Back to Basics

Under the title of Public Health & Workforce Development are a number of grants, scholarships and other programs, providing training, services and a whole new array of studies relating to health care – a lot of money being spent to support the expansion of government, special interests, illegal immigrants and labor unions, but little to help solve the health care issues.

The first expansion is the establishment of the Public Health Investment Fund, which requires deposits from the revenues of the Treasury in the amount of $88,700,000,000 over 10 years. This money is authorized to be appropriated by the Committee on Appropriations of the House and Senate for carrying out the activities under the designated public health provisions. These areas include Community Health Centers, National Health Service Corps Program, National Health Service Corps Scholarship and Loan Repayment Programs, Primary Care Loan Funds, Primary Care Education Programs, Nursing Workforce Development, The National Center for Health Statistics and the Agency For Healthcare Research and Quality.

To make these programs even more appealing is the stipulation that “Amounts appropriated under this section, and outlays flowing from such appropriations, shall not be taken into account for purposes of any budget enforcement procedures including allocations under section 302(a) and (b) of the Balanced Budget and Emergency Deficit Control Act and budget solutions for fiscal years during which appropriations are made from the fund.” More spending without any concern for balancing the budget or controlling the country’s deficit. We don’t have it, but let’s spend it!

The first program – Community Health Centers – will obtain increased funding in the amount of $38,800,000,000.

The National Health Service Corps is being amended allowing the Secretary to issue waivers to individuals who enter into a contract for obligated service to pay for their education. It further raises the loan repayment amount from $35,000 to $50,000 and will be adjusted thereafter to reflect inflation. Additional appropriated funds for this program are $796,000,000 over the next 10 years. Additional funding is authorized in the amount of $3,171,000,000 over 10 years to cover the National Health Corps Scholarship and Loan Repayment Programs.

The Frontline Health Providers Loan Repayment Program will be established to address unmet health care needs in certain areas, populations, or facilities as designated by the Secretary. Individuals participating in this program must agree to serve for a period of 2 years in a health professional needs area specified in the program. This program has a clause that if there are an insufficient number of applicants for the program, then all excess funds from the program will be transferred to the National Health Service Corps to recruit more people to take advantage of this fund.

The Secretary shall establish a primary care training and capacity building program consisting of grants and contracts to plan, develop, operate or participate in accredited professional training in the field of family medicine, general internal medicine, general pediatrics or geriatrics. Funds for this program are from the Public Health Investment Fund in the amount of $3,023,000,000 for 10 years and will include the following:

• Capacity Building in Primary Care – grants to specialties of family medicine, general internal medicine, general pediatrics or geriatrics, with preference given to entities that train individuals who are from underrepresented minority groups or disadvantaged backgrounds.
• Training of Medical Residents in Community-Based Setting – a program established for the training of medical residents in community-based settings, with preferences given to entities that support teaching programs addressing the health care needs of vulnerable populations or are a Federally qualified health center or rural health clinic, as well as preference to those training individuals from underrepresented minority groups or disadvantaged background.

• Training for General, Pediatric or Public Health Dentists and Dental Hygienists – grants and contracts to plan, develop, operate or participate in an accredited professional training program or oral health professionals, with preference given to individuals who are from underrepresented minority groups or disadvantaged backgrounds.

Grants for Health Professionals Education – Advanced Education Nursing Grants is being amended, including increases in dollar amounts for the Nurse Faculty Loan Program. Funding for this program is $1, 450,000,000 over 10 years.

The Public Health Workforce Corps is being amended and expanded by the following: Creating the Public Health Workforce Scholarship Program, Public Health Workforce Loan Repayment Program, Enhancing the Public Health Workforce, and Preventive Medicine and Public Health Training Grant Program. Appropriations for these programs total $642,000,000 over 10 years. The Enhancing the Public Health Workforce even includes provisions for veterinary medicine! I’m not sure how veterinarians will provide quality health care to people or decrease health care costs, but it’s nice to see even our animals will be included in the grant programs.

Under the Subtitle “Adapting Workforce to Evolving Health System Needs” there are a number of grants and programs including:

• Health Professionals Training for Diversity, which includes scholarships for disadvantaged students, loan repayments and fellowships regarding faculty positions, and educational assistant in health professions regarding individuals from disadvantaged background.

• The Nursing Workforce Diversity Grants is being amended and adding the Coordination of Diversity and Cultural Competency Programs.

• The Secretary will establish a cultural and linguistic competency training program for health care professionals, including nurses, consisting of grants and contracts to develop and implement models of cultural and linguistic competency training. Preference will be given to entities that address cultural and linguistic needs of the population and health disparities, and placing health professionals in regions experiencing significant changes in the cultural and linguistic demographics of populations, including communities along the United States-Mexico border. Obviously this program will benefit all the illegal immigrants coming from Mexico to obtain free health care.

Appropriations for these programs total $1,138,000,000 over 10 years.

Grants and contracts are given to develop training programs to promote the delivery of health services through interdisciplinary and team-based models, with preferences given to entities that demonstrated training to the greatest number of health professionals who serve in underserved communities.

The debates over healthcare reform with regard to senior coverage is very disturbing. It is incomprehensible to even think there is debate over providing medical care based on an age vs. productivity model. To the younger generations who are not concerned about this topic, you just might want to take notice. You too will be the seniors and will be facing the same, if not worse, scenario. What may be of even more concern is that if the government can determine your medical care on this basis what might be next?

One has to acknowledge that as we age we generally require more medical care. That care costs money. However, the seniors you are trying to deprive of care have worked all their lives and have paid into a system that promised to take care of them after they retired. They didn’t have a choice in this system and they paid in, with the government taking more and more of their paycheck every year. They paid so their parents and grandparents would be cared for. They paid so they would receive care. Now their children, grandchildren and great-grandchildren are turning their backs on them! HOW DARE YOU!

Perhaps they should have been, or should now start being, as selfish as you are. Instead of putting money into a system that wants to now reject them, they should have been putting that money into their own personal medical accounts that could only be used for them. Instead of spending their money in this country so you can keep your jobs, they should be saving all they can so they can go elsewhere to get the medical treatments they need. Many already have the means to do just that, so if the democratic party bill passes you will soon be complaining that the only the “rich” can get care because they can pay for it somewhere else. That may be a true fact, but you wanted it that way!

Who decides what is no longer productive? Is it age alone, the amount or your income, or some other arbitrary meter? My parents are in their 70’s and are still working and contributing to society. In fact, my father has spent the last 3 years overseeing the building of their new church and he did it with NO compensation. Would you be willing to give up 3 years of your life to do charity work without receiving a dime? If he could have been paid he would have earned quite a respectable income for those 3 years.

Although I am currently not employed, I babysit my granddaughter so my daughter and work, that was my choice. Is that not contributing to the income pool? She is allowed to keep her hard-earned income rather than spending it all in daycare expenses. If she has to spend all her paycheck to cover daycare expenses then she drops out of the workforce further reducing the income pool and becomes part of the welfare pool, draining the system even more. I know many grandmothers who are watching grandchildren so their children can either finish school or work. Who is to say that these contributions make you “at risk” for receiving medical treatment?

Where does the income productivity factor end? The criminals currently serving lifetime sentences – they will never be a productive income source and are only a drain on the system – do we just instill the death penalty for all life sentences?

How about the people on disability? Because they are disabled they cannot contribute to the income chain and are draining the medical system because of care they might need. Do we deny them medical treatment too?

What about the children born with disabilities who will never be able to be productive citizens? Do we deny them medical care? What if YOU become disabled because of an auto crash or some other injury? If the incident would render you with a permanent disability that would keep you from continuing to be a productive citizen should you be denied treatment?

How long do you stay on unemployment before you are declared an unproductive individual and then are denied medical treatment?

The permanent congressmen that could be interpreted by many as not being productive citizens – can they be denied medical treatment too?