Our Health Policy Matters

Isn’t it worth a few dollars to preserve essential mental health services?   It would appear that many state legislators would say no. According to the National Alliance on Mental Illness, states have cut a total of $1.6 billion for mental health services over the past three years. That was just the teaser.   This year, states around the country are making people with mental illness pay the price for tax cuts and deficits. NAMI state-by-state data show that the State of Florida spends no more for mental health services than it did in 2009.   But Health News Florida reports that the Florida Senate has proposed millions of dollars of cuts to mental health.   Next week, its Appropriations Committee will vote whether to cut $137 million from adult mental health services, 57% of the total outpatient budget.   Anyone who thinks these services aren’t essential should think again. On a single day this spring, in addition to offering its full array of group counseling, AA, NA, and individu

Babies crawl before they walk.  c. Microsoft Office Image The Affordable Care Act (ACA) marks its first birthday this week.   It may not be off to a running start, but it isn’t exactly sitting still either.   The most debated provisions, like the individual mandate and the Medicaid expansions, are still three years in the future. In the first year, ACA’s biggest developmental milestones have affected older Americans, people with mental and physical disabilities, and consumers in general.   Which of these populations is making the most progress? Medicare recipients and early retirees have taken the most steps forward .     As of January 1 st , all Medicare Part B recipients are entitled to a free annual physical, with free cancer, cardiovascular, and skeletal screenings, and free flu shots.   150,000 beneficiaries had taken advantage of this through February 23 rd .   This number will grow, to many millions before the end of the year. Also, over 3.4 million Part D recipients who

The catastrophic nightmare in Japan could happen anywhere.  It is a reminder of the fragile relationship between our environment and our health. As the tsunami waves swept over the land, they swept away any pretense that we are more powerful than our environment.   The mere shifting by several feet of two constantly moving plates of the earth resulted in the death of thousands, the destruction of a region, and catastrophic worldwide effects. Experts have noted that as many as 24% of premature deaths can be attributed to environmental factors .  These result from our inadequate understanding of our environment, and/or our inability to manage its forces. While the underdeveloped world is more susceptible, the Japanese tsunami reminds us that the overdeveloped world is not immune.    The images are more powerful than their descriptions.  In the wake of such destruction, we can see -- as we do in the aftermath of hurricanes -- the breeding grounds for disease.  We know that many

Why is it so important that Florida has won a $35.7 million health reform act grant to participate in the federal “Money Follows the Person” program? A recent news story provides the answer.    It tells the story of a 20-something Florida resident who is a quadriplegic living in a nursing home.   He doesn’t want to live there.   But he doesn’t have a choice.   It’s the only option for which the Florida Medicaid program will pay.   We hope he’ll be alive for many years.   A back-of-the-envelope calculation suggests that the cost of his care could approach $4 million by the time he is 65. A December, 2009, AARP Long Term Care Brief showed that Florida spent 86% of its Medicaid long term care dollar on institution-based services.   It spent about half the national average on home and community-based services (HCBS). The “Money Follows the Person” program offers a low cost remedy.   Enacted in 2007, the program has already provided over $1.4 billion to 30 states.   It has helped over 30,

Policymakers across the country have declared war on health.   You may have missed the headline, but this is a war with many casualties. Its objective is to topple health care as we know it.   When health care falls, our health will be the victim. Battles are raging in many states to cut the legs out from under health care financing. The Arizona Senate Appropriations Committee recently voted to eliminate the Medicaid program.   This would make 1.3 million people uninsured and cost the state $7.5 billion in federal funding.   A Florida Senate leader has threatened to eliminate Medicaid unless the federal government agrees to massive changes.   This would cost Florida over $10 billion, and make 3 million people uninsured. Wisconsin’s Governor has proposed dropping over 60,000 people from Medicaid because they are too rich.   “Too rich” means a two-person household income of less than $29,100.       Medicaid isn’t the only target.   Pennsylvania just cancelled its state-funded health