OT: Bush trying to eliminate public hospitals
- From: compassionate conservative <lordkoos@xxxxxxxxxxx>
- Date: Sun, 2 Dec 2007 14:21:20 -0800 (PST)
Bush Tries to Eliminate Public and Teaching Hospitals: Action Needed
Hotlist
Sun Dec 02, 2007
While people are focused on universal care, the Bush Administration is
incrementally chipping away at our existing public health safety net.
The most recent assault on our public health care infrastructure is
escaping the notice of mainstream media and citizen journalists alike,
probably because it is not easily explained. I am referring to a
proposed arcane regulations change by the Center for Medicaid and
Medicare Services (CMS) which, if enacted, will result in $4 to $5
billion dollars over 5 years in cuts to public hospitals and other
hospitals that serve indigent patients. In addition, CMS is proposing
other rules changes that will result in billions of dollars of
reductions to teaching hospitals.
These hospitals serve as the backbone of our public health safety net,
train the next generation of physicians and health care professionals,
and are essential to any kind of response to disaster, terrorist
attack or pandemic outbreak. Without them, our already frayed public
health infrastructure may disintegrate.
On January 18, 2007, CMS issued a sweeping rule that, if it goes into
effect, will drastically limit Medicaid payments to public health care
providers, and to private providers who serve the indigent and
uninsured.
In response, Congress enacted a one year moratorium on the rules
change, which was buried in the supplemental appropriations bill (P.L.
110-28, Section 7002) that funds military operations in Afghanistan
and Iraq. The moratorium allows Congress time to consider and develop
rules that simplify Medicaid without harming our safety net by
preventing CMS from enacting the new rule until May 25.
In a display of contempt, CMS published its proposed rule in the
Federal Register on the same day that Bush signed the one-year
moratorium provision into law. States must now expend resources,
regardless of Congressional action, preparing to implement the
regulations.
The rules changes are expected to effect public institutions in the
following ways:
Currently, the Federal Government matches county contributions to
designated hospitals approximately 3 to 1 with Medicaid dollars to
help subsidize the cost of care for low-income patients who are not
covered by Medicaid. The new rule limits Medicaid payments to cost,
preventing Medicaid from being used to subsidize the care of non-
Medicaid eligible indigent clients. This will result in millions of
dollars in annual cuts to institutions that provide care to the
uninsured. Local governments in impoverished communities will be
unable to make up the losses. Many hospitals may be forced to
privatize, close their doors, or severely curtail services.
The rule restricts ways in which counties can raise matching dollars
to tax revenues only, disallowing partnering institutions from
assisting governments to raise the match. Local governments in low-
income communities often lack the tax base required to fully subsidize
the care of their constituents without forming partnerships. Multi-
county hospital systems are sometimes able to route funds from
profitable hospitals to low-income communities for the purposes of
serving the uninsured.
The rule prevents hospitals from using Medicaid payments to offset the
cost of teaching, impeding our ability to produce a new generation of
physicians and other health care professionals.
The rule invests CMS with broad new authority to audit local
governments, significantly increasing the range of transactions and
documents subject to review, thus increasing the administrative costs
of fund management. The audit requirements will pose a barrier to
participation for cash-and-staff-strapped local governments.
In many disenfranchised communities, local government is the only
entity representing constituents. Removal of decision-making authority
over health care financing, and particularly over programs financed
through local tax revenues, from the community to the state will
further disenfranchise the poor. States are more likely to award
health care contracts to entities that are not primarily interested in
serving indigent populations. It is important that health care
decision-making authority remain vested in local governments, and is
not, for the sake of "convenience" transferred to state or federal
jusrisdiction.
On November first, the National Association of Public Hospitals and
Health Systems offered testimony before Congress. Alan Aviles,
President of the New York Health and Hospitals Corporation described
the potentially drastic impacts the cuts would impose to public
health, and to the ability of local government to respond to natural
or manmade disasters. He should know. His hospitals treated the
victims of 9/11. Mr. Aviles stated that many hospitals will be forced
to choose between closures of emergency rooms, or primary care and
outpatient services.
The impacts to communities are drastic and far-reaching:
In rural communities, where the same hospital serves all income
levels, closure or cutbacks will leave all residents out in the cold
regardless of ability to pay, and may leave multi-county regions
without access to hospital care or trauma services.
Hospitals are essential to disaster preparedness, and to our ability
to respond to infectious disease. In many communities, they are also a
source of primary care. The elimination of infrastructure among the
poor to address the spread of recently mutated diseases (influenza),
medication-resistant forms of illness (tuberculosis and MRSA), and
diseases which may not be widely immunized against because specific
immunizations are risky or expensive (anthrax) or they are considered
eradicated in the US (smallpox, typhoid, cholera and increasingly,
even polio), will result in outbreaks among the wealthy as well.
All resources are needed in the event of a disaster that produces mass
casualties such as 9/11 or the Minnesota bridge collapse. If entire
multi-county regions are left without access to emergency services, no
effective response will be possible. If the President of the United
States happens to be injured in such a disaster, he will not be able
to access treatment.
Fortunately, some members of Congress are working towards a solution.
Representatives Eliot Engel (D-NY) and Sue Myrick (R-NC) have
introduced the Preserve Our Public and Teaching Hospitals Act (H.R.
3533). Please call your US Representative and ask them to co-sponsor
this bill! Please ask your Senator to introduce a similar bill into
the Senate!
.
- Prev by Date: Re: OT: Bush - Citing Terror Threats While Cutting Funds
- Next by Date: Re: NoAlOx?
- Previous by thread: Rewire a Plexi - cascading 1st stage
- Next by thread: OT: Corporate Polluters, Others, In Last-Minute Lobbying Frenzy
- Index(es):
Relevant Pages
|
