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KC Mayor's Race: Health Care

By Kelley Weiss

http://stream.publicbroadcasting.net/production/mp3/kcur/local-kcur-574358.mp3

Kansas City, MO – Two Kansas City fixtures are vying to become the next mayor -- Alvin Brooks and Mark Funkhouser. The candidate who becomes mayor will be responsible for several city functions including public health funding for the health department and indigent care clinics and hospitals. They have debated several issues including crime, education, city services and the economy. But some recent national and state polls show voters rank health care as one of their top concerns. KCUR's health reporter, Kelley Weiss, has more.

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The head of the Kansas City health department, Dr. Rex Archer, says the key to healthy people is in prevention. Archer likes to equate approaches to making Kansas City healthier with an old test for insanity...

Dr. Rex Archer: "They would sit somebody down in front of a bucket, turn on the flow of water in to the bucket and give the person a spoon. And, the person would then be told empty the bucket. And if they spooned away and then asked for another bigger spoon or eventually got up and got a mop but never turned off the flow into the bucket they were considered insane."

Archer is using that as a metaphor for how the city handles health: politicians need to turn the flow of disease down before throwing money at emptying the bucket, or treating patients in clinic.

And, mayor pro-tem and city council member Alvin Brooks says he agrees. To control chronic illnesses in our community - like diabetes, childhood obesity and heart disease - funding and services for preventative care must be available.

Alvin Brooks: "Prevention, educational programs, eating habits, obesity, all those kinds of things we have to make sure there are those health providers and indigent care health providers that are providing to our citizens."

Former city auditor Mark Funkhouser also agrees and takes it a step farther to say that better health does not come by treating chronic illnesses or severe trauma with short term medical care, known as acute care. He and Brooks also mentioned they're commitment to fighting chronic diseases in minority communities. Here's Funkhouser.

Mark Funkhouser: "We have a lot more diabetes, hypertension, prostate cancer and low weight child birth among African Americans and minority populations, Hispanics, then we do the white folks. I would like to reduce those disparities and I'd like to improve our outcomes overall. I'm not talking about acute care, necessarily, which is probably where most of the money goes now."

Archer says that too much money does go towards treating people after they are already sick. The health department gets more than $8 million from the city and $11 million in grants to use on public health - like giving immunizations, improving environmental health and controlling communicable disease like HIV, influenza and hepatitis.

At the downtown Hospital Hill campus of Truman Medical Centers hospital CEO John Bluford says his hospital works as one of the major safety net providers for the city.

John Bluford: "You can see it's a pretty busy center - the census is always full. This is one of four units and there are 11 beds on each unit..."

Last year Bluford says the hospital provided $80 million in uncompensated care. Through a taxpayer approved health levy and county money Truman gets half of that money back. But Bluford says that leaves his hospital with a bill of $40 million in free health care. In a perfect world he says he'd like to see the city pay that difference.

John Bluford: "The ideal would be that they fund the entire uncompensated care gap. That's somewhat unrealistic because it's $40 million so at the very least we want to maintain exactly what we have."

And, both Brooks and Funkhouser say they want to maintain the funding going towards the health department, indigent care community clinics and hospitals. But, both candidates say it's hard to fix the growing problem of the uninsured and underinsured at the city level. Compound that with state cuts to Medicaid - which serves the poor and disabled - and cities face what Funkhouser calls a "looming disaster" in coverage and access to health services.

So, Brooks says if he becomes mayor he'll make sure there is accountability for the public funds subsidizing health care and he wants to improve services for minority communities. Funkhouser agrees on those points but says he'll work with the providers and health experts in the field to identify needs and then work towards filling them.

Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.

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