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05/25/05
Coverage of Town Hall Los Angeles speakers on Life and Times is made possible by a grant from the Boeing Company.
Val Zavala>> Tonight on Life and Times --
The federal government will finally help bear the burden of treating undocumented immigrants, but does the emergency room bailout go far enough?
Ira Mehlman>> Whether it's being paid for by government at the local level or is being paid for by the federal government, it's still our money.
Val>> And then, how do they keep the audiences coming back year after year? The stereotype-busting secret of the East-West Players.
It's all straight ahead on tonight's Life and Times.
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>> Who should pay the medical bills for millions of illegal immigrants? Well, for years, the state of California has been trying to get the federal government to ante up. Well, finally the feds have, but is it a victory in principle only? Hena Cuevas takes a look at what this means for one Southern California hospital.
Hena Cuevas>> When paramedics rush a patient into an emergency room in Los Angeles County, treatment always comes first.
>> "Do you have any pain anyplace? In your back?"
Hena Cuevas>> It's only after the patient is stabilized that hospitals ask how he or she will pay for the services and it seems that more and more of them can't cover the cost.
Dr. Brian Johnston>> The biggest issue is being paid for the services we provide.
Hena Cuevas>> Dr. Brian Johnston has worked in the emergency department at White Memorial Hospital in downtown Los Angeles for thirty years.
Dr. Brian Johnston>> The problem is that there are large numbers of uninsured and there are large numbers of people whose insurance companies refuse to pay once the services have been rendered.
Hena Cuevas>> It's widely accepted that many of the uninsured are also undocumented immigrants and critics like Ira Mehlman of the Federation for American Immigration Reform say that places an enormous strain on the state.
Ira Mehlman>> As long as you're going to have millions and millions of people pouring in here with no health insurance and no resources to pay for their health care, you're going to have a health care system that's in crisis.
Hena Cuevas>> Nearly thirty percent of the uninsured who use the emergency room at White Memorial are illegal immigrants who, in many cases, use the ER as their primary care physician and, according to the law, they can't be turned away even if they can't pay. Now, after decades of pleas from the state for help with those expenses, the federal government is stepping in. The Department of Health and Human Services will spend one billion dollars nationwide over the next four years to help hospitals cover some of the expenses of treating illegal immigrants. What do you think is the significance of the federal government finally paying out this money to help the hospitals?
Ira Mehlman>> Well, on the one hand, it's an acknowledgement from the federal government that the federal government's failure to control illegal immigration is a serious problem that is costing states and communities all across the country a lot of money.
Hena Cuevas>> California is expected to receive more of the bailout than any other state, nearly seventy-one million dollars. And Los Angeles County could get about forty percent of that, or twenty-eight million dollars, not nearly enough when the deficit is twenty times that amount. According to the California Medical Association, emergency room losses in 2002 alone topped six hundred million dollars.
Dr. Thomas Garthwaite>> Our hospitals have a budget deficit about as far out as the eye can see.
Hena Cuevas>> Dr. Thomas Garthwaite, Director of Los Angeles County's Department of Health Services, says the system is severely under-funded.
Dr. Thomas Garthwaite>> It used to be said that the real key to real estate was location, but the real key to running a profitable hospital is now location. You have to build your hospitals away from the uninsured if you're going to run an emergency room. Otherwise, you have all these patients who come in and have no hope of paying these enormous hospital bills.
Hena Cuevas>> But will this solve the problem?
Dr. Thomas Garthwaite>> No, I don't think it solves the problem, but, you know, it's a step in the right direction. So to actually have some funding go towards where it's very much needed is helpful. Even though it's not all the funding we need, it's in the right direction.
Hena Cuevas>> For Mehlman, it's not just about the money.
Ira Mehlman>> We're dealing with the symptoms of the problem rather than dealing with the cause of the problem itself, and the cause of the problem is uncontrolled mass illegal immigration that's been going on for many, many years.
Hena Cuevas>> But Dr. Johnston, who sees the uninsured daily, says the problem goes beyond treating those who are here illegally.
Dr. Brian Johnston>> Illegal immigrants are part of the problem, but they're not the largest part by any stretch. About seventy-five percent of the problem is people who are legally here and United States citizens. There's no question that anybody who is uninsured puts a strain on the system. To blame it on illegal immigrants, I think, is fallacious.
Hena Cuevas>> As a rule, hospitals don't check the immigration status of any of their patients. But now to receive the federal funds, doctors will have to start asking questions.
Dr. Thomas Garthwaite>> We can't ask directly, are you here illegally? So we have to ask several questions that kind of put the person in a category that would make you assume that they're here perhaps illegally.
Hena Cuevas>> Mehlman argues that doctors will have to ask illegal immigrants the same things they ask patients who are here legally, questions about insurance and verifying ID.
Ira Mehlman>> When people with private health insurance walk into a doctor's office, they're asked pretty much to empty their wallets and have every document photocopied. The doctors do it because they know the private health insurance companies won't pay if they don't. There is no moral or ethical reason why they can't do the same thing when it's you and me, the taxpayers, paying for it.
Dr. Thomas Garthwaite>> The biggest concern with doing screening is the perception that the screening will lead to you being put in some database or being turned in to immigration authorities and, therefore, individuals who need health care might avoid health care.
Hena Cuevas>> Dr. Johnston says that asking questions about immigration status would interfere with his first priority: treating the patient.
Dr. Brian Johnston>> Well, I'm not going to ask. I don't ask. That's not part of the doctor-patient relationship and I'm not going to ask that question. My worry is that people will stay away for fear of that question and I don't know what effect that is going to have.
Hena Cuevas>> So you think there might be fear?
Dr. Brian Johnston>> Oh, I'm sure there will be fear. This issue has been raised before. I think that those who are here illegally and don't have papers are very sensitive to it. I would be very surprised if there wasn't fear.
Hena Cuevas>> And Johnston argues that fear may cause many of the undocumented to delay treatment, making it even more expensive in the long run.
Dr. Brian Johnston>> You know, we know what to do. We have the technology. We have the knowledge. What we need to do is fund our health care system and not just for illegals, for everyone.
Hena Cuevas>> The California Medical Association estimates that one out of five Californians is living without health insurance.
Dr. Thomas Garthwaite>> I would also say that the needs of the uninsured in Los Angeles largely and greatly out-strip the available resources.
Dr. Brian Johnston>> Our county health care system has been backing out. They've been closing beds. They've shut down clinic visits. They've closed public health clinics. So to blame that on the illegal immigrants, I think, is divisive, erroneous and inflammatory.
Hena Cuevas>> But Mehlman says that no one should expect taxpayers to foot the bill for free medical care while both state and federal government are running deficits.
Ira Mehlman>> As noble as it is to try to provide health care for people, we have finite resources. We live in a finite world. One of the things we've got to remember is that, whether it's being paid for by government at the local level or is being paid for by the federal government, it's still our money.
Hena Cuevas>> I'm Hena Cuevas for Life and Times.
Kcet.org is the place to look for the very latest on Life and Times. You'll find previews of upcoming stories, transcripts and audio of past episodes and links to some of our most interesting features. Just go to kcet.org and click on "Life and Times".
Toni Guinyard>> Now for an update on efforts to decrease daytime container truck traffic in and around the ports of Los Angeles and Long Beach. Beginning in mid-July, the ports will extend the hours of operations to include Saturdays and stay open until three in the morning during the week. Cargo owners who continue operating during the peak weekday hours of eight a.m. to five p.m. will be charged a fee for each loaded import and export container passing through marine terminal gates.
During the initial startup period, a twenty dollar fee will be assessed for each cargo container and, once the off-peak program is in full operation, the so-called traffic mitigation fee will cost cargo owners forty to eighty dollars per container depending on the container's size. The off-peak program will be operated by Pier Pass, a nonprofit organization created by marine terminal operators. The off-peak program's goal is to encourage cargo owners to shift operations to nights and weekends when there is less traffic congestion on area freeways.
Val>> He's been dispensing sex advice to teenagers for more than twenty years and they know him by name: Dr. Drew from the nationally syndicated radio show, "Loveline". But Dr. Drew Pinsky is also an expert on drug addiction and he treats addicts at Las Encinas Hospital in Pasadena. Vicki Curry talked to Dr. Drew Pinsky at the Meridian Hotel where he was a guest speaker at Town Hall Los Angeles.
Vicki Curry>> Drew Pinsky, you've been working on addiction issues for, what, over fifteen years now?
Dr. Drew Pinsky>> Over twenty years, really, yeah.
Vicki Curry>> So over your experience, where do you see us now in terms of addiction as a society?
Dr. Drew Pinsky>> Well, I believe it's become really the health problem of our time. I mean, we live in a time when we are conquering many diseases and addictions and psychiatric problems have emerged as such common issues and so much that is left undealt with that destroys lives, destroys careers. What people don't understand is that, in our culture, these things are taken very casually and the fact is that this is a disease and there is a treatment and the treatment works.
Many people don't know how to identify the disease. They don't have an understanding of what this thing is that sort of usurps the motivational priorities in the brain where everything else becomes secondary to the pursuit of a drug. Sometimes it's very subtle and very slow in how it takes over, but once it does, it takes over everything even when the person is not really aware of it. It's just something, a tone, that they're constantly driving them in a particular direction whereby the usual motivational priorities in one's life, family, work, these sorts of things, take a back seat to the pursuit of a drug.
People don't see it coming. They don't know when it's there and they don't know what to do about it once it is there. We have very effective treatments now. We understand this disease. We understand the biology of it and people need to understand it and take advantage of it.
Vicki Curry>> So, as you say, it's a disease of the brain. So do you see that perhaps there is a slow and better understanding coming about for addiction issues?
Dr. Drew Pinsky>> Absolutely. There are whole entire institutions dedicated to this now and, as a result of our biological understanding, we now have sort of pharmacological and/or behavioral kinds of interventions to go specifically at that biology. And, of course, they're more effective. When we understand what we're dealing with, we can create very targeted kinds of treatments. Depending on what the drug of choice is, we have things that we can do now that really help people with this disease.
Still, I think fundamentally any worthwhile treatment program is still going to use Twelve Step as its core. It's a very complex, biological process, so the kinds of things that we are assisting people with are really just that: assistance. They're not going to take the disease away. They're not going to be able to make that person be able to drink normally again, but it will sort of help with that biological grip so they can do the hard work of the Twelve Step recovery program.
Vicki Curry>> Do you find that most addictions start at a young age with teenagers or young adults?
Dr. Drew Pinsky>> Well, yeah, a lot of people do start in teenage years and the more severe forms of addictions start earlier. People that are going to be poly-drug addicted, people that are going to be more severely addicted start when they're young. When I see somebody starting with pot under the age of fourteen, I know we're going to have a problem. That's a common thing.
You know, one of the interesting things that's happened now in inpatient treatment for chemical dependency -- I run an inpatient program in Pasadena at Las Encinas Hospital -- I know now, if you are sick enough or if your addiction is severe enough and you're in inpatient treatment in my program, there is essentially a one hundred percent probability that you had childhood trauma, sexual abuse, physical abuse or neglect. Those are the sort of inciting influences on this disease.
It's a genetic disorder. I'm talking a little bit about that tonight. But the gene is not everything. The gene is responsible for about sixty percent of this disease. Forty percent is environmental. And if it's a severe addiction, that forty percent is usually made up of some set of trauma. "Loveline" has become all about that now. It's essentially all we talk about on "Loveline" now, kids that are dealing with childhood trauma and then acting out or re-enacting their traumas with their relationships with their peers. That's what "Loveline" is right now. That's what it's become.
Vicki Curry>> So you've been co-hosting "Loveline" now for over twenty years. How has that changed over the time?
Dr. Drew Pinsky>> Well, I have Adam Carolla to contend with now (laughter). It has changed quite a bit because with Adam there's a lot more sort of improvisational comedy in it. It also has a national audience now, which has certainly changed over twenty years. Obviously, the drug and alcohol stuff has become more pervasive and more intense and more scary because the drugs they're using are more dangerous and more toxic.
Vicki Curry>> Have the kids changed?
Dr. Drew Pinsky>> You know, what I have seen, particularly in the last seven or eight years, is a growing sort of rift. There are kids that are being really well parented and are turning out so healthy. They're almost perfect. They're almost too perfect (laughter). And there are kids that are just not getting what they need. I don't know quite what it means and both populations seem to be sort of growing and the distance between them is certainly not narrowing. The other kids are the ones going to the great schools, getting the good jobs, and the kids that are trying to survive horrible abusive systems are getting pregnant and diseases and off they go to whatever they can do to survive. I'm very concerned about that.
What I'm concerned about is that we don't really talk about that as a culture. I mean, what's happening? As we say on our show, it's screwed up people having screwed up kids. It's like let's be careful. Let's really pay attention to that whole parenting process and support it and particularly, I think, support women. That's the thing that we've sort of missed because we don't really give women what they need to be able to take care of their kids, support their kids, if they're alone particularly and be a quality parent.
Vicki Curry>> So Life and Times did a profile of you and of "Loveline" back in 1992 and, back then, you were expressing some concerns about was your work doing any good? Was it the right forum? How are you feeling now twenty years later?
Dr. Drew Pinsky>> I probably still have the same concerns (laughter).
Vicki Curry>> But you're still there.
Dr. Drew Pinsky>> It seems to have been sort of become part of the cultural landscape for young people and they're much more -- what I hear back from them is that they learn and they're listening and it's a way of reaching them, that they don't get information -- they never have an opportunity to get information this way anywhere else and it seems to reach them. They don't always still make great choices even though they've got the information, which is the other thing our culture does. We assume that, if we can educate kids, they'll behave properly. No, no, no. We've got to nurture them far differently in terms of our relationships with them as adults.
This program seems to reach them in a way that other things don't and it seems to help them make good choices. I hope it still does. It certainly is wonderful that they let us in still. I mean, now I've got gray hair and I'm older and they still let us in. I'm so grateful that I get to see what their world looks like and to try and offer them something to help them.
Vicki Curry>> So now having teenagers and having this show, are you glad that there's a show like this available for them?
Dr. Drew Pinsky>> Bottom line?
Vicki Curry>> Yeah. I mean, granted, they're probably not going to listen to dad's show.
Dr. Drew Pinsky>> They're not going to listen to dad's show (laughter). I actually believe that kids under fifteen should categorically not be listening to my show, in my opinion.
Vicki Curry>> You do get a lot of kids at that age, right?
Dr. Drew Pinsky>> We do get a lot, absolutely, and we discourage them. We say, hey, come on, we yell at their mom and dad. But kids get onto stuff, you know. We try to keep it so that it doesn't get too dangerous for that age group. I hope my kids listen when they're fifteen and sixteen. I'd like them to know that I understand what's going on there. It's beginning to come into focus for them what I do.
Vicki Curry>> Right. Now we get it.
Dr. Drew Pinsky>> Yeah, it's getting weird.
Vicki Curry>> Dr. Drew Pinsky, thank you so much for taking the time to speak with us.
Dr. Drew Pinsky>> My pleasure. Thank you.
Val>> Dr. Drew Pinsky was a guest of Town Hall Los Angeles. If you'd like more information on future speakers and panels, you can go to their website at townhall-la.org.
To send a comment or a question to our program, you can reach us by mail at this address:
Life and Times
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You can also call our viewer comment line (323) 953-5555) or contact us the fast way by e-mail at kcet.org.
Val>> They are a trail-blazing group that helped put Los Angeles on the map for serious theater. They are the East-West Players, the oldest and largest Asian-American theater group in the country and they're now celebrating their fortieth anniversary. We thought it was the perfect time to open up the Life and Times Vault and revisit this cultural treasure.
Patt Morrison>> In an old part of town in an old church made new, there is a theater, the David Henry Hwang Theater, and the acting troupe that calls it home is the East-West Players, the oldest Asian-American ensemble in the country.
[Film Clip]
Patt Morrison>> For more than thirty years, East-West and sometimes only East-West has given Asian-American performers the chance to play roles beyond the stereotypes, even beyond traditions.
[Film Clip]
Alvin Ing>> Last year, I was in "Cabaret". I played a Jewish character. I mean, where else would I be accepted to do a Jewish character? (laughter)
Keone Young>> Why am I loyal? Because it's still the only organization that represents my point of view.
[Film Clip]
Patt Morrison>> East-West's survival and success have encouraged imitator theater companies across the country, but its financial track record has set new standards. The players raised nearly two million dollars, money that moved them from this small ninety-nine seat theater in Silverlake to this mid-sized one in Little Tokyo.
>> It's very rewarding to watch something grow and develop and to get to this point. If you knew what we knew (laughter) to get here.
Patt Morrison>> And on this night, the company that has trained and sent forth many of the best-known Asian actors of our time is preparing for its inaugural performance in the new theater, the Stephen Sondheim's musical, "Pacific Overtures".
>> Actors' secret. Baby wipes, knee pads, knee pads (laughter).
>> I like to think I give something to people. I give them some laughter, I give them something that, you know, just changes their day.
Patt Morrison>> All of this began in 1965 with a shoestring production of the legendary "Rashaman". Just to be on stage was enough back then. Nowadays, there is more at stake than performance, like the tale of "Rashaman" itself. Each player seeks to bring to life something of her story, of his point of view.
Debra Nishimura>> We can tell our stories better, and who else but us? It's coming from our hearts to your hearts.
Alvin Ing>> We give glimpses of our lives and lifestyle and culture, but from our perspective.
[Film Clip]
Keone Young>> We've always been portrayed as passive, submissive, hating our own culture. Look at all the stories. "Madame Butterfly", "Miss Saigon".
[Film Clip]
Keone Young> Asian woman falls in love with what? White, military imperialist.
Tim Dang>> I think what's happened is that we've been a little exoticized. The mainstream audience is still looking to see an exotic presentation of the Asian-Pacific performer or Asian-Pacific work and they're totally negating or making invisible that there is this Asian-American experience that is happening here in America in Los Angeles.
[Film Clip]
Patt Morrison>> More Asian-American actors are reading lines, but they are not always their lines, not the works of Asian-American playwrights.
Debra Nishimura>> We're only as good as our playwrights and, right now, we have very few Asian-American playwrights.
Tim Dang>> Without the writer writing about Asian-Americans, then we don't have those opportunities for Asian-Americans.
[Film Clip]
Patt Morrison>> The lesson of Los Angeles that is learned and lost and learned again is that theater companies rise and fall sometimes unnoticed in the hulking shadow of the movie and television industry. Theater audiences must be wooed to attend, casts must be persuaded to stay the course, donors and government funders alike must be persuaded of the worth of the enterprise. Amid all of this, East-West has a remarkable longevity.
Tim Dang>> The challenge of the East-West players is how are we going to re-invent ourselves once more? How are we going to get the people who came to see our first show back for the second show?
Keone Young>> I think we're faced with the question of do we stake a claim and try to become mainstream or do we have our own significant voice?
[Film Clip]
Patt Morrison>> The need for that decision will come soon enough. For now, the players are delighted to be a part of the life and livelihood of Little Tokyo and to have a part in this most ancient and lively of arts.
Tim Dang>> One of the East-West Players' goals is to be part of a community where our work is determined not on what we look like or how we look or our experience, but because our art or what we present to the community is educational, entertaining, enlightening.
[Film Clip]
Val>> Since that story first aired, the East-West Players have gotten resettled comfortably in their new accommodations. For more information on the theater group, you can call the number on your screen (213-625-7000) or go to their website at eastwestplayers.org. And that's our program. I'm Val Zavala. For everyone at Life and Times, thanks for watching. We'll see you next time.
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.
Coverage of Town Hall Los Angeles speakers on Life and Times is made possible by a grant from the Boeing Company.
Val>> Next time on Life and Times --
When it comes to office buildings, it may not be easy being green, but it is important.
>> Buildings use twice as much energy as cars and trucks. Seventy percent of the electricity in the United States is consumed by our homes and our office buildings.
Val>> That's next time on Life and Times.
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