Name: Tanir Ami
Position: CEO, OLE Health
J.: You’re the CEO of OLE Health, a nonprofit community clinic that offers health services to low-income and uninsured residents at four locations in Napa Valley. It’s also a federally qualified health center — how does that work financially?
Tanir Ami: It’s a struggle. It doesn’t always work. As a FQHC, we have unusual ways of funding ourselves. A lot of it is donations from the community. And a lot of it is thanks to enhanced reimbursement rates that we get due to all of the additional services we provide.
Your clinic’s model of preventive health care for everyone who needs it seems counter to the Trump administration’s views on delivery of services. What’s your take on this?
For the past five years, I thought we were on a trajectory to erase the tiers of health care, with the haves and the have-nots receiving separate kinds of treatment. But now it seems we’re on a trajectory to see those tiers be even more pronounced.
The idea that we’re going to watch low-income families go back to not having health insurance is repulsive. The fear of what medical bankruptcy and humongous medical bills will do to those that are already struggling with an inadequate income is horrifying to watch. It’s appalling.
News stories are talking about Congress voting to “repeal and delay” the Affordable Care Act, also known as Obamacare. What do you think “Trump-care” is going to look like?
Republicans in the House know that 22 million people just got health insurance over the last three years. They can’t just waltz in and say, “No, you can’t get coverage anymore,” so they have to do something to fake it and make it seem like no one’s going to lose coverage. But we have a new administration led by a businessman. They are all about the free market, and in this case, the free market is the for-profit health insurance companies. And Obamacare put restrictions on this.
My hunch is that those restrictions are going to go away, in a way where the administration will be able to say, “Oh, everyone has coverage.” But the coverage will be horrible. These companies are going to come up with really cheap products that don’t cover anything. It’ll be a tempting piece of insurance if you’re a low-income family, because the out-of-pocket is low. The true cost will be on the back end, and that’s where we’ll see people denying themselves care.
What can we do to prepare and mobilize?
One of the things we can be doing is notifying our state legislators that we want them to do everything possible to maintain funding for the Medicaid program. My hope is that we move to universal coverage, like in Israel, where they have a really nice combination of universal coverage with some consumer choice. But I do think it’s the time for people to really pick up the language of universal coverage again and scream that message even louder.
OLE Health opened in 1972, relying on volunteers or hospital staffers to run things like local flu-shot clinics. Now it offers complete medical care to more than 33,000 people a year on a sliding scale. What’s the secret to its success?
The model of care we provide is patient-centered and team-based. And we do that because it’s just better care. It’s not realistic to think that one primary care provider is going to meet the needs of a human being whose needs are vast and complicated. Whether it’s about nutrition and healthy eating, a personal trainer, acupuncture or dental care, we provide all of those services, and we tailor them to the specific health goals of each person. It’s a new model of care that should be widespread and more readily available, particularly to low-income families who have less access to the basic resources that some of us have come to take for granted.
Does your work in health care intersect with your Judaism?
I’m the only person who works at OLE who’s Jewish — which was kind of a shock coming from Berkeley and Albany. It’s made me feel more aware of, and proud of, what it means to have such a specific background. Such a heavy history. The values that come from that, of tikkun olam, really speak to me — the idea that the work I do in the world is to help better other people’s lives, to spread care and kindness.
What kinds of things you do for fun?
Did you just use the word fun? Haha. I’m a mother of three, so I really enjoy hanging out with my children. My favorite things to do are read and watch documentaries that are relevant to my progressive worldview, about food sourcing and social justice.