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Congressional candidates talk priorities during forum
candidates
Congressional District 10 candidates - except for incumbent Jeff Denham - address the issues during a public forum hosted by the League of Women voters on Wednesday. - photo by ANGELINA MARTIN/The Journal

Whether Republican or Democrat, the six candidates vying to replace Rep. Jeff Denham in Congress all agreed on one thing during a debate this week: It’s time for a change.

The Central Valley race is listed as one of the Democratic Congressional Campaign Committee’s initial targets in their mission of flipping Republican-controlled districts over to Democrats, and what began with a competition that saw 13 challengers ready to face Denham has now fallen to six. With less than two months until the June 5 Primary Election, Democrats Mike Barkley, Michael Eggman, Josh Harder, Virginia Madueño and Sue Zwahlen and Republican Ted Howze on Wednesday answered voter questions and shared why they believe they are the best candidate to represent California’s 10th District.

The candidates were forced to think logically rather than politically thanks to the first question of the night, which asked if Congress is irrelevant now. Congress isn’t irrelevant, they all agreed, but Eggman wondered if the concept has become irrelevant for the working people of the country as big corporations fill the pockets of representatives with campaign money. He and the others took the opportunity – and many more throughout the event – to criticize Denham, who was not present at the event, for taking money from corporations and for voting against the wishes of many of his constituents.

“I don’t think (Congress) has become irrelevant, but I certainly think it’s become ineffective in the issues that matter most,” Harder said, pointing to Denham’s “yes” vote on the American Health Care Act, which would have stripped health care from many District 10 residents including his younger brother, who was born with a preexisting condition.

Howze agreed with Harder, stating that Congress has become irresponsible and Denham unreachable.

“I’m a fellow Republican and when you can’t have a conversation with your representative about what you feel are hotbed issues and what you need to work on, it’s become completely irresponsible,” Howze said.

Issues like water, immigration and gun control were hot topics during the discussion, and the candidates’ similarities in these areas were made evident through their similar answers. All would like to increase access to safe and reliable water in the district, and all agree that comprehensive immigration reform is needed.

While the Democratic candidates agreed on other issues like accepting refugees and commonsense gun control, the lone Republican Howze made his differing opinions known, stating law-abiding gun owners should have the right to bear arms and that refugees of “young, fighting age” coming from Syria should be screened.

More differences between all of the candidates came to light when they were asked to name legislation that would most benefit the area.

For Madueño, the daughter of immigrants, immigration reform is her top legislative priority.

“How many people are being adversely affected right now? Knowing that farmers right now in the community, employers in the community, can’t find enough workers…right now our economy is on the brink of suffering some major, major repercussions that we’re not going to be able to repair,” she said. “We also have over 800,000 youth – rising star kids – that should be and need to be allowed in this country.”

Both Zwahlen and Eggman believe that the nation’s health care system is in great need of a fix.

“The costs are exorbitant and out of hand for most of us in this room, I’m sure,” Zwahlen said, adding that she would like to see “Medicare for all” turn from a slogan into a reality. “After 40 years in the emergency room, I have seen a lot through my window of the world and I have a heart and have empathy for the patients that I see everyday and their pressing needs.”

Barkley’s first move, if elected, would be to repeal the GOP tax bill, while Harder hopes to work for better-paying jobs in the Valley through investment in infrastructure and Career Technical Education.

“Part of that program is federally-funded and it’s getting zeroed out in the Trump budget,” Harder said. “Those are the sorts of solutions that we need a Congressman who’s going to invest in them, not just somebody focused on creating more tax cuts for a handful of wealthy corporations.”

Howze said that fundamentally, the most important thing that Congress will do next is restructure “entitlements,” like Social Security, to “ensure their longevity.” If elected, he would like to work to see Medicare and Medicaid split completely, with Medicare working at the federal level to cover elderly and Medicaid becoming a state program to cover poor children and the disabled.

“America is headed on a path of bankruptcy whether we like it or not, and no one wants to touch it or talk about it because it’s a political hot potato,” Howze said. “I will.”

Wednesday’s candidate forum, hosted by the Stanislaus County League of Women Voters, is one of two to be held before the June 5 Primary Election. A second candidate forum will take place from 7 p.m. to 8:15 p.m. April 25 at the Bianchi Center, 110 South 2nd Ave. in Oakdale.

 

 

 

Costa, Gray propose congressional bill to address critical physician shortage in rural areas
Costa and Gray
San Joaquin Valley congressional members Rep. Jim Costa, D-Fresno, left, and Rep. Adam Gray, D-Merced, are shown discussing their bill H.R. 2106 in a virtual press conference on Tuesday.

BY TIM SHEEHAN

CV Journalism Collaborative

Two San Joaquin Valley congressional representatives have introduced a bill that could help address the vast shortage of doctors in the region, particularly in underserved areas. 

Rep. Jim Costa, D-Fresno, and Rep. Adam Gray, D-Merced, say the Medical Education Act would, if passed, establish a program of grants to support expanded medical education programs in underserved areas of the nation.

The Valley could be one of the key areas that would benefit from the legislation. California has about 90 primary care doctors per 100,000 residents statewide, the federal Health Resources & Services Administration reported in November 2024. 

That’s more than the ratio in some states, and less than some others. The nationwide ratio is about 84 doctors per 100,000 residents.

But in the San Joaquin Valley, home to about 4.3 million people, doctors are much more scarce – about 47 primary care physicians per 100,000 residents, according to Dr. Tom Utecht, chief medical officer at the Fresno-based Community Health System.

That number is “a little over half of what is necessary to take care of a population,” Utecht said Tuesday in a video press conference. “We have the lowest physicians-per-capita rate in all of California, in the San Joaquin Valley.”

Introduced last month, the Medical Education Act is something of a placeholder for the time being until the Congressional Research Service can weigh in with financial estimates of what is needed in different parts of the country, Costa said. 

A companion version was introduced in March in the U.S. Senate by Sen. Tim Kaine, D-West Virginia, and Sen. Alex Padilla, D-Los Angeles.

At this point, the legislation does not specify how much money will ultimately be sought or how grants would be structured.

Costa said the shortage of doctors in the region “is combined with language barriers, cultural barriers and distances … and that would really go for rural parts of our country regardless where folks live.”

“If you live in rural areas, it’s just more difficult to have access to good quality health care,” he added.

Costa said the legislation, if it can survive a Republican-controlled House and Senate and a Republican president, “would be transformative because it would invest expanded resources to minority-serving institutions and colleges located in rural and underserved areas to establish schools of medicine and osteopathic medicine.”

The bill would also create an avenue for more historically Black colleges and universities, as well as Hispanic-serving institutions, to establish medical education programs, Costa said.

Gray noted that when he was in the state Legislature, he and colleagues “worked to get hundreds of millions of dollars in funding to expand the UC Merced campus, to ultimately secure the funding to put the first medical education building up on campus.”

Gray added that the UC San Francisco’s medical education program in Fresno “is an important part of creating the (medical) workforce of the future for the valley, but more importantly, solving this access to care issue that plagues Valley communities.”

At UC Merced, director of medical education Dr. Margo Vener said there has been a surge of interest in the university’s program that funnels students through an undergraduate program for their bachelor of science degree through a medical school degree in collaboration with UC San Francisco.

“All the students that we are enrolling are from the Valley and for the Valley, because they want to really make a difference in promoting health in their communities,” Vener said. That, she added, is likely to eventually translate to those would-be doctors to stay in the Valley to practice medicine.

“The data suggests that two factors really strongly influence where physicians stay to practice,” Vener said. “One of them is where they’re from, which, of course, is why we’re recruiting students from the Valley for the Valley just to stay (and) be doctors for their community. And the other factor is where you went to residency. Those are the two biggest drivers.”

That’s something that was underscored by Dr. Kenny Banh, assistant dean of undergraduate education at UCSF Fresno. “Regional campuses such as UC Merced and UCSF Fresno not only grow doctors, but they take those doctors, physicians and medical students from their communities in the region, and train them in those regions to go back to be physicians in those areas,” he said.

While the costs of the Costa-Gray legislation are yet to be determined, Banh said there are also costs associated with doing nothing to expand medical education.

“There’s health care costs, regardless of how we work it, if we don’t invest in having an adequate supply of physicians,” Banh said. “There’s a cost on the human that can’t access care” and doesn’t get to a doctor until a condition is not treatable “or with significantly worse morbidity and mortality outcomes.”

“And that cost is borne by health systems taxpayers, one way or the other,” Banh added.

But even if the Costa-Gray bill were to pass in this congressional session, the payoff of home-grown medical schools producing a bumper crop of physicians in the Valley or other deprived parts of the country would be years down the road.

“I think it’s really important to understand why we need to invest now for our future, because it takes so darn long” for a student to go from being a college freshman to a practicing doctor, surgeon or specialist, UC Merced’s Vener said. 

After a four-year bachelor’s degree, a student must then complete four years of medical school, which in turn is followed by a residency of three to five years.

“Then often people will do a fellowship to become, for example, a cardiologist or a gastroenterologist or something like that,” she added.

“If you start investing in just one student now, it’s going to take such a long time before they really are there to take care of you at that moment when you need them to be your gastroenterologist, your cardiologist, your emergency physician, or, dare I say, your family doctor,” Vener said.

That, she said, is why it’s also necessary to expand residency programs that can attract would-be physicians into the region in hopes that they will remain once they complete their training. “We need those doctors now, and that’s why this effort is important,” Vener said, “because this is what will both inspire people to stay, but also inspire people to really come and embrace the communities and serve them.”

In a related development, state Assemblymember Esmeralda Soria, D-Fresno, recently introduced a bill for the University of California system to develop a comprehensive funding plan for expanding the current SJV Prime+ BS-to-MD partnership between UC San Francisco and UC Merced, with the goal of transitioning the program to a fully independent medical school operated by UC Merced.

“We have seen firsthand the impacts of medical workforce shortages throughout the Central Valley,” Soria said in a prepared statement. “AB 58 would help ensure the Legislature is equipped with the information needed to secure appropriate funding for the medical education provided for our community at UC Merced.”

— Tim Sheehan is the Health Care Reporting Fellow at the nonprofit Central Valley Journalism Collaborative. The fellowship is supported by a grant from the Fresno State Institute for Media and Public Trust. Contact Sheehan at tim@cvlocaljournalism.org.