Map of life expectancy at birth from Global Education Project.

Tuesday, August 30, 2005

Yet another tiresome rant on the Culture of Life

As Congress returns from its vacation next week, the good Christians who govern our country will take up various cuts in federal spending mandated by the budget act. Among these are $10 billion [editor's note: arggh! I originally wrote "million." I'm worse than NBC news.] in annual reductions in spending on Medicaid, whose financing is shared between the federal government and the states. Various proposals are floating in the DC smog, some of which would squeeze providers such as community health centers and hospitals, others of which would limit eligibility and benefits. Efforts are also underway to shift costs to the states by changing accounting rules. The states are responding to their increasing costs by throwing people off of the roles and reducing covered services.

Medicaid is an entitlement program, which means that overall spending increases when more people are eligible and the cost of health care increases. These tend to go together, because as health insurance gets more expensive, more of the working poor lose employer-provided coverage and are forced onto the Medicaid roles. Overall spending on Medicaid has been increasing at about 10% a year recently. But there is a big payoff to society. Medicaid pays for health screenings for poor and low-income children, and for treatment of conditions that would compromise their futures, such as hearing and vision impairment, lead poisoning, and congenital abnormalities. It pays for childhood immunizations, and for preventive services for adults. It provides essential support for institutions as well, such as community health centers, community mental health clinics, and safety net hospitals. Medicaid keeps people out of emergency rooms. It pays for long term care for the elderly. The services for kids are important to our future, but the largest share of expenditures is for adults with disabilities, followed by poor elderly people. Cutting Medicaid means killing people -- children, people with disablities, frail and disabled elders.

The American Public Health Association has produced a good, succinct report describing the current state of Medicaid, and critiquing various reform proposals, and making recommendations for the future of the program. (Click the top link on the page.)

Meanwhile, here in the Culture of Life, although we can't afford to pay for poor children's eyeglasses or grandma's nursing care, the Cost of War is rolling past $191 billion. This war, which has only killed about 100,000 people so far, is apparently succeeding in the president's goal of establishing a Shiite theocracy closely associated with Iran's clerical rulers. In order to assure the security of the Islamic Republic of Sumer, the U.S. will continue to occupy the country for many years to come, at least if the leadership of the Democratic Party has anything to say about it. But clearly that is a much higher priority than taking care of our own children, disabled and elderly people. Just ask your minister, he'll tell you.

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