I hate to be the bearer of bad news, but, Ken, I hope you never get to be on
Medicaid.


-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On Behalf
Of Justice For All Moderator
Sent: Wednesday, September 07, 2005 10:00 AM
To: [log in to unmask]
Subject: Marta Russell -- The Medicaid Kill Off

Marta Russell -- The Medicaid Kill Off

ZNet Commentary
The Medicaid Kill Off September 04, 2005
By Marta Russell

Bush and the Congress slashed $10 billion from the Medicaid budget for this
coming year. Medicaid is the primary public health care program for
impoverished persons that serves over 53 million people.

The cut is clearly an attack on poor people and it may wind up killing
disabled and chronically ill persons before all is done. It is also a strike
from those segments in our society who wish to dismantle the entire Medicaid
system and there are undercurrents that will force a rollback of disabled
people's civil rights.

Even before this $10 billion slicing goes into effect, governors and state
legislatures in states such as Mississippi, Missouri, Minnesota, and
Tennessee are cutting back on Medicaid to reduce costs. Maneuvers include
restricting eligibility, paring down the rolls by kicking people off the
program entirely, eliminating or reducing "optional" benefits such as
prescription drugs, wheelchairs, diabetic testing supplies, rehabilitation
services, even oxygen, initiating co-payments for services including drugs,
and reducing payments to doctors and hospitals.

Privatization or subcontracting oversight of programs is also being promoted
in several states, such as Florida, though there is no reason to believe
this will reduce costs, rather it is an ideological shift to the right -
more "free market" healthcare. Placing private corporations in the middle
between citizens and government mostly adds more overhead. Then, of course,
those corporations' goal is to make profits taking dollars from going
straight to patient care.

In the middle of all this are disabled people fighting for their right to
live in the community. As I write, significantly disabled protesters in
Tennessee have occupied the Republican governor's office at the Capitol for
over 3 weeks to stop cuts to their state Medicaid program (known as
Tenncare). Gov. Phil Bredesen has responded by saying: No Food or Water.

Gashing Medicaid promises to roll back the clock on disabled persons who
nearly always were locked up, warehoused, with no option to live in the
community before direct (in-home) support services became a part of some
states' Medicaid program. Present rollbacks to Medicaid are undermining
disabled people's civil rights - the right to be free of institutionalized
"care" (see E.W. and L.C. v Olmstead Supreme Court decision outlining the
right for services to be delivered in the "least restrictive" setting).

Tactics like denying medications and treatments force disabled persons into
nursing homes to get services they must have to survive. Nursing homes have
proved to be costlier than in home services. Why this fact is not a part of
every state's Medicaid budget discussion is a grave oversight - but then we
know the nursing home lobby spends tens of thousands to protect its turf.

In many cases being placed in a nursing home is no less than a death
sentence. Some members of ADAPT will tell you they'd rather die than go into
a nursing home. They know - first hand - what goes on in them.

The governors say their budgets can no longer sustain the growing Medicaid
program. Rising Medicaid costs are often attributed to the economic
downturn. In part this is correct because as people lose their jobs they
generally lose their healthcare and this increases the need for Medicaid. As
more people lose their jobs (and cannot afford Cobra premiums - their
healthcare) they flock to Medicaid.

There are other factors. Employers such as Wal-Mart, the largest and most
profitable retailer in the U.S., does not provide healthcare for most of its
employees. Instead the corporation sends workers to the local Medicaid
office to apply for public healthcare.

Private insurers have increased their premiums to unaffordable levels for
middle and low-income people forcing them to turn to Medicaid when they can.
Yet another reason is that prescription drugs have increased in price by
double digits over the past years driving up Medicaid costs all across the
nation.

Not surprisingly, the Republican governors have struck the first blows
against the most vulnerable sections of society. Gov. Haley Barbour of
Mississippi and former chairman of the Republican National Committee, Gov.
Matt Blunt of Missouri, Gov. Phil Bredesen of Tennessee, and Gov. Tim
Pawlenty of Minnesota supported slashing this vital program rather than
raise taxes or insist that President Bush provide more Medicaid dollars
(federal government typically pays 57% of the program's overall costs) -
which Bush could do if there was the political will. Perhaps a reminder is
due here that Bush, while at Harvard Business School, said that he opposed
Medicaid, Medicare, and Social Security. It is no fluke that we see this
attack on Medicaid now.

It is optional whether to cover some disabled persons or not under Medicaid
rules - a pure piece of bad welfare state planning if ever there was one.
The people who are covered unconditionally are children, pregnant women, and
blind people. Gov. Haley Barbour's effort in Mississippi to reclassify
65,000 Medicaid recipients as ineligible "poverty-level aged and disabled"
was stopped in court last year. But new restrictions on medications have
been enacted in Mississippi that will limit the number of prescriptions a
person on Medicaid receives to five beginning next year. Only two name-brand
prescriptions are allowed. While saving the state money, the rule change is
likely to seriously impact the lives of 80,000 elderly, mobility impaired,
deaf, blind, "mentally ill," diabetic, and cancer-ridden recipients. This
type of rollback does not deal with the outrageous prices placed on
medicines by drug manufacturers nor other kinds of healthcare inflation.
Instead it forces cutbacks that are damaging to recipients' well being. In
Missouri, Gov. Matt Blunt has scheduled 90,000 Medicaid recipients to be
severed from the state rolls next year. The cut was Blunt's solution to
balancing the budget without increasing taxes, despite widespread public
disapproval.

 "The cuts we face sent a big refund back to the feds because they won't
have to pay out matching funds for Medicaid," says one advocate from
Missouri.

The White House had people on the ground in Missouri when the state was
working on ways to end Medicaid there according to one source.

Gov. Blunt's stated plan is to end Medicaid in four years.

"It could be a brutal cautionary tale. We should watch for other states to
try to enact some of the same kinds of change," my source warned.

Since 1996 the costs of prescription drugs to the Minnesota Medicaid program
have skyrocketed. Gov. Tim Pawlenty is overseeing reductions of services
provided by MinnesotaCare. He is in the process of slashing Medicaid costs
by reducing services and increasing fees for those enrolled in the program.

Under the governorship of Phil Bredesen in Tennessee, people on Medicaid are
in a desperate situation. Gov. Bredesen is executing the cruelest slashing
of public health coverage in the history of the nation. According to ADAPT,
every day around two thousand people enrolled in TennCare, the state
Medicaid program, receive letters of termination or reduction of
benefits.

Hundreds of thousands of disabled and chronically ill Tennesseans are living
in fear because of Gov. Bredesen's decision to strip them of the only health
care they have. Many Medicaid beneficiaries have disabilities and virtually
all can't afford to pay for their health care out of their disability
checks. The protestors are still in formation in their sit-in at the Gov.'s
office. They are there to try and stop the Governor from making massive
cutbacks to TennCare that would dump over 200,000 people off services.

Among the people who will be deeply harmed by the cuts are 100 individuals
who use ventilators. Up until now they were getting services in the
community but the Gov.'s plan shuttles them into nursing homes. This is a
clear swipe at their civil rights: a violation of the Olmstead Supreme Court
ruling on "least restrictive environment."

ADAPT confronted Gov. Bredesen.

 "So you are saying," asked Randy Alexander of Tennessee ADAPT, "you will
institutionalize people because they have a disability?"

"Yes," replied Bredesen, "I care about them, I'm not cutting their services
I'm going to provide their services in a nursing home."

"We are talking about basic human rights here," said Alexander before the
Governor could leave, "you have admitted today this state, is willing to
imprison people simply because they have a disability."

This is only the beginning. Ten billion more to be taken from Medicaid next
year.

A record deficit, coupled with right-wing ideology, and overextended empire
underlies the demolition of Medicaid upon which these disabled people's
freedom rests.

The current impetus is towards less restriction of pharmaceutical and
insurance corporate profits, a rollback of government programs for the
people, large tax cuts to the rich, and less health care security for the
working class. The endless war Cheney spoke of will feed the "defense"
contractors and the "rebuilding" company Halliburton, Bechtel, and Kellogg,
Brown and Root. It will increase military spending needed to maintain the US
Empire -- all of which will continue to increase the already over-stretched
deficit.

Bush's term will be marked as one that killed tens of thousands of innocent
Iraqis and others in territories the US has invaded, killed over 1800 troops
who should not have been sent overseas in the first place and now, given
time these factors will kill off Medicaid and innocent poor people with it
in the US -- if the people do not arise and fight this momentum as though
their life depends on it " and it does.




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