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01/11/06
Val Zavala>> Tonight on Life and Times --
California offers free medical care for the poorest patients, but what does it offer the doctors who treat them?
Dr. Brian Johnston>> The payment from Medi-Cal would have been about twenty-four dollars. It will be twenty dollars now, which means that, you know, I can't buy a large pizza for that. I can't, you know, go to the movies for that.
Val Zavala>> And then, the California Poppy Reserve puts on a glorious display every year, but are some people planting the seeds of destruction?
These stories and more next on tonight's Life and Times.
Announcer>> Life and Times is made possible through the generous support of the L.K. Whittier Foundation dedicated to improving the quality of life by supporting innovative endeavors in the fields of medicine, health, science and education.
And by a generous grant from Jim and Anne Rothenberg.
Val Zavala>> Being a doctor in California is generally a well-paid profession unless you treat California's neediest citizens. For doctors who are willing to take Medi-Cal patients, fees have been going down and now they're getting even worse.
It's hard to believe that veterinarians treating pets get paid more per service than doctors who treat Medi-Cal patients. That's right. A veterinarian fixing a dog's broken leg will get about five hundred dollars. A physician fixing a broken arm of a person on Medi-Cal? Forty-four. When it comes to caring for our neediest patients, California doctors are among the lowest paid in the nation and the rates have just gotten lower by five percent.
Dr. Brian Johnston>> Well, the Medi-Cal reimbursements have gone from poor to worse. California, before the cut went through, was fiftieth out of fifty states for physician reimbursement in Medi-Cal.
Val Zavala>> Meaning we pay physicians who treat Medi-Cal patients less than what Mississippi does or Alabama and is the worst in the nation?
Dr. Brian Johnston>> Worst in the nation, the lowest in the nation.
Val Zavala>> Dr. Brian Johnston has been an emergency room physician at White Memorial Hospital in East Los Angeles for thirty years. Many of his patients are on Medi-Cal. Medi-Cal is the state's safety net for the poor. More than six million Californians who have no other coverage rely on Medi-Cal. Many are elderly, disabled or the working poor. Doctors have no obligation to accept Medi-Cal patients, but Dr. Johnston does, even though it means getting paid very little.
Dr. Brian Johnston>> I could spend forty-five minutes with that patient. The payment from Medi-Cal would have been about twenty-four dollars. It will be twenty dollars now, which means that, you know, I can't buy a large pizza for that. I can't, you know, go to the movies for that. It's ridiculous. I mean, the only reason you would do that is because you have a human being in front of you who is really suffering and really needs help, so you do it.
Val Zavala>> About ten miles away at Children's Hospital in Hollywood, Dr. Stuart Siegel is struggling with the same problem. He treats cancer patients, many of them without insurance. His fee from Medi-Cal is even less than what Medicare would pay.
Dr. Stuart Siegel>> I might receive something in the range of sixty to eighty dollars possibly for a regular follow-up office visit. But with Medi-Cal, that number is going to be under forty dollars for that kind of visit. I would be happy if I could get reimbursed at Medicare rates for the care that I provide, as would be my colleagues.
Val Zavala>> I first met Dr. Siegel six years ago. Even then, state reimbursement rates for treating seriously ill children were low. Since then, things have gotten worse and, today, two-thirds of California's doctors choose not to take Medi-Cal patients.
Dr. Stuart Siegel>> With these rate reductions, the chances of physicians deciding that they want to be part of the system obviously go down.
Val Zavala>> And it's hard on patients as well who have to search for doctors willing to take them.
Dr. Stuart Siegel>> They may have to travel literally even hundreds of miles to find a physician with certain specialties that would be willing to care for them.
Val Zavala>> The fee cuts were passed back in 2003 during the Davis administration, but a legal challenge kept them from going into effect until this year under Governor Schwarzenegger.
Dr. Brian Johnston>> What the governor is saying and what Medi-Cal is saying is, well, we just have to obey the law.
Val Zavala>> State health officials also say that the cuts were supposed to be retroactive, but Governor Schwarzenegger and lawmakers limited the cuts to just this year. In other words, things could have been much worse. The Department of Health Services says it doesn't like the idea of cutting doctors' fees, but they say it's better than cutting benefits to patients. In fact, they say, over the past twenty years, California has expanded the number of people who are eligible for Medi-Cal and given them more services. A spokesman for the State Department of Health Services says that no state is more generous with its Medi-Cal benefits than California. For example, California is one of only a dozen states offering dental services.
Dr. Stuart Siegel>> The problem is that, if you say you're providing them, but then you don't pay adequately for them and therefore you don't have the providers there to deliver them, are you really providing them?
Val Zavala>> But Dr. Johnston says that it's not just the meager fees that keep physicians away from the Medi-Cal program. It's the bureaucracy.
Dr. Brian Johnston>> For example, if I decided to become a Medi-Cal provider today and didn't have a provider number -- I couldn't get paid until I got the provider number -- it would take me a year or more to get the number.
Dr. Stuart Siegel>> I know that many physicians who see Medi-Cal patients don't even bother to bill because it literally costs more for them to bill than the reimbursement they receive. You can imagine, with that kind of situation, why so many doctors will not see patients with Medi-Cal coverage.
Val Zavala>> A spokesman for the State Department of Health Services says, "We recognize the hardship the cuts will cause and appreciate the valuable services that physicians deliver to Medi-Cal patients." They are working with doctors associations to find other ways to save money. And how much will the cuts save? An estimated sixty million dollars a year. It sounds like a lot, but it is less than two-tenths of one percent of the total the state spends on Medi-Cal each year.
Dr. Brian Johnston>> That saves the state sixteen million dollars, but because of the federal match, it takes a hundred twenty million dollars out of the health care system.
Val Zavala>> And, says Dr. Johnston, once doctors drop out of the Medi-Cal program, it's very unlikely they'll rejoin.
Dr. Brian Johnston>> Once an office says "no more", I don't think they're going to go back. My worry is that people will drop out and stay out.
Val Zavala>> When there are fewer doctors treating Medi-Cal patients, you can be sure more sick people will turn up in our already crowded emergency rooms.
>> "There's actually one, two, three, four, five, six patients right now and then there's four more admissions that I haven't even put on the board yet."
Dr. Brian Johnston>> Twenty-five percent of the patients coming to the emergency departments are on Medi-Cal and that's because they can't get into an office, they can't get into a program. "Then one of them has been here twenty hours and fifty-two minutes?"
>> "Correct, and two have been here over twelve hours."
Val Zavala>> The Medi-Cal cuts don't just affect doctors, but home health care workers as well.
Dr. Stuart Siegel>> We're hoping it's transitory. We hope the public will understand the terrible effect that this will have on the general health of the population. It will affect everybody, not just the patients who are not getting medical care, because the general health of the population will go down and the public will understand that this is a real priority.
Dr. Brian Johnston>> This is not the way it ought to be. Not in the fifth largest economy in the world. Not in a civilized country. Not in a country that says, you know, "with liberty and justice for all". Does our system meet the needs of our people? I think clearly it doesn't. I think it's not designed to meet the needs of people. It's designed to fit a budget.
Arnold Schwarzenegger>> "We need more roads, more hospitals, more schools, more nurses, more teachers."
Val Zavala>> And come budget time, it will be up to the governor and state lawmakers to decide whether Medi-Cal reimbursements will be raised next year.
Arnold Schwarzenegger>> "Thank you very much and God bless all of you. Thank you."
Val Zavala>> I'm Val Zavala for Life and Times.
Announcer>> Kcet.org is the place to look for the very latest on Life and Times. You'll find previews of upcoming stories, plus transcripts and audio of past episodes and links to some of our most interesting features. Just go to kcet.org, scroll down the page and click on "Life and Times".
Val Zavala>> Once a year, it turns into a field of gold. It's the famous poppy preserve near Lancaster. But now some people have a different idea. They think it will be a great spot for a race track and a wind farm and, as Sam Louie tells us, that has the poppy people concerned.
Mike Powell>> It's like a fire. The orange is so intense. The color is so saturated, so intense, it just glows. It's a beautiful flower that way.
Sam Louie>> During a good spring, thousands of poppies in full bloom grace the landscape of Lancaster about seventy miles north of Los Angeles.
Mike Powell>> Every year, we get visitors from almost essentially every state of the union and typically we get visitors from almost forty foreign countries every year come to the poppies, so the reputation of the poppy reserve is known worldwide.
Sam Louie>> Mike Powell is Chairman of the Friends of the Poppy Reserve, a support group for the state landmark. But these days, they're fighting a battle to preserve it.
Mike Powell>> "It's pretty cool. Lots of poppies in here."
Sam Louie>> In November, they are only small sprouts, so Powell marks them with toothpicks as a way to track their growth. But Powell is also keeping an eye on two separate projects that he feels could jeopardize the beauty of the thirty-year old poppy reserve. One is a wind farm. The other is a race track.
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Sam Louie>> The proposed race track could bring about two hundred vintage cars like these racing around a three and a half mile track. If approved, it would be built several miles north of the reserve. Powell, though, believes the track would drive people away from the reserve.
Mike Powell>> We also asked them how it would impact their future visitation and, on the race track, over eighty percent of the people said that they would either come less frequent or would never come again if that race track was built in.
Tom Malloy>> "The one next to us right here, the Blue #40, is the car that Mario Andretti finished second in the 1981 Indianapolis 500."
Sam Louie>> The man behind the race track idea is Tom Malloy, a vintage race car collector and enthusiast. He describes what the track would be like.
Tom Malloy>> Just club racing during the weekends and it will be testing during the week, Porsche owner club type events, the Ferrari club type events, certain large manufacturers of cars may want to come out and test their cars or put on their new line of cars and show them, and that's what this is all about. "This car is a Curtis Craft 500C, 1954 vintage, and it raced and was entered in Indianapolis all the way through the 1960's."
Sam Louie>> Malloy owns more than thirty vintage cars. He started racing when he was eleven.
Tom Malloy>> "But this is a car that I built for the soap box derby that I took up to the Arroyo Seco".
Sam Louie>> But now at the age of sixty-six, Malloy says it's much harder to find a place to race classic cars.
Tom Malloy>> It's becoming more difficult to find the dates to do this vintage racing, but also it's very difficult to find a place that's going to have the accommodations, the creature comforts, that we plan on building at Fairmont Butte.
Sam Louie>> The race track is still in its early stages. An environmental impact report is in the works. He hopes to submit it to county officials by the end of the year. If the process goes as planned, Malloy thinks groundbreaking could happen in late 2006. While he understands noise is an issue, he also believes he can be a good neighbor.
Tom Malloy>> We're establishing a threshold for noise, so many decibels, that is absolutely determined while I'm talking to you right now that there will be a maximum set for this race track so we don't go over.
Sam Louie>> While the race track plan is underway, another idea is in the wind. It's a wind farm. Wind farms similar to this one would convert wind to electricity for Los Angeles. Powell took us to the highest point at the poppy reserve and described how the view would be affected by this.
Mike Powell>> From the Tehachapi viewpoint, there are mountains that way. All the way across here, this would all be blocked by turbines.
Sam Louie>> However, wind farm developers say that this area is an excellent place for capturing and generating energy.
Jan Johnson>> The Tehachapi area is probably the last best untapped resource for renewable energy in California. There are some estimates that the Tehachapi area could supply forty-five hundred megawatts. That's enough for maybe 1.2 million homes.
Sam Louie>> Jan Johnson is with PPM Energy, a wind farm developer based in Portland, Oregon. PPM has not submitted any paperwork, but the plan is to place more than one hundred of these large turbines just south of the poppy reserve. The wind farm would then link to a transmission line which Southern California Edison plans to complete by 2008.
Alis Clausen>> We have to build additional transmission lines into the areas that renewable technologies are the most prevalent. The wind doesn't blow everywhere, so we have to build transmission to the areas where wind energy is a viable technology.
Sam Louie>> State law will require public utilities to get twenty percent of their energy from renewable sources by the year 2017. With this in mind, some energy companies believe wind power is the way to go.
Jan Johnson>> Wind power has become cost-competitive with any form of new generation. This is a very big deal right now as we face increasing energy costs throughout the country and, so recently here in California, we've had the recent rolling blackouts.
Sam Louie>> Still, opponents believe that large windmills and poppy fields don't mix.
Mike Powell>> Here at the highest point on the vista, you’d be looking up at the tips of these three blades. These blades are as big in diameter -- swept area, these blades are about the wingspan of a 747.
Jan Johnson>> The poppy reserve is a beautiful area and we put up wind farms in a lot of beautiful places in Iowa, in Colorado, in Oregon and Washington and other parts of California. And we work very hard with the communities to make sure that they are appropriate use.
Sam Louie>> And there's something else: the impact on wildlife.
Mike Powell>> This valley is a wintering site for a number of different birds. The turbines are known to have a problem with bird kills.
Jan Johnson>> Wind turbines have improved in their technology. They are not the old lattice kind anymore. They're the tubular towers, so that the bird kills are much less. There's much less impact on bird populations because they can't perch.
Sam Louie>> As for the impact on tourism, backers of both projects believe they might actually help draw more people to the area.
Tom Malloy>> There are people that don't even know that it exists and might find out by the fact that there's a sign out there. They come to the races and might say, "Hey, I didn't even know this thing was this close" and might go over to it.
Jan Johnson>> We have a wind farm in Iowa right beside one of the only three blue water lakes in all of America. It's one of those beautiful glacier-carved lakes and actually that community has experienced more tourism because of the wind project.
Sam Louie>> Both proposals must be approved by Los Angeles County. In the meantime, the Friends of the Poppy Reserve are gearing up for a fight. And the question will be, will this be the view that visitors continue to enjoy or will the winds of change bring a different look to the scenery? I'm Sam Louie for Life and Times.
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Val Zavala>> Orange County's cultural profile is rising. A beautiful new performing arts center is opening on the campus of Cal State Fullerton and, as Roger Cooper tells us, it's got not one or two, but three unique theaters.
Roger Cooper>> It's been a long time coming, but there it sits on the campus of Cal State Fullerton. Built at a cost of forty-eight million dollars, it's the dream facility that faculty and students have wished for, the new Cal State Fullerton Performing Arts Center, one hundred nine thousand square feet of theaters and rehearsal halls for music, plays and dance, a beautiful state-of-the-art building for teaching and enjoying the performing arts, and it makes University President, Milton A. Gordon, very proud.
Milton A. Gordon>> I'm in my sixteenth year here and I started working towards this building opening in the first year that I got here. Actually, it was on the planning board before I arrived, so I would conservatively estimate that the planning for this building has gone on for at least eighteen or nineteen years. I consider it the front door to the campus now.
Roger Cooper>> We got to tour the campus's new front door guided by the Dean of the School of Arts, Jerry Samuelson.
Jerry Samuelson>> This is the Jim Young thrust theater. We decided when we built this facility that we already had a proscenium theater. We wanted our students to have the opportunity to perform in this kind of a setting, so now we have all bases covered.
Roger Cooper>> You're a theater person. What does it mean to you to have a facility like this?
Jerry Samuelson>> Well, we've been under very crowded conditions for a lot of years and now to have a building like this with all of these wonderful facilities is just a dream come true really.
Roger Cooper>> And the acoustics?
Jerry Samuelson>> The acoustics are -- we hope they're perfect (laughter). That's all we want is perfect acoustics.
[Film Clip]
Roger Cooper>> Students will also have use of this new black box theater which seats a hundred fifty for more intimate productions like this: "Grasmere" written by a Cal State Fullerton student.
[Film Clip]
Roger Cooper>> Earlier productions like this one won the school acclaim and invitations to perform it in Washington, New York and Chicago.
[Film Clip]
Jerry Samuelson>> We've had a really excellent program. Our theater program is ranked sixteenth in the nation, top sixteen of programs, and now they have a facility that matches what we've been able to do in very cramped quarters. It's really wonderful.
Roger Cooper>> Associate Dean, Joe Arnold, likes the feel in the new theater.
Joe Arnold>> I think the thing for everyone to remember is that these are magnificent spaces in this venue, but they're all student focused. This is all about student learning.
Roger Cooper>> But the new performance venue that really makes jaws drop is inside these doors.
Jerry Samuelson>> Behold.
Roger Cooper>> Wow. What have we got here?
Jerry Samuelson>> This is our Vaughncille Joseph Meng Concert Hall. This is a facility just for music, a true concert hall where the stage is out into the body of the audience and the canopy is movable. It's down in a very low position right now. It flies way, way up into the hall.
Roger Cooper>> It's sort of like being under a flying saucer as it comes in (laughter).
Jerry Samuelson>> It's one big flying saucer. It really is, yeah.
Milton A. Gordon>> It will give us the right facility to showcase our students and our faculty and, on that, I could not be prouder. But it will also allow the university to incorporate more into the community. The one thing I've always insisted upon is that we're a part of the community, the entire community, the larger community.
Jerry Samuelson>> This is my chance to sing, but I can't sing.
Roger Cooper>> Same problem here (laughter).
Jerry Samuelson>> But it is. It's wonderful looking out from this view, isn't it?
Roger Cooper>> With this center, Cal State Fullerton is taking a stand against the trends of cutting arts programs.
Milton A. Gordon>> It always saddens me that, when you get in a budget crunch, the arts are frequently programs that some want to cut. I think it's a mistake. Education is more than just a classroom experience.
Jerry Samuelson>> In our state system, you have to get in the queue in order to get funding. We finally came to the top of the list and we did get forty-three million dollars from the state to build this facility. We also raised approximately five million dollars from private funds to help complete the building.
Roger Cooper>> Any great hall needs a grand piano and Cal State Fullerton picked one. Wow. What is this?
Jerry Samuelson>> This is a Hamburg Steinway. We sent two of our people from the music department over to Germany and they had the opportunity to look at five different pianos at the factory over there.
Roger Cooper>> You know what I'm going to ask you. Could you honor us with one key?
Jerry Samuelson>> (Laughter) Since I don't play --
Roger Cooper>> -- all the better.
[Film Clip]
Jerry Samuelson>> My piano faculty are going to have a fit that the Dean came in here and touched this piano (laughter).
Roger Cooper>> Rounding out the new Performing Arts Center, a scene shop, a laboratory where students can learn lighting, and three new state-of-the-art dance studios.
Jerry Samuelson>> Well, there is a basket-weave of wood underneath this and then there's felt and then there's this special finish that goes on top.
Roger Cooper>> Cal State Fullerton's Center joins the ranks of premier performing venues on the west coast. Along with the Disney Hall and the Orange County Performing Arts Centers, Segerstrom Hall which opens this fall.
Jerry Samuelson>> This is going to be the best darned facility (laughter) in our system and I think, here on the west coast, this is going to be a wonderful, wonderful performing arts facility.
Roger Cooper>> Mr. President, did you ever go on stage in a performance?
Milton A. Gordon>> You know, this will be the first time I've ever admitted to it, but, yes, I did. As an undergraduate, I failed, but I did try. As an undergraduate, I did try out for one of the Shakespearian plays, a part in that, and I was totally rejected. As a mathematician, I just don't think I'm the performing type, so I don't think being on the stage is for me. So I just take the enjoyment of watching really talented people perform.
Roger Cooper>> Cal State Fullerton's arts program has always been very strong, producing alums who land on Broadway, alums like international opera star, Deborah Voigt, who's returned for the opening. Now this school has the facility to turn out even more great performances. At Cal State Fullerton, I'm Roger Cooper for Life and Times.
Val Zavala>> For information on upcoming performances, you can go to their website at www.fullerton.edu. And that's our program. I'm Val Zavala. For everyone at Life and Times, thanks for watching. We'll see you next time.
Announcer>> Life and Times was made possible through the generous support of the L.K. Whittier Foundation dedicated to improving the quality of life by supporting innovative endeavors in the fields of medicine, health, science and education.
And by a generous grant from Jim and Anne Rothenberg.
Val Zavala>> Next time on Life and Times --
They contain graphic violence and adult content, but who should keep them away from kids?
>> We don't think the government should be in there telling retailers and parents what games are appropriate and which ones are not.
>> A seventeen year old, there should be some type of guidelines in reference to the types of games that they're buying especially if you talk about a lot of violence.
Val Zavala>> That's next time on Life and Times.
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