasure working all of you to protect our country, one smile and laugh at a time. I know that some of the military higher-ups are upset to see their budgets dropping with former
“enemies” now looking to work on cultural exchanges, sitting for tea, and collaborating to begin a UN/ WHO/ WTO/OPEC movement “Laughing as One.”

There is no one interested in fighting us, and the prospects for future wars is looking bleaker and bleaker. However, it is always gratifying to hear from the thousands of teachers calling to say how great it is that we have begun to fund our public school systems, the environmentalists thanking us for helping to bring the electric car to all U.S households, negating the oil companies power (which is actually quite small, now that we have no wars), and those calling to thank us for allowing funds to go toward addressing inequities in our society.

And as we break for lunch in downtown where we will try out my newest weapon, the Free Hugs signs, on the business executives, I will give you a joke to chuckle to, “Imagine a country who thinks that its national security can be won by inflicting violence on all of humanity who are cannot claim American citizenship!”

(Raucous laughter and splashing of water explodes amidst the bubbling water.)

Anthony Fleg, a regular NMI contributor, is a family medicine resident physician at the University of New Mexico.

But even before the tabloid feeding frenzy over this celebrity incident, local high school students decided to take a stand against domestic violence (DV) because they realized the detrimental effects it has on students and larger society.

At 6 p.m. on Saturday, the Albuquerque High School (AHS) Student Senate will host a charity event at Old Albuquerque High School. “Students Helping Students: Domestic Violence and Its Impact on Student Achievement” will include student poetry about DV, proclamations from Gov. Bill Richardson and the Albuquerque’s City Council, and recognition of local individuals who work with DV victims.

Marissa Chacon, a senior at AHS who plans to attend the University of New Mexico, said the Student Senate thought it was time to bring this issue into the open.

“From my experience, a lot of people deal with this, but it is hidden behind closed doors,” she said. “This is a way to bring awareness, education and support for those victims of DV.” Chacon and her classmates hope to raise $10,000 at the event, with $8,500 going toward senior scholarships and $1,500 going to ENLACE Comunitario, a local nonprofit whose mission is to eliminate domestic violence and advance immigrant rights.

ENLACE’s outreach associate, Blanca Pedigo, said that her organization provides previously unavailable DV services to the local Spanish-speaking population and serves 700 families each year. She said that her organization’s clients face many difficult decisions regarding whether to stay with an abusive partner or not, including issues of financial and emotional stability for others in the family.

“But why do we focus on ‘Why did she stay?’ instead of asking ‘Why did he abuse her?’” she asked, pointing out that the current magazine headlines choose to focus on whether Rihanna will stay with her partner instead of asking why Chris Brown decided to attack her.

The answer to this question returned us to the issue of DV being an issue that is not talked about in public, not openly addressed often enough. However, there are promising tides of change to change that.

In the last few years, New Mexico has developed a Domestic Violence Homicide Review Team under state statute. This group’s recently released report of the 21 DV homicides statewide in 2008 illustrates that DV does not end with moving away from the abuser; 75 percent of DV homicide victims were separated from their offender at the time of death.

In addition to efforts to study DV, there is also a need for more men to stand up as educators, as advocates that DV is not acceptable.

“Working to end family violence one man at a time,” the mantra of the national organization Men’s Network Against Domestic Violence, is an example of where this is beginning to happen.

For those who cannot attend Saturday’s event but who wish to get involved in DV advocacy, the New Mexico Coalition Against Domestic Violence welcomes you to get in touch with them (email: info@nmcadv.org, ph# 505-246-9240).

And on a smaller level, Pedigo reminds us, “If you know someone in a DV situation, listen to them. Let them know that they are not alone, and work to empower them to seek the help they need.”

Anthony Fleg, a regular NMI contributor, is a family medicine resident physician at the University of New Mexico and a coordinator for the Native Health Initiative.

For the last year, polls have reported consistently that health care is a priority for New Mexicans and their fellow citizens around the United States.

In fact, health care reform was important enough to merit a special legislative session last summer, resulting in a stalemate over Gov. Bill Richardson’s proposals. Everyone agrees that our over-priced, under-producing, and fragmented health care system is in need of serious attention.

Yet with about two weeks left in the 2009 legislative session at the Roundhouse, there has been no significant action toward reform.

Why?

First, a few basic principles about the state of health care in New Mexico. Our state shares the dubious distinction with Texas as having the highest percentage of uninsured residents — roughly one in four. Up to an additional quarter of the population is what is known as “underinsured,” meaning that their coverage is fragile, prone to lapses, or doesn’t adequately cover basic medical services — or a combination of these shortcomings all at the same time.

A recent survey shows that only six of 10 New Mexican workers are covered by employer-sponsored health care, the lowest percentage among all states.

So, the answer is simple, right? Just insure all of New Mexicans.

This is where political and ideological opinions differ greatly, making it difficult to achieve consensus needed for reform. The role of the insurance companies is at the center of the debate, with some advocating for the removal of for-profit private insurers as the foundation for health insurance.

Dr. Bruce Trigg, a pediatrician and chair of the Network of Health Professionals for a National Health Program, feels strongly that only a single-payer, Medicare-for-all approach is going to cover all citizens while containing costs. “We see what greed did in the stock market, but that same greed is at work every day in health care,” Trigg argues.

In this year’s legislative session, two major proposals to overhaul the health care system in our state have been presented: the Health Security Act and the Health Authority. Neither would eliminate insurance companies, but the proposals would and could, respectively, change the playing field with regard to health care insurance.

The Health Security Act, a product of the Health Security for New Mexicans Campaign, would allow New Mexico to set up a cooperative-style health plan covering 1.6 million of New Mexico’s 2 million residents (excluding those served by federal health care, such as those in the military), allowing private insurance to be sold only as supplemental coverage.

“Our bill has broad-based public support, including businesses and many cities and counties,” claims Dana Millen, the Education and Outreach Coordinator for the Campaign. “It is a paradigm shift that will get us to affordable, universal health care by putting all of us into one risk pool.”

Currently, the bill’s sponsor, Sen. Carlos Cisneros, a Questa Democrat, is waiting to bring it before Senate’s Finance Committee. It has already passed by a 5-3 margin in the Senate Public Affairs Committee.

In the past weeks, it had an unsuccessful run through the House where it attracted packed crowds for its committee hearings. The bill was tabled in the Business and Industry Committee.

Then there is the Health Care Authority Act, a bill that would create an independent authority of health care professionals, consumer advocates, business and policy experts who would be charged with coming up with a “comprehensive action plan for accessible and affordable health care for all people living in New Mexico.”

Roxane Spruce Bly of Health Action New Mexico, one of the organizations supporting this bill, feels that this bill works to limit the influence of the special interest groups financially invested in the status quo and allows time to think through the best plan for the state. This bill, sponsored by state Rep. Mimi Stewart, an Albuquerque Democrat, passed the Business and Industry Committee this past week by a vote of 11-0. It now waits to be considered by the House Appropriations and Finance Committee.

Gov. Richardson, meanwhile, has a health care agenda encompassed in 10 bills, one of which “seeks to move forward on decreasing the number of uninsured New Mexicans and addressing cost, quality and access issues,” according to a press release released Jan. 26 by the governor’s office outlining his health agenda for this year’s session.

“This package of health care reform legislation fits in this year’s agenda of creating jobs and balancing a tight budget. This is the right time to tackle these issues to help secure affordable health coverage and quality healthcare for all New Mexicans,” the Democratic governor is quoted as saying.

Lots of ideas, lots of talk, but again, why are we not seeing more urgency and at least something resembling badly needed reforms in this realm from Santa Fe?

Ask five legislators and you will get five different answers. Some are waiting from action at the federal level. Others are simply hesitant or resistant to make large changes in a system that they feel works pretty well, most of the time. And then there is the excuse of the year — bad timing — given the state’s severe budget woes.

Having spent much of the last weeks at the Roundhouse, it is clear to me that while this is a golden opportunity to enact the large-scale reform that is needed to heal a health care system currently on life support, too many factions and too little consensus among the coalitions and politicians involved mean the issue is unlikely to get anywhere, anytime soon.

Meanwhile, the Roundhouse chatter among heath care reform activists is that the Richardson administration seems intent on blocking all reform efforts not coming from within its ranks.

My prognosis: Until a more cooperative spirit takes hold, the uninsured and underinsured, along with the broken system that tries to support them, will hobble along, hoping to survive long enough to see meaningful health care reform come to be.

Anthony Fleg, a regular NMI contributor, is a family medicine resident physician at the University of New Mexico and a coordinator for the Native Health Initiative.

In four books, the author and diabetes educator weaves together stories of eagles, coyotes, spinning tales of a return to traditional ways of living that bring about wellness and health. Quotes from the books, along with vibrant watercolor paintings by artists Patrick Rolo of the Bad River Band of Ojibwe, and Lisa Fifield of Oneida — both of Wisconsin — make up an impressive exhibit that combines art, health and storytelling at the Albuquerque-based Indian Pueblo Cultural Center (IPCC).

The exhibit — Through the Eyes of the Eagle (pdf) — opened on Saturday.

With a well-attended opening dinner that included speakers from health, policy and tribal government backgrounds, the opening reception began what promises to be an exciting four-month display of the exhibit.

Amy Johnson, IPCC curator, looking at the exhibit she worked so hard to embellish in time for the opening, remarked that the powerful thing about Perez’s work is its encouraging tone.

“She finds a way to present healthy living in a positive way, showing youth not what they are doing wrong, but instead guiding them in a positive way,” Johnson told NMI.

Sadly, Perez had a death in her family and could not attend the reception. Her daughter, Felicia Candalario attended and spoke on her behalf. “This is such a special day for mom –- she never thought this was going to get this big, but I am proud of her,” Candalario said. “She put her heart and soul into this.”

Ron Solimon, CEO and president of the museum, said this exhibit, a mixture of art, education, culture and heath, reminds viewers of the work that still needs to be done to reverse the frightening trends of children with habits and medical conditions that threaten their future quality of life.

“I hope to see children and their families lining up to see this, because once they are pulled in by the stories and colors, they will absorb the messages of healing through culture that is so strongly evident here.”

The exhibit runs from Jan. 31 to May 25 at the IPCC’s Avanyu Gallery. Admission to “Through the Eyes of the Eagle” is included with admission to the museum. There are many health-related events for children happening in conjunction with the exhibit –- see the IPCC Web site for more details.

Anthony Fleg is a family medicine resident physician at the University of New Mexico and a coordinator for the Native Health Initiative.