Our Health Policy Matters

Legislators have created a Medicaid monster, which eats up 22% or more of their state budgets.   Now they want to slay it.   However, they’re not seeing the real monster clearly.   Cutting the legs out from under Medicaid recipients isn’t the same as cutting the monster down to size. A Florida bill illustrates how states are attacking the wrong things.   Under a Florida Medicaid reform proposal , Medicaid patients would be charged $100 for non-emergency visits to a hospital emergency room.   The purpose is to save money by discouraging unreasonable use of emergency rooms.   Nearly half of all visits to emergency rooms are for non-emergency reasons.   This is true of Medicaid patients, insured patients, and uninsured patients.   The main reason the percentage is so high isn’t that people choose to go to the emergency room for minor complaints.   Laypeople aren’t qualified to diagnose their own emergencies.   Health professionals tell them to use emergency room because it’s better to be

Are essential health and behavioral health services a priority for our elected officials?   We got a clear picture when House leaders offered their 2011 continuing resolution and President Obama proposed his 2012 budget this past week.     Both the continuing resolution to fund federal agencies for the current fiscal year and the President’s budget proposal for next year cut billions of dollars from the federal budget.   Some essential health services are surprising targets. Cost Per Person to Restore Proposed Health Cuts For a total savings of $2 billion, or just over six dollars a person, would we choose to slice what they chose to slice, or would we make health services a bigger priority? The continuing resolution proposed to cut $1.3 billion from community health centers.   These centers are located in every state.   They provide comprehensive primary care to everyone, regardless of their ability to pay.   They employ doctors, dentists, nurses, counselors, and other health prof

When you’re headed in the wrong direction, running to the front of the crowd and yelling charge may not be the best strategy.   On Monday, Governor Rick Scott of Florida did this when he proposed his new state budget.   Like every state, Florida has struggled over the past few years as state revenues have declined.   The Center on Budget and Policy Priorities has documented just how tough that job has become – at least 21 states have already proposed budgets this year with inflation-adjusted spending below 2008 levels.   In presenting his bare-bones $66 billion budget, Governor Scott promised to bring new business principles to state government.   The problem is that he forgot an old one.   If you don’t increase the supply of a product when demand goes up, you’re going to pay an increased price.   He proposed $4 billion in cuts (over two years) from current Medicaid levels.   Medicaid is almost 30% of the state budget, and cutting it would help him close a budget gap caused by reduci

The late comedian Jack Benny made himself the butt of a running gag about how cheap he was.   A crook would come up to him and demand “your money or your life!”   After a long pause, Benny would deadpan to the increasingly impatient crook, “I’m thinking about it.” It’s funny to think about someone who would hold onto his own money so tightly that he would put his own life at risk.   It’s not funny to think about people who would do the same and put their children’s lives at risk. At the beginning of the 21 st century, we could feel good about the progress we were making to improve the health of our children.   While child poverty rates were doggedly high, other key indicators, including infant mortality rates, low birthweight rates, immunization rates, and violence rates, were all improving.   We had reason to believe that even the “compassionate, conservative” approach to policymaking would continue to get results. It didn’t happen.   Some data from the Annie E. Casey Foundation’s