Last Monday afternoon, I heard U. S. Representative Joe Barton (Republican from the 6th Congressional District here in Texas) speak to a group of health care providers and advocates. We assembled at Parkland Memorial Hospital at the invitation of Dr. Ron Anderson, President and CEO for our public hospital system.
Congressman Barton is a powerful fellow. He chairs the Energy and Commerce Committee in the U. S. House of Representatives and this year he is chair of the conference committee made up of Representatives and Senators who must come up with reconciliation plans for matching legislation with budget by the end of September.
I have no idea why this is true, but the good Congressman's committee is in charge of Medicaid legislation and funding. He was in town to listen to our ideas on how the health insurance product for the poorest Americans ought to be managed, funded and reformed.
In the course of his presentation, he mentioned that 85% of the costs associated with Medicaid have to do with elderly Americans who use the program to provide long-term, end-of-life care.
Medicaid was originally conceived as a program to serve the health care needs of the poor. It has morphed into a plan to pay for the end-of-life care for many Americans who really aren't poor. More on that in a moment.
Mr. Barton began by telling us that his committee needed to shave several billion dollars off of Medicaid appropriations over the next decade. He was looking for solutions and invited us to offer our ideas.
I think I have at least a partial solution. I think I know where to find the savings he is looking for. It won't be popular, but it would be fair.
Here's how my idea would work.
Close the loop holes on all of the middle class people, like me, and families, like mine, who abuse the system by shifting the wealth of elderly parents to their children before they die. By making this wealth transfer, prosperous aging adults can currently qualify for Medicaid as a long-term care strategy when they should be using a portion of their accumulated wealth to pay the bill themselves.
What is saved for middle class families is lost for the poor, the ones for whom the program was designed in the first place.
Rather than cutting back on care for those who are really poor, Congress should shut out those who aren't. If the nation wants a long-term care program for middle class people, then it should build one, but not on the backs of or at the expense of our poorest citizens.
I know Mr. Barton could find his $15 billion, or whatever the number actually is--he wasn't too clear on that himself.
The Medicaid mess is a good example of how those at the very bottom "take it on the chin" again and again.
It is not right.
In fact, in my book it is immoral.
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