Health Care

I don't want to go into a rant once again about what the government is doing to my husband on health care. I've already written about it and the only change is for the worse.

Now he's expected to pay a $1,400 deductible per month (out of a not quite $900 income) for the state program to cover his co-pay. We sink a little deeper each month. They've begun billing us for the premiums on prescription drug coverage and have double his co-pay on prescriptions. He takes a lot of medicine and it all adds up.

If it's happening to us, it's happening all over the country. How can they possibly justify a monthly deductible higher than his Social Security?

Our local mental health unit has been laying off people and refusing treatment to many of their clients. You're suicidal? They give you the number of the local help line. Homicidal? I guess they wait until you kill someone.

I'm ranting and I said I wouldn't. They also plan, at least here in CA, to cut services to special needs kids which includes our Elcie. I don't know yet what that will entail.

We're not parasites; we've both worked all our lives to keep our heads barely above water. He worked until he could no longer and I gave up employment to care for the girls.

The system is broken.

Evidently, the New York Times agrees. Here, as reprinted in Truthout today, is what they said.

Passing the Buck on Health Care
The New York Times Editorial

Monday 12 February 2007

President Bush's new budget would extend the administration's warped priorities deep into the realm of federally supported health care programs. The administration long ago sacrificed any meaningful domestic agenda to finance tax cuts for the wealthy and its reckless war in Iraq. The White House's reckless determination to make the tax cuts permanent is now driving it to slash domestic spending in health and other vital programs.

Instead of trying to address the underlying problems of escalating health care costs, Mr. Bush's strategy is to cut services or shift more of the bill to states, health care providers and individuals.

In the Medicare program, which covers health care for Americans aged 65 and over, the administration would find most of its savings by slowing the annual increase in reimbursements for services, forcing hospitals and other providers to absorb the burden. Given Medicare's precarious financial straits, the package appears broadly acceptable.

The real outrage is that the administration has not proposed comparable reductions in the large overpayments - roughly 12 percent more per patient - made to private managed care plans that enroll Medicare beneficiaries. The budget would also phase out Medicare bad-debt payments, forcing hospitals to swallow beneficiaries' unpaid bills.

The budget also looks to save money by eliminating inflation indexing so that as incomes rise, so would the number of people required to pay higher premiums. Although this is a sneaky way to raise premiums, it is hard to argue with the notion that better-off beneficiaries should pay more to help rescue a financially strained program.

What seems counterproductive is Mr. Bush's plan to lower federal matching funds for Medicaid administration - forcing the states to find more of their own funds or sacrifice good management and oversight. More worrisome is his plan to cut back on state programs that insure the young.

The most shortsighted restrictions would come in the highly acclaimed State Children's Health Insurance Program, which uses federal matching funds to provide coverage for low- and moderate-income children who are not quite poor enough to qualify for Medicaid. The program has been enormously successful in reducing the number of uninsured children. Yet now the administration wants to reduce its matching rate and limit enrollment to children in households earning no more than twice the federal poverty level. That would undercut programs in 16 states that have expanded coverage to children above that level.

Although the administration's budget would grant the children's program a small $5 billion increase spread over five years, that's less than half, and possibly only a third, of the amount needed just to maintain current enrollments and participation rates. This is too high a price to pay for more tax cuts and Mr. Bush's ill-managed presidency.

Billions in Tax Cuts for The Elite; Cuts in Medical Care for Elderly and Poor

Bush’s proposed health-care cuts spark debate

Some see salvation, others see doom for Medicare and Medicaid

By Christopher Lee and Lori Montgomery

Updated: 10:43 p.m. CT Feb 10, 2007

Depending on whom you ask, the budget that President Bush proposed last week will save or sink Medicare and Medicaid, two popular programs that, along with Social Security, threaten to swamp the federal budget as the baby-boom generation retires.

Bush, citing the need for fiscal responsibility, proposed reducing by $101 billion over five years the spending growth of the two health programs, which serve 93 million people and will cost the government $564 billion this year. One of his most controversial ideas is to charge wealthier seniors higher Medicare premiums for the second time in the program's 41-year history.

Budget experts call the plan one of the most significant efforts in years to rein in federal spending on entitlement programs. But health-care providers and advocates for beneficiaries call the proposed cuts arbitrary and say they would exact an unaffordable toll on a big part of the nation's health-care system.

"It is very, very significant that they're willing to put on the table some specific proposals," said Comptroller General David M. Walker, who frequently warns of the government's troubled long-term fiscal outlook.

Stuart M. Butler, a budget expert at the conservative Heritage Foundation, said, "It's the only way forward in dealing with a huge unfunded obligation that right now is being left in the lap of our children and grandchildren."

Sacrificing Medicare for the war?
Others see the proposals as likely to do more harm than good, and many congressional Democrats have accused Bush of trying to pay for the Iraq war and his signature tax cuts by reducing health care for elderly and poor Americans.

"There are problems in terms of future financing of Medicare, and those need to be dealt with in a comprehensive way," said Charles N. Kahn III, president of the Federation of American Hospitals. "To think we're going to solve all those problems by simply saying, 'We're not going to pay those who provide service what we need to pay them' is more than problematic. . . . This has more to do with the balanced budget and other things than it does with the preservation of Medicare."

Senate Finance Committee Chairman Max Baucus (D-Mont.) said the Bush plan does nothing to address the underlying causes of the financial woes of Medicare and Medicaid -- rising health-care costs.

"I know it's difficult, but the administration would be doing this country a much greater service by finding ways to lower the underlying costs of Medicare and Medicaid, rather than just lopping off the top," Baucus said. "These costs will just get transferred somewhere else -- emergency rooms or uncompensated care."

Hospitals, care facilities concerned
Some of the institutions affected most would be hospitals, nursing homes, home health agencies and other providers, whose Medicare payments would be more than $61 billion lower than anticipated over five years (although still higher overall). Bush also proposes automatic across-the-board cuts in provider payments if Medicare spending reaches certain levels for two consecutive years. His budget would not forestall a planned 10 percent cut in Medicare payments to doctors next year.

Bruce Yarwood, president of the American Health Care Association, said the 9,000 nursing homes he represents would receive about $10 billion less than anticipated over five years.

"We'll squeeze, cut and trim administrative costs," he said. "You take a look at your staffing patterns, and rather than four people on the night shift you have three. And rather than seven or eight on the day shift you have six. You take a look at your maintenance crew; you say, 'Rather than mow the lawn every week, I'll mow it every two weeks,' so you lay off a maintenance guy." [WA: nursing homes are already notoriously understaffed; cuts in staffing further lessen the quality of care. ]

CONTINUED: Fears that docs will flee

---

1 2 Next >