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AX: Ruth Saperstein: Please, can you help me?
Truong: Yes, I'm coming.
Saperstein: Please.
Good morning, Ms. Saperstein." [fade]
Narr: Thach-Giao Truong is in her first year at Columbia's teaching hospital, New York Presbyterian. This hospital could lose some $24 million a year if the federal and state cuts go through. She works long hours and is often at the hospital, working up to 27 hours straight.
AX: Truong: You are very exhausted. The rhythm is ok. You get used to the rhythm.
Narr: More experienced doctors oversee Truong and give her guidance. But she is the primary physician treating her patients. That means this 26-year-old is the one who talks with patients and listens to their problems. On her rounds today, Truong stops in on Ruth Saperstein…a tiny lady with silver curls. She lives in a nursing home and is in the hospital for congestive heart failure that has caused swelling in her legs. Truong asks about her progress.
AX:
Truong: Yeah. Are you walking around at all?
Saperstien: No.
Truong: Are you working with physical therapy? No? Ok, I'm gonna call them today and make sure they walk with you.
Saperstien: They were here.
Truong: They were? Yesterday. What did they do with you?
Saperstein: They couldn't do anything with me.
Truong: Why not?
Saperstien: I don't know.
Narr: On her shift today, Truong has seen five patients. Three are uninsured. Two are homeless. The Bush administration has proposed cuts to Medicare and Medicaid, the federal plan that insures the elderly and poor, the very patients that Truong treats every day. President Bush defends the cuts, saying that paying for graduate medical education is - quote - "outside of Medicaid's primary purpose."
If the cuts go through, physicians like Truong could be axed. Dealing with needy patients requires Truong to be part doctor, part social worker. She stops in on Juan Flores. He's homeless and Truong asks him about his plans after discharge.
AX: Where do you want to go? Have you thought about where you want to go, when you're better and stable? Where do you want to go? Do you have a home?
Flores: Anywhere. No. I don't have a home.
Ok, so we can set you up with a shelter. Is that something you are interested in? A shelter?
Yeah?
Narr: Hospital officials did respond to repeated requests for an interview. Truong herself says she fears that additional cutbacks could hurt patients.
AX: For an academic hospital like Columbia, it would be a disaster because we don't want to turn away anybody.
Narr: Governor's Spitzer's spokesperson, Jennifer Givner, says that New York spends too much on medical training programs already. About 77 thousand dollars for every medical resident. This is three times what California spends on its residents.
AX: Givner: We certainly recognize the importance of medical students and their training, and their value in the healthcare system.
Narr: Givner says that the governor's budget proposal isn't really a cut to graduate students, but a restructuring of Medicaid spending to make the system serve patients better.
AX: This is a first step in proposing a restructuring. We are not talking about all-out cuts. We are talking about creating efficiencies and establishing something very important to the governor, which is accountability. It's not a blank check, and go do what you want to do anymore. The focus for Medicaid is to take it more as a patient first issue, rather than a facility first, or hospital first. It is going to be a patient first, focused, campaign.
Narr: Hospital groups and unions have mobilized against Governor Spitzer's healthcare proposals. Democrats in Congress have vowed to fight the Bush cuts too. While policymakers grapple with solutions to government's spiraling healthcare costs, young doctors like Truong will continue to be the safety net for the country's neediest patients. Irene Jay Liu, Columbia Radio News