Transcript - July 6, 2007
BRANCACCIO: Welcome to NOW.
I've got a couple numbers for you to think about. The first? According to the Federal Government, 45 percent of all children in the United States get some form of public medical assistance. Sounds like a lot, right?
Now how about this one: there are about 9 million children in this country who are not covered by either public or private health care. That's a pretty big number as well...
Now there is a government health insurance program that's supposed to help those low income children, but it's running out of money. And the program is caught up in a battle between those who think the government insures too many children, and those who think it's not doing enough.
Senior correspondent Maria Hinojosa and producer Deborah Runcie have our report.
SMITH: Near, far, near, far, near far...
HINOJOSA: Amanda Smith is a real estate agent and single mother.
SMITH: You ready to go?
HINOJOSA: She lives in McDonough Georgia, which is about 40 minutes from the capital city of Atlanta.
SMITH: I've never asked for anything from the State, and now I am. And it's not there. And that's hard. It's kinda' hard to swallow.
HINOJOSA: With expenses including $110 a week for daycare, Amanda is struggling to make ends meet. She says she needs help paying for health insurance for her 16 month old daughter, Sarah Margaret.
SMITH: I certainly wanna take care of my own bills. But at the same time, when you know, that's why our government is there, to help out when you need it it's I don't want to be fed or taken care of for the rest of my life, but in a difficult time, that's why these programs are there.
HINOJOSA: With Amanda making roughly $24,000 a year, Sarah Margaret doesn't qualify for Medicaid—her mom makes too much money, but she does qualify for the state children's health insurance program, better known as S-CHIP.
TV COMMERCIAL: "If you're happy and you know it clap your hands..."
HINOJOSA: When the Federal Government created the program 10 years ago, covering children like Sarah Margaret is exactly what it had in mind. S-CHIP provides health insurance nationwide for low-income, working families that have children under the age of 19. But when Amanda went online to apply for Georgia's version of S-CHIP—Peachcare for Kids—Something unexpected happened.
SMITH: Closed enrollment. Yey! It says as of March 11th PeachCare for Kids is closed. During this time you will not be allowed to reinstate your children if their coverage is cancelled for any reason, such as failure to pay. This is when my heart sinks...or if you don't already have it, you're toast.
HINOJOSA: It turns out Peachcare hasn't been enrolling any new applicants. Georgia, along with 10 other states, is in need of more federal money for S-CHIP.
The shortage of funds has led to a political stalemate in Washington, which has left millions of low-income children nationwide uninsured and at risk.
SMITH: Just thinking 'bout her and how much more I would like to be able to do for her right now, and I wanna give my baby the very best of everything and I can't do that right now.
HINOJOSA: Under S-CHIP, Amanda's monthly premium would have been only $22 dollars a month for full coverage. Instead, she's paying $117 dollars a month for private coverage with limited benefits.
DR. BECKFORD: It's good to see you! Hi Paige, how are you?
HINOJOSA: Georgia pediatrician Avril Beckford says nationwide, some of the children who are being denied the financial support they need from S-CHIP, may end up paying with their lives.
DR. BECKFORD: Health insurance if you have a chronic condition, is clearly unaffordable. That would be a great impact to anyone. And we need to have systems in place that operate smoothly and efficiently to be able to immediately step up to the plate.
HINOJOSA: Sr. Beckford is talking about 14 year old Ashley Brewer. She has type one diabetes, which is the most serious form of the disease. It's not preventable, and it can't be cured. Dr. Beckford has been treating Ashley since she was four years old.
DR. BECKFORD: Do you always insert your Insulin SAT on your arm?
HINOJOSA: But now, Ashley and her mother Paige face another challenge. Just a couple of weeks before we met them, Paige Brewer's husband was laid off.
DR. BECKFORD: How are you doing as a person, how's the family doing?
BREWER: Well actually my husband just lost his job, and we went and applied for Medicaid...
HINOJOSA: Without the coverage his job provide, the family can't afford the expensive medical care their daughter needs to treat her diabetes.
DR. BECKFORD: There's enough to worry about when you have to prick your finger 14 times a day, than worrying about where the insulin is coming from.
HINOJOSA: The cost: $908 dollars a month for supplies alone.
DR. BECKFORD: So you wore it on the back of your prom dress?
ASHLEY BREWER: Yeah.
DR. BECKFORD: Beautiful!
HINOJOSA: The Brewers have applied for Medicaid. But there's a minimum waiting period of two months...and in the meantime, Ashley's life hangs in the balance.
DR. BECKFORD: If Ashley didn't have her insulin today, she wouldn't be with us tonight. She lives from hour to hour.
HINOJOSA: Normally, Peachcare would provide temporary coverage for Ashley's treatments. But because of the funding crisis, when the Brewers applied, they too were turned away.
So when they told you at—at PeachCare, "Sorry, the enrollment's closed."
BREWER: And I said, 'Well, what do we do in the meantime?' And she goes, 'Well, here's a book—list of churches that can help you with some food and some clothes.'
Well, I said, 'Well, but what about her medication? She's got di—the diabetes. Well, how are we gonna pay for it?' And she said, 'We're sorry. There's nothing we can do to help you.'
HINJOSA: And so when the politicians say the doors are closed...
BREWER: Then it makes me feel like they're tryin' to hold her back from becomin' somebody that she could possibly be. Sorry.
HINOJOSA: At this point, there isn't a single state or federal program that will help pay for Ashley's medicine. Georgia Governor Sonny Perdue, a Republican, says there's pain out there because the federal government is not fulfilling its obligation to pay its share of S-CHIP.
We met a young woman named Ashley who um has diabetes. Her father just lost his job. It will cost her $908 a month, literally, to survive. Um they don't have the money. And because of the fact that enrollment is frozen, right now, she can't get help. So what do you say to a young woman like Ashley?
GOVERNOR PERDUE: That's why she should call her Congress—members, and say; We want this resolved right now. Let me—let me really clear about this. Georgia stands ready, is ready. We're currently funding the federal portion now, as we've run out of money. We're doing our part and the federal part. We're doing all that we can. To blame us for freezing a part—where our federal partners are not fulfilling their obligation, is not right, and I won't accept that blame. We're doing our part. You tell her to call her Congressman.
HINOJOSA: And I'm sure if I called her and said; Listen, the Governor says you should call your member of Congress. She would say, "That's not gonna pay what I need to survive. So the next thing you would say to her would be?"
GOVERNOR PERDUE: We can do no more. We're doing the State's portion and the federal portion. For you to take an individual and wanna' cast blame on the State of Georgia, and me, and what would I do, and what would I offer her. I—I do take offense to that.
HINOJOSA: For ten years, S-CHIP has provided a safety net for low-income families. With strong bi-partisan support, the program now covers 6 million kids. But now a bloc in Congress—mainly Democrats—wants to expand coverage—for more children and higher income families—edging towards what some say is universal healthcare.
And that has created a political standoff in Washington.
NORWALK: I think the dividing line between the administration and others who would spend a lot more on S-CHIP first is, who do you cover? And our focus has been covering those low-income children, as S-CHIP was initially intended to do.
HINOJOSA: Leslie Norwalk is the acting administrator at The Centers for Medicare and Medicaid Services. She says that states themselves are responsible for the S-CHIP crisis, because they expanded the program to include people it never intended to—like adults.
NORWALK: If we're going to spend more money on S-CHIP than we do on other federal programs, then let's focus on what S-CHIP should focus on. That's kids, particularly kids who have lower incomes. Let's make sure that they get the insurance that they need. And that's exactly what we're intending to do here.
HINOJOSA: Georgia doesn't have any adults on the program, but fourteen other states do. The reasoning was that those states could reach more uninsured children if they enrolled their parents.
But now that over 670,000 adults are being covered by the state children's health insurance program, the Bush administration and its allies, like Georgia Republican Congressman Nathan Deal, are saying "enough."
You've been quoted as saying that, "Petty and not so petty dishonesties erode taxpayer's trust." What do you mean in regards to the SCHIP program?
CONGRESSMAN DEAL: Well, yes. States that try to manipulate the programs, you know about four states that insure more adults than they do children. That's not the purpose of this initial legislation. And we ought to—refocus it on children.
HINOJOSA: But there's another reason S-CHIP is in trouble. The administration is alarmed at what it says are a growing number of parents who are dropping more expensive, private coverage, for the lower costs and better benefits of S-CHIP.
In short, Republicans are worried that S-CHIP could be bad for the private medical insurance business. Congressman Deal says it's human nature that if omeone can get the government to pay for something, they will.
CONGRESSMAN DEAL: ...unfortunately, we see many people take the attitude that even though they don't qualify for taxpayer supported healthcare—they want to expand the debate to say, "Well, we should be provided with this." I think there's a degree or personal responsibility that cannot be overlooked in this—discussion.
HINOJOSA: Deal is co-sponsoring a bill for the future funding of S-CHIP, but he's asking for big changes: that no new adults are enrolled, and that the states cover the cost for adding any families making more than $41,000 a year.
CONGRESSMAN DEAL: One of the debates that is going to be going on in the reauthorization for this bill this year, is how high the poverty level should be set. You're going to find that it then becomes a way for the wealthier states to raise the level of poverty up to include more of their population because they get a higher percent of federal money than they would get under Medicaid. And then the poorer states are struggling to pay their part of Medicaid, having great difficulty, continuing to participate in the S-CHIP program.
HINOJOSA: The program's supporters argue that limiting enrollment to families making under $41,000 dollars a year, will punish low-income families living in states that have a high cost of living. Some even want to see that number doubled, but the administration says that with almost half of all American children now on some form of public medical assistance, the program needs to be scaled back, and only cover those it was originally intended for.
NORWALK: It is one way many are considering, 'Gee, this is how to do universal coverage,' and if you look at the very expensive costs—over double what we project it will cost to continue to fund S-CHIP over the next five years. You have to wonder what this program is really about. Is it really about the initial thought of covering low-income children?
HINOJOSA: The two sides are very far apart. While Democrats say it will cost sixty billion dollars just to maintain the program at current levels for another five years, the administration is proposing less than half that amount.
LESLIE NORWALK: We took a very hard look at Census Bureau Statistics, The CDC statistics on whose insured in this country, and what levels they are in terms of who's poor and so on.
HINOJOSA: But even as the administration attempts to shrink S-CHIP, the fact is there are nine and a half million children nationwide who aren't covered by any insurance at all. This is putting even more pressure on the states.
GOVERNOR PERDUE: It's not my prerogative as a Governor of a state to tell Congress how to do their business. I'm more interested that they do their business, and the federal government and Congress needs to come up with a reauthorization bill for the future.
HINOJOSA: That reauthorization bill isn't expected to be voted on anytime soon. If anything, the debate will only intensify as the September 30th deadline draws closer. No one knows how it will end. And in the meantime, enrollment in Peachcare Is still frozen.
So, essentially, you're saying if there's a kid who is frozen out of Peach Care because of where SCHIP stands right now, that child should turn to their community and hope that someone steps up to the plate and says, "We'll treat you for free because we're good people"?
CONGRESSMAN DEAL: (LAUGHTER) Well, that's certainly one of the choices that many communities are making, mine being one of them. But on a broader scale of that you have to say, "Well—you know, what are the responsibilities of the parents in those situations?"
BREWER: To me, it's not about which politician can get what medical bill signed. It's about Ashley's health and keeping her alive.
HINOJOSA: Georgia's department of health says it might be able to secure the money to unfreeze Peachcare in the next week, but for the Brewer family, and their doctor, all the posturing in Washington over the future of S-CHIP, just isn't as important as the immediate health care needs of children like Ashley.
DR. BECKFORD: When politicians are in meeting rooms and bureaucracy, bureaucrats are pushing pen and paper and saying comeback in a month and file your papers, they're missing point. This is about a person who has a pump with insulin that keeps her alive from hour to hour.
BREWER: To me, it, it gets me here because I know that it's not just my Ashley that has these problems and that can't afford it.
BRANCACCIO: For more on this story you can go to our website... PBS.ORG is the jumping off place for that.
I want you to meet a guy you've never heard of who's written a book some people are calling the "Black Harry Potter." Why the introduction? Because you'll thank me later. Also, the man has thought a lot about what to do about awful statistics that show that most kids grades 8-through-12 are not proficient at reading. Among African American students, just 13 percent make the grade. The author of "Marvelous World"—a book that got noticed first in the real world before getting noticed in the publishing world—is Troy Tompkins, pen name "Trow C-L-E."
Troy CLE thanks for doing this.
TROY CLE: Not a problem. Happy to be here.
BRANCACCIO: They're calling you and the work the Black Harry Potter. How do you describe it? I mean, Martian Chronicles? Narnia? It's a lot of things.
TROY CLE: Actually, the book has been called an enigma (LAUGHTER) because it's—it's obviously quote-unquote "urban" but at the same time it's—influenced by like say hip-hop that is as much as it's influenced by rock music. It's heavily action driven but it rests on a foundation of more classical literature.
BRANCACCIO: I mean Harry Potter is in this, I guess, Victorian English school out in the country. This is not.
TROY CLE: No, this is in East Orange, New Jersey. (LAUGHTER) where I was born and—and grew up and—and there aren't any like young adult fantasies that take place in such a location, so it's just a new approach.
Like I said, the book is an enigma, I'm an enigma too, by the way (LAUGHTER) because I grew up in East Orange.
My parents they had me be a classically trained pianist. I studied acting, you know. I went to prep school, right? So, my friends on the other hand were not such —not so fortunate. So, it's like I have a balance of being from East Orange, New Jersey and having the—educational and cultural background to say, you know what, I can meld both of these together so that we have a book that has some type of redeeming quality to it and at the same time, it's true to that kid who doesn't want to read who is from East Orange, New Jersey.
BRANCACCIO: Now, you self-published this before you got the big time publisher that you have now, right?
TROY CLE: Uh-huh (AFFIRM).
BRANCACCIO: Tell me about that.
TROY CLE: I used more or less the—independent hip-hop approach. You know, when you would put your own records out? I did that with the book. The book was sort of like my mix tape to generate buzz.
BRANCACCIO: In general the publishing industry is not doing particularly well right now. But with titles that have urban themes, African-American themes, that's actually a booming market right now.
TROY CLE: Yeah, because a lot of literature had kept individuals of color just—they weren't included. We're talking about a whole group—a whole race of people that was just basically left out of the genre to my knowledge—the young adult fantasy.
Some people think that the book is about good versus evil. It's not. It's—I won't—you know, divulge everything, but it's more so about the war that we are faced every day with, in ourselves. You know so the book is influenced in part by the philosophies of Emmanuel Kant and David Hume, which a lot of people don't expect. And one was about reason and one was about passion.
BRANCACCIO: A lot of moving parts in that narrative. It's pretty complex. Are you gonna get young readers to digest that?
TROY CLE: Yeah, there's on example of a nine year-old girl—my—friend's daughter, she called me up. She says, "Troy, I got your book. I loved it." And she totally understood about the passion versus reason, the whole elements of the book that. She said, "It's just like a video game."
BRANCACCIO: So, classic issue of low expectations, people who might say that this is—
TROY CLE: Yes.
BRANCACCIO: —this is—too complex for young readers.
TROY CLE: Exactly because why is this book too complex—you know?
BRANCACCIO: 'Cause you've had reviewers say that.
TROY CLE: I'm not directing this at the reviewers per se. I think that's part of the educational process'—shortcomings, low expectations. I specifically wrote this book to be challenging. So if they didn't read, it was going to be sink or swim with this book. And most kids are swimming with this book.
BRANCACCIO: How do we get more young people, teenagers in particular to get reading?
TROY CLE: Not all kids learn the same way. But, when you can take a visual aid that is on par with everything that they already just interface with that creates the intrigue and the interest to say, ok maybe I will pick up this book because it looks better than my video game.
BRANCACCIO: You also have a background in digital design—computer design. And when you meet with young people you don't just flash the book, do you? You—you took—
CLE: Oh, no, no, no. See, the thing is—is if the kid doesn't like to read, even if you were to stand in front of them and read and it's something that they really, really liked, sometimes that's just not enough.
BRANCACCIO: So, you show that on the screen?
TROY CLE: I show that on the screen. It's an animatic, which you get to before you do the full-blown, highly rendered version. Kids, you know, they lose their minds when they see it and they don't expect me to show that to them.
BRANCACCIO: Some people watching this are saying, "Well, it's a shame he has to go to that level of extremes to—to sell the idea of reading, but it's just the way it is."
TROY CLE: If you are really about getting kids to read and you know that you must interface with everything that they already love, you have to get off your butt and say, How do I do that? ...because why do most books sell anyway? The cover. If you don't know anything about the book and you only get the cover and say, "Oh, I like that." Right? I just took it to the next step, by saying, "I'm going to animate this. Put it in front of you." You know? So, you know that the action that you saw here is better than—what you've been playing on your X-Box 360. And that's a book, check the book out.
BRANCACCIO: This isn't just about your business as an author, or really as a media producer, being successful.
TROY CLE: I want all kids, but especially children of color to read more. And it becomes a matter of me getting that book to them.
And then maybe this book will be a catalyst for them to say, "You know what? I love Marvelous World, let's go back to literary classics."
BRANCACCIO: Well, Troy CLE, Marvelous World, thank you very much.
TROY CLE: Thank you so much. It's a pleasure being here.
BRANCACCIO: There was a decent piece of news this week for those who have been following our story on Nour Al Khal. She's the Iraqi translator and journalist who fled her country after being targeted by the same death squads that murdered her colleague, American reporter Stephen Vincent.
Nour Al-Khal is one of thousands of Iraqis who risked—and lost—everything by working for the Americans.
Nour was with Stephen Vincent when they were kidnapped by a group of armed men in the Iraqi city of Basra nearly two years ago. He was killed; she was shot three times but survived. Still fearing for her life, Nour escaped to Amman, Jordan—where she lived in hiding.
Half way around the world was Stephen's widow: Lisa Ramaci. Lisa was so grateful for how Nour stood by Stephen during the kidnapping that she became Nour's biggest champion. For the past eighteen months, Lisa's been battling a reluctant American government to bring Nour to the safety of the U.S. But at New York's JFK airport last week—the waiting was over. She arrived just in time for the July Fourth holiday.
RAMACI: Thank God you're here. You're here. You're in America. You're safe now.
NOUR AL-KHAL: I hope so. Thank you so much.
BRANCACCIO: and...now here's a look at what we're working on for next week:
Is California now leading the world in the fight to cut carbon emissions?
SCHWARZENEGGER: Other countries like India, China, Brazil and Mexico will join us when they see what we're doing. And so will finally our federal government...trust me.
BRANCACCIO: And that's it for NOW. From New York, I'm David Brancaccio. We'll see you next week.