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is equitably financed with public accountability for public funds. In the U.S., according to Humphreys, health care costs account for 12 percent of the Gross National Product yet leave 38 million people uninsured. Administrative costs devour more than 22 percent of the money spent on health care in the U.S. In Canada, only eight percent of the GNP is spent on health care through a private but regulated national health care system that serves 100 percent of the population. Only 2.5 percent of Canadian health care expenses are spent on administration. Seventy-five percent of Americans, Humphreys claimed, consistently support in opinion polls the enactment of a national health program, and they respond that they are willing to pay more taxes to assure that the poor are provided with adequate access to health care. According to Gray Panthers national health care advocates: eleven countries have lower infant mortality rates than the United States, twelve countries are more effective in preventing cancer deaths, citizens of 14 countries have longer life expectancies than Americans, twenty-six countries have lower cardiovascular death rates. “Highways are not in the marketplace,” Humphreys said, quoting a Congressional staff member. “Nor are the police, schools, or the military this country has seen to it that there are certain areas that are of such vital importance that they should not be subjected to the whims of the marketplace. We believe that health care is such, and that it is not a consumer good that should depend on how much money a person has.” Dialing for Doctors: One Mother’s Solution FOR JANICE MOERBE, the health care system in Austin works. But only because she makes it work. The 44-year-old single mother of three devotes most of her time to caring for her threeyear-old son, Scott Mickan, who was born prematurely and with several birth defects. When she is not caring for Scott, Moerbe is often on the phone scrambling to patch together agency and eleemosynary support to keep Scott at home. The city of Austin’s Medical Assistance Program, Travis County’s Department of Public Health, the Chronically Ill and Disabled Children’s Program of the Texas Department of Health, and the Kiwanis Club, all of which provide certain limited services, stand between Scott and a state institution. And though the list suggests broad state support, Moerbe and health care providers who work with her argue that keeping Scott at home is very tenuous. Scott, who weighed less than three pounds when he was born, requires round-the-clock medical care. He his Pierre Robbins Syndrome which prevents him from eating without a gastronomy tube and a feeding machine. An obstructed windpipe requires that he breath through a tracheotomy tube, and oxygen bottles and a mist machine make breathing easier for him. At three years of age he is unable to stand without support because of Cerebral Palsy. While asleep, Scott must be moved every hour to prevent the accumulation of fluid in his lungs. And a suction machine is required to keep the tracheotomy and gastronomy tubes clear so that Scott can eat and breathe. Seated in the Senate chamber at an April 14 hearing, the three-yearold was connected to a life-support LOUIS DUBOSE Scott Woken and Janice Moerbe system that might have been designed by NASA. During the first year of his life, according to his mother, Scott’s medical bills exceeded $200,000. “The bills are all on hold now,” Moerbe said. But foreclosure proceedings on her home have been started and stopped several times, she added. Medical bills, she understands, are the leading cause of bankruptcy in the U.S. Moerbe, who can not work because she serves as her child’s nurse as well as a mother, says that she could not manage without the help of Medical Assistance of Austin. A registered nurse relieves her for two hours each working day to allow time to shop, run errands, and spend some time with her 14-year old daughter. “I couldn’t live without the MAP nurse,” Moerbe said. Yet in most cities in Texas she would have to. The city of Austin, which commits $21 million each year to indigent health and Travis County provide public health services at a level that is found nowhere else in the state. According to a Williamson County public health official, families in north Travis County move several blocks into a new house and find themselves without services. For Janice Moerbe, assembling the hardware or “durable medical goods” and programs to keep her son at home has been difficult. She waited eight months for a travel chair and stand-in table, for which Scott qualified, to be delivered by the Chronically ill and Disabled Children’s Program of the state health department. At the end of eight months, she asked Travis County Senator Gonzalo Barrientos to intervene. The chair was delivered within ten days. And recently, with the help of a legal aid attorney, she won an appeals fight with Medicaid. Prior to her appeal, she could not get Medicaid assistance because she didn’t meet their “spend-down requirement”; Scott hadn’t spent enough time in the hospital during the previous year. She also had to appeal for Medicaid payments for transportation to an Austin Hospital where her son had qualified for speech therapy, another service that was initially denied. Charlotte Katzin, a public health nurse who worked with Scott when he was served by another agency, said that Moerbe has done a remarkable job of putting together a package of services for a child who would otherwise require full time nursing care or hospitalization at great expense. “If she would return to work,” Katzin said of Moerbe, “it would cost at least $250 a day for a nurse to go in and do what she does.” It is not likely that Janice Moerbe will return to work. She will, she insists, continue to keep her child at home. “It’s a constant fight,” she said. “But I’ve got a whole notebook full of phone numbers.” L.D. THE TEXAS OBSERVER 15