Biden health chief says limited funds restricts ability to help those in need

Apr. 4—ALBUQUERQUE — Xavier Becerra is from the government, and there are only limited ways he can help.

Speaking Thursday at a question-and-answer session at the National Hispanic Cultural Center on Latino access to rural health care, the U.S. Secretary of Health and Human Services said legal limitations and limited money approved by a deeply divided Congress make funding new priorities a "zero-sum game."

"We cannot decrease it one penny here without decreasing it by a penny over here. ... I know it's very frustrating to hear this, but it is the truth," he said.

That means, for example, upping Medicare reimbursements to primary care practitioners means medical specialists don't see as big an increase, Becerra said.

Becerra joined U.S. Reps. Teresa Leger Fernández and Melanie Stansbury at the event, where attendees asked about possible solutions such as making it easier for doctors from other countries to practice in the U.S. and incentivizing medical practitioners to act as teachers and mentors.

Fredrick Sandoval, executive director of the New Mexico-based National Latino Behavioral Health Association, said he'd like to see the Substance Abuse and Mental Health Services Administration dramatically increase funding for community-level prevention programs to fight fentanyl use, saying that, across the country, only 1 in 10 Latinos over the age of 12 has access to substance abuse services. He described the fentanyl crisis as a "forest fire" that's grown out of control.

"You don't have just a little campfire, we have a forest fire," Sandoval said. "The forest fire is our fentanyl issue."

Becerra told attendees that while the issues raised are not new, the federal government has strict limits on what it can do in the realm of health care, which is considered a state responsibility, and the Health and Human Services Department has been a particular target in partisan budgetary battles.

"SAMHSA doesn't have a tree that gives it more money, and SAMHSA is only what Congress gives us," he said. "... This year, the Department of Health and Human Services, including SAMHSA, took the biggest cuts in order to satisfy those in Congress ... who have demanded reductions."

Becerra, a former California congressman, said political fighting, funding and legal limits are a frustrating reality.

"That's why some of us have called for a different way to do health care, a single-payer system of health care," Becerra said to applause.

Stansbury said countries with single-payer systems and national health care programs have lower costs and better patient outcomes. But, she said, getting to universal health care would be "extraordinarily challenging."

"We've got private companies, we've got public entities that are providing health care," she said. "We've got contentious politics in Congress. We're in the middle of a presidential elections year. So how do you fix the problem ... is the most immediate question in front of us."

Limitations aside, Becerra said, Health and Human Services still has a powerful way to effect policy.

"Everything we do, we put money on the table," he said. "And we tell the states, 'You want to grab that money? You got to do what we say in order to get that money.' "

Becerra pointed to President Joe Biden's proposal to double federal spending on community health centers around the country, the pandemic rollout of free COVID-19 vaccines and ongoing shifts in how Medicaid can be used.

"If you think Medicaid is only a dollar that gets used to reimburse a physician or a hospital, you haven't seen what we're doing lately," Becerra said. "... Today we want to use Medicaid in schools. Today we want to help you keep someone housed who otherwise would have deteriorating health if they didn't have a place to live."

Becerra said he knows there's not enough money going toward some needs, especially behavioral health.

"When a 10-year-old is thinking about committing suicide ... something's wrong," Becerra said.

As well as taking part in the health care roundtable, Becerra joined U.S. Sen. Ben Ray Luján and Albuquerque Mayor Tim Keller for an event at the under-construction medical sobering center at Albuquerque's Gateway Center. Becerra said the sobering center, which is receiving $4.2 million of congressionally directed funding, is an example of a service that can help stop a bad situation from becoming worse.

Part of the Gibson Health Hub, the center at 5400 Gibson Blvd. SE will serve as a detox clinic while taking pressure off emergency rooms, keeping people out of jail and supporting the community.

"[This center] is going to help a lot of families hopefully catch them early to prevent things from getting really bad rather than just trying to remediate," he said. "... These centers are hopefully places to treat and prevent."