Wednesday, July 6, 2011

Short-Sighted At Seeing Short-Sightedness

Congresswoman Cathy McMorris Rodgers joined Senator Tom Harkin in writing an op-ed piece about getting the most of out Medicaid dollars when treating the mentally disabled by placing more in the community which they say is less expensive than placing them in institutions.

For example, the average national Medicaid cost to serve a person with an intellectual disability in an institution in 2009 was approximately $137,000, compared to an average of $44,000 to serve the same person in the community.

In this day and age, anyone quoting numbers, dollar's, etc., should provide links to their sources. How hard can that be any more? Consequently, it's difficult to verify these numbers or find out what they really mean. And you'll find this next part seems a little ambiguous.

In 2009, 17.4 percent of all national Medicaid expenditures went to serve people in institutions. Our continued heavy reliance on outdated and expensive institutions to serve people with disabilities reflects inertia and politics rather than the needs of people with disabilities.

Notice it states "to serve people in institutions" without defining people or institutions. Many elderly are in nursing homes and could be included in this definition. And I am unable to find any support for the figure of 17.4 percent. I'd like to know where that came from.

One interesting aspect of this op-ed is that they highlight the high cost of care and fault the states for not reducing costs and instead cutting services as if this was the only reason states are unable to meet the needs and requirements of Medicaid patients.

These cuts have typically been short-sighted. Rather than taking steps to reduce wasteful spending on institutional settings, many states have cut the services that keep people with disabilities in their own homes and communities.

McMorris Rodgers and Harkin make a case that appears valid but I would feel much more comfortable knowing where the numbers came from.

But since we're on the subject of being short-sighted, here's what a report by the Kaiser Commission on Medicaid and the Uninsured has to say about the House budget that McMorris Rodgers voted for:

The House Budget Plan includes two major provisions relevant to Medicaid. First, it would repeal the Affordable Care Act (ACA), which includes a major expansion of Medicaid with mostly federal funding to nearly all non-elderly individuals, including adults without dependent children, up to 138 percent of poverty. The repeal of ACA would result in substantial reductions in currently-projected Medicaid enrollment and federal spending. Second, the House Budget Plan would convert existing Medicaid financing from open-ended, matched federal spending for eligible individuals to a block grant under which federal spending is capped annually by state and is distributed based on a formula rather than actual costs.

And that's how you reduce the amount the federal government pays for Medicaid. You don't raise taxes and you pay less for Medicaid which increases the burden on states, charitable institutions and hospitals and leaves many of the poor with a single remedy--the ER. It reminds me of a quote from the president to whom she said, "You make me proud to be an American" after his 2008 State of the Union speech.

"I mean, people have access to health care in America. They can just go to the emergency room." - George W. Bush

No comments: