48% of U.S. Births Are Funded by Medicaid. Should we Feel Proud or Ashamed?


A recent study of the Journal of Women’s Health sent shock waves throughout the country and medical community when it revealed that state Medicaid programs finance 48% of births in the U.S. or roughly 2 million babies each year.

As an obstetrician who devoted her life caring for medically and fiscally underserved women, those numbers don’t surprise me a bit given the current state of our wretched economy and the dismal politics that go along with it. However, anyone who has ever witnessed the birth of a baby knows that it is nothing short of a miracle.

Of course, there will be extremists who will address pregnant Medicaid recipients with the stereotypical labels of “Welfare Queens,” “moochers” and other derogatory terms based on the limitations of their narrow perspective. However in truth, most of these women hold minimal wage jobs, sales positions that don’t provide insurance or are unable to use their husbands’ healthcare plan because pregnancy is considered a “pre-existing” condition. Some are also budding entrepreneurs.

The way in which we treat our middle class and working poor reflects our values as a nation. While I’m not proud of the fact that the wealth of Bill Gates and Warren Buffet alone account for 40% of the U.S. population’s wealth, I am proud and grateful that they use their money to help the least among us through programs funded by their respective and collective foundations. I am also proud to live in a country where we have compassion and value for human life.

Medicaid has helped finance over 2 million births in our country. Do you feel proud or ashamed?

I’m a Physician and Hospitals are Starting to Scare Me

Warning sign

When you entire a hospital, there should be a bright, yellow caution sign that says “Enter at Your Own Risk” and for those who think I’m exaggerating, I assure you I’m not. My concerns are real and they should be yours as well.

In my city, there are only two healthcare systems in town in addition to the VA system which reduces the competition and thus, the level of quality care. I was a patient at one of those hospitals and ended up on CNN because of the outrageous bill that I received. A few days ago, the Orlando Sentinel reported that one of those hospitals is cutting their staff by 20% and the night shift nurses’ salaries by 15% as a result of a bogus program called “Value Creation.” The announcement was made while the CEO, who earns over a million-dollars-a- year frolicked in the sun at a Caribbean resort with her family compliments of one of the hospital suppliers. Isn’t that a conflict of interest by the way?
Night-shift nurses work under trying conditions because they don’t have the level of support that occurs during the day shift. They work at night because the additional money helps a single mother take care of her family; or a nurse to go to school; or eliminate the need for a babysitter because the mother is allowed to stay home with her kids during the day time.

In addition to cutting back the nurses’ salaries, the hospital plans to eliminate pharmacists, respiratory therapists and increase the price of cafeteria food by 20%. Why am I scared to enter this hospital? Because the night shift will be short of nurses if I happened to be admitted at night. There will be fewer pharmacists to prepare medication in the event of an emergency. The staff morale will be low and the quality of care will be diminished which results in more medical mistakes.

A hospital is no longer a place of healing. It’s a business. And that’s a shame.

A Life Well Lived: The Legacy of Nurse Midwife Maude E. Callen

Maude Callen 1It is said that a picture is worth a thousand words and it was the photographic genius of the late W. Eugene Smith’s photo essay, “Nurse Midwife” published in a 1951 edition of Life Magazine that grasped my attention and introduced me to the late, great Maude E. Callen, a nurse midwife.

Callen was born almost 40 years after the Emancipation Proclamation in Quincy, Florida and was one of 13 children who would become an orphan by age 6. Quincy is located in Gadsen County and to this very day, has one of the worse infant mortality rates in Florida. It’s a wonder that Callen survived her birth and miraculously ended up in the home of her uncle, William J. Gunn whose story is equally fascinating because he was a former slave and carriage driver that became one of the first African American physicians in Florida. His medical school education at Meharry School of Medicine was paid for by his former employer, Dr. George W. Betton, a white physician.

Callen graduated from Florida Agriculture and Mechanical University (FAMU) the year her uncle died and completed her nursing education at Tuskegee Institute. She later trained at the Georgia Infirmary that was started in 1832 and became the first hospital for African Americans in the nation. It was also one of the first institutions to train African American nurses.

Callen eventually arrived in Pineville, South Carolina in 1923 which was one of the poorest towns in Berkeley County. As recent as 2010, it only has approximately 2,000 people who earn an average of $20,000 a year. Callen was one of only 9 nurse midwives in the entire state that delivered babies and it is estimated that she delivered approximately 600 to 800 babies during her career. She faced challenges most of us can’t imagine such as delivering babies by kerosene lamps although there was clearly electricity by the 1950’s; having patients arrive in oxcarts to her home in the middle of the night and performing home births to women in a 400-square mile radius of muddy roads.

Dr William J GunnHer selfless deeds did not go unnoticed. After Smith’s photo essay was published, people donated $22,000 to her practice and a clinic was built in her honor. When President Reagan invited her to the White House, she allegedly said “You can’t just call me up and ask me to be somewhere. I’ve got to do my job.”Callen did that “job” until she retired in 1971 and continued to volunteer until she died at the age of 91.

Callen may have never made it to the White House as a guest of President Ronald Reagan but she is definitely an American hero.

I encourage everyone to view Smith’s wonderful photographic essay and be inspired.