Parkland Health and Hospital System CEO, Dr. Ron Anderson, one of the nation's staunch defenders of the important mission of America's public hospitals, is concerned. Very concerned.
Healthcare reform, with its promise of coverage for about 30 million uninsured Americans, is under attack. The newly elected majority in the House of Representatives is planning an all-out assault on this legislation -- from outright repeal to significantly hamstringing implementation by denying funding.
To complicate matters, new surveys show that the number of uninsured Americans continues to grow. According to USA Today, that number is now 50.7 million.
Meanwhile, in Texas, where the GOP now has a virtual super majority in the House that would enable them to pass their agenda without too much difficulty, one member has proposed that the state withdraw from the Medicaid program. Facing an estimated budget deficit that could reach $25 billion and a constitutional mandate for a balanced budget, even legislators who have been more moderate in the past, are saying this idea should be considered. The Governor, Rick Perry, seems to agree. The legislature, which meets every other year and will convene this January, already has House staff members developing cost-benefit scenarios for the Medicaid debate.
Dr. Anderson and other Texas healthcare executives know this could devastate hospitals, particularly those tax-supported safety net facilities like Parkland whose charity care costs exceed $500 million each year. In a struggling economy, those numbers could get worse. Dr. Anderson told a recent meeting of the ACHE of North Texas, that he is most concerned that the legislature will cut spending across the board, severely compromising federal matching dollar programs and hampering Parkland's ability to fulfill its mission.
In virtually every state, voters who went to polls this month, were angry. Primarily they were focused on the federal deficit and the long-term debt. Republicans, who now dominate the U.S. House of Representatives where all spending bills originate, have not yet specifically listed how they will they eliminate the budget deficit and reduce the debt. But given that national defense, Medicare, Social Security and interest payments comprise more than 70 percent of the federal budget, it does not take a mathematical wizard to realize that at some point additional reductions in Medicare spending will have to be on the table since that is the single biggest time bomb in the government's total of unfunded liabilities. For the record, as of this writing, the federal government's unfunded liabilities -- commitments that have been made but for which there is no money set aside for payment -- total $53 TRILLION. Medicare far and away is the largest component of that number.
Not many will argue against the economic and national security necessity of balancing the budget and, over time, dramatically reducing our national debt, especially since nearly 50 percent of the U.S. debt is held by overseas parties like China. But just as the U.S. economy is improving -- albeit ever so slightly -- draconian cuts in healthcare programs to help those in our society who need it the most -- the least among us -- seems poorly timed.
And that is why Dr. Anderson is so concerned.
© 2010 John Gregory Self
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Posted by: zhang | November 24, 2010 at 08:27 PM