A Progressive Take On Obama's Health Bill

Congressman Raul Grijalva (D-AZ), co-chair of the Progressive Caucus, has been an outspoken supporter of giving Americans a public option, or a government-run health insurance plan that would compete in an open marketplace alongside private insurers. He talks with host Michel Martin about his views on where the health care bill stands now.

MICHEL MARTIN, host:

MARTIN: Now we turn to congressman Raul Grijalva, co-chair of the Progressive Caucus. Congressman, thank you for joining us.

Representative RAUL GRIJALVA (Democrat, Arizona): It's good to be with you, Michel.

MARTIN: Well, I'd like to pick up where we left off with congresswoman Lee. You've been very insistent about the need for a public option. So, are you going to support this version of the health-care overhaul?

Rep. GRIJALVA: Yeah. And I agree with the assessment that Barbara just had. The disappointment is palatable. I mean, a public option would have provided us not only with a real mechanism for cost savings and competition and a public presence within health reform but more importantly, it would have, I think, generated the kind of public support that expansive health reform needs.

And the fact that it's not there, we can blame the Senate or we can blame inertia, or we can blame the fact that the administration didn't push for this item early enough in the process when the Senate rejected it. But I think we're past the finger-pointing stage. We're down to this week, taking a first, significant step toward health reform in this country.

The system's broken. We have to acknowledge that. Is this the perfect fix? No. But it is the beginning of a fix and therefore, my instinct is to support it.

MARTIN: One issue that we haven't heard much about is that if more people get insurance, more people come into this system - this is part of the experience that they've had in Massachusetts, where they passed a universal access bill a couple of years ago under the leadership of Mitt Romney, who is a Republican.

As I understand it, the lowest number of med school graduates entering primary care was graduated in 20 years. Saying that another way, the last class of med school graduates that completed their education, that was the lowest number of people going into primary care in 20 years - which means there may not be enough doctors to treat these people.

I just want to play a short clip from a conversation we had with a group of med school students yesterday. I'll just play it for you.

Mr. DAN HENDERSON (Medical Student, University of Connecticut; Health Justice Fellow, American Medical Student Association): When I tell them I want to do primary care, they either say, really? Or, good for you in kind of the same way they might respond if I told them I was going into the Peace Corps or something. You know, primary care is kind of viewed as a sacrifice.

MARTIN: Congressman, is this part of the conversation in health-care overhaul? Is there anything in the bill to address the capacity issue?

Rep. GRIJALVA: Yes. The capacity issue important both on all the supportive staff needed, nursing included. Part of it was dealt with in the higher ed bill, which is such an important item as well, where the incentives and the encouragement were toward primary care in terms of college and college preparation, that those students going into that area would receive increased incentives and support to do that. That's one area.

But I think it's also fundamentally that the culture of medical school and the governors that set the curriculum, it's dominated by specialists. I think one of the things that has to happen is to put primary care and those physicians going into it, the same status that we're placing the specialty areas. Right now, it's dominated by specialties. Curriculum is dominated by that. Paying back your loans and the cost is dominated by what specialty can I go in, in order to quickly erase the debt that I have? Those are all factors.

And so, it's part incentive, part building capacity, but also dealing with the culture of medical education as it is right now.

MARTIN: So let's switch gears now, and talk for the couple of minutes that we have left about immigration overhaul plans. Last week, members of the Congressional Hispanic Caucus met with the president a couple of hours after the black caucus did, and their focus was on unemployment. And I understand that the Hispanic caucus was also concerned about unemployment. But members want to know when this vital issue will come to the fore.

Now, you know there's this big pro-immigration march planned for this weekend. So, what is your sense of this? Is there any sense that this issue is going to re-emerge as a priority?

Rep. GRIJALVA: Well, I think it has to. I think that is the commitment that was made not just to the immigrant community or to the Latino community, but a commitment made in general, that we're going to deal with this other broken part of our system, the immigration system - and a commitment made by the administration, made by congressional leadership, and made by many members that are presently sitting in office. And I think...

MARTIN: OK. But Barbara Lee talked about political will. Is there the political will there to take this on as well?

Rep. GRIJALVA: I think if the political will is not there, then the consequence of not dealing with it are not going to be good. And going into midterm elections, to have a significant part of the base deciding that they don't want to participate because commitments have not been met, or movement has not happened on an issue, I think would spell increased problems, political problems for our party. And I think if the political will is not there then certainly, the political instinct should be there to deal with this issue.

MARTIN: Is the capacity there to deal with this? You already hear people complaining that the president's tried to do too much, too soon.

Rep. GRIJALVA: Well, I think the capacity is there. And I think a lesson to be learned from the health-care reform is not to sit idly not to sit behind and watch the dynamics, but to jump in and participate in the dynamics - as the president is doing now on health care. And I think it's the same thing with immigration. That pulpit, that leadership, that voice is going to have to be part and parcel of the whole discussion.

MARTIN: Raul Grijalva is a member of Congress. He is a Democrat from Arizona. He's co-chair of the Progressive Caucus. He was kind enough to join us from his office, and we thank you.

Rep. GRIJALVA: Thank you.

MARTIN: Thank you so much for joining us. Previously, we were joined by congresswoman Barbara Lee. She's a Democrat from California. And she's chair of the Congressional Black Caucus. We heard from her a few minutes earlier.

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