If you could have a job that paid well, provided excellent benefits, and the majority of the time you did not have to complete your assigned tasks but yet you still got a paycheck, wouldn’t you jump at the chance to have such a gig? Welcome to the United States Congress! Like me, I am positive many of you are simply outraged at the shameful affairs of our legislators. These highly educated and in most cases, seasoned politicians, have failed to halt the budget sequester.
Sequestration is the process of automatic across the board budget cuts. It is a result of congress failing to reduce the deficit in 2011 by 1.2 trillion dollars. During 2011 lawmakers agreed that if they did not reach a deal, that 1.2 trillion dollars of budget cuts, including defense and domestic spending, would occur.
For example, Medicare will be cut by 2%. Although 2% may seem like an insignificant figure, small medical practices usually cannot afford to absorb such deficits. I am concerned that the limited pool of physicians who accept Medicare will dwindle even further. Too many physicians are already refusing to accept it and many of them are starting boutique style practices to avoid the hassles associated with insurance plans. The cuts would also put a freeze on hiring in various other healthcare settings. An analysis by Tripp Umbach reported that the Medicare cuts would result in 496,000 jobs being eliminated in 2013 and a loss of 766,000 jobs in 2021.
Hospitals are expected to lose approximately 144,000 jobs, home health loses 39,000, and food services about 33,000. However these draconian cuts are not only affecting direct and indirect patient care, but also the training of future doctors and research. NIH, the National Institute of Health is included in this wave of cuts and that results in less money awarded to facilities across the nation, limiting their abilities to find innovative ways to cure disease.
Other disappointing healthcare news includes the recent defeat of a plan to expand Missouri Medicaid. About 20 people testified on behalf of the expansion, but the Senate Appropriations Committee defeated the legislation. In addition, two amendments that would have expanded Medicaid in the next state budget were also defeated. Missouri currently has about 880,000 people on Medicaid and the expansion would have added an additional 260,000 lower income adults. The first three years of this expansion would have been funded by the federal government. After that, states would then have to start picking up the costs up to 10%.
A report issued by the Missouri Hospital Association and the Missouri Chamber of Commerce and Industry stated that the cost of providing care to the uninsured could reach $3.5 million by 2019 if Medicaid expansion was not enacted. Per that report, those costs will probably be absorbed by persons with commercial plans, causing their premiums and fees to rise.
Missouri’s current MO HealthNet program covers 1 out of every 7 Missourians. It pays for about 48% of all births in the state and it covers 1 out every 11 seniors over the age of 65. In addition, 61% of all nursing home care is also covered by MO HealthNet.
In 2011, the racial demographics of Missouri Medicaid recipients were as follows: 62% were white, 21% black, and 6% Hispanic. Nation-wide, 42% were white, 20% black, and 29% Hispanic. I included these numbers because most opponents of programs like Medicaid try to paint it as some type of entitlement program for minorities. However, the above numbers clearly illustrate a different picture. Many of our rural Missouri legislators are adamantly opposed to expanding Medicaid. Yet, it is their constituents who would be harmed the most if such legislation were not passed. So how do these politicians keep getting re-elected back to Jefferson City when clearly they are not voting in the best interest of their districts?
Never could I have imagined how politics and healthcare were so intimately intertwined. I guess I was under the impression that everyone held the same moral compass as I: the health of our society is vital and a social responsibility of us all. However, I often must shake myself into reality and accept that some members of our great democracy do not share my level of concern for the poor. Therefore, for those of us who still have a glimmer of hope for our country’s leaders to eventually start making intelligent, ethical, and fiscally responsible legislation, let us continue to make our voices heard.
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
