This article was written by Ricky Choi, MD, San Francisco area pediatrician and NPA Board Member. It is cross-posted from the San Francisco Chronicle Blog where it originally appeared on June 29, 2011.
What if I were to tell you that Washington is trying to balance the budget by making cuts to a program that covers 70% of the nation’s nursing home costs and 43% of all births in California? Well they are.
The rancorous debate over how to balance the federal budget includes drastic cuts to Medicaid. And while this program may seem distant to people in power and the general public, the reality is that cuts will effect far more people than you expect and may even impact you or someone you know.
Here are a few statistics to ponder:
* Medicaid covers 60 million people.
* 2 in 5 children in the United States get their health insurance through Medicaid (30 million children).
* More than 1/3 of all births are covered by Medicaid which includes prenatal and maternity care.
* 7 in 10 people living in nursing homes are covered by Medicaid.
* Medicaid provides 1/4 of all funding for mental health care.
Doesn’t the Medicaid program cost a lot of money? Yes it does. But it’s a good deal if you consider that the average annual Medicaid spending per child is $2,422 and $7,683 for each adult and that the costs per enrollee is growing more slowly than premiums from employer based coverage (4.6% vs 7.7%).
Medicaid costs are going up because millions more are are needing it in these difficult times. Medicaid would be your safety net if you were to lose a job or experience a sudden drop in income.
For community health centers like mine, Medicaid is a lifeline. 37% of health center patients are covered by Medicaid. And this money is well spent. Community health centers have been shown to provide high quality cost effective care its 23 million patients.
Medicaid has its faults but few would argue that it is a lynch pin for our health care system and represents our nation’s moral commitment to help low income communities.
Attempts to make “reforms” like converting Medicaid into a block grant as championed by Representative Paul Ryan in legislation which passed in the House in April or applying a global spending cap are just gimmicks. The real impact will be a decrease in funds already cash strapped states have to pay for these programs, a loss of services or even closure of community health centers, and more uninsured people. In fact, these methods will not even cut costs, it will just shift the cost to states, providers and patients. It’s a shell game.
To make cuts to a program that is vital to the health of one in every five Americans is hazardous to our nation’s health. Don’t take it from me. One of our patients shares, “My friend is very frustrated with this government that prides itself on its democracy and equality for all, and yet blindly takes away the most basic services from its most vulnerable people who cannot otherwise afford or have access to medical care. There are millions of others in the same situation and it gets worse for those with multiple chronic conditions.”