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Wednesday, July 9, 2008

The Fallacies of Government Health Care Programs

In 2005, Missouri experienced the most severe Medicaid cuts since the program began 30 years from then. Already, near 1 million Missourians are uninsured. So Blount chops 100,000 from Medicaid this year, who needed the medical resources the most. In addition, Blount had another 300,000 Medicaid patients have their medical benefits greatly reduced. Why? Possibly to build more athletic stadiums in the state of Missouri. Futhermore, Blount created a ‘war room’ for corporate lobbyists to dispense gifts during the state’s legislative session for this egotistical psychopath to enjoy those obsequious to him, yet also seems to enjoy the suffering experienced by others, as illustrated with the Medicaid issue, which was the largest cut of any state in the history of the program for those in the most need of resources he cannot conceptualize or care about, as he should.

Limited income parents suffered the most with this atrocity, as more than 50,000 of them lost medical coverage for their families. And after Blount stated in 2007 that Missouri is now strong, prosperous, and vibrant regarding the state’s budget and the robust economy, he never repaired at all the damage he did to those suffering Missourians in 2005, and never indicated to do what he should have done. Remember that most on Medicaid in Missouri are children. In the U.S., the total cost of Medicaid is around 300 billion dollars a year. States have their own discretion on how their Medicaid programs are operated, and this is largely unexamined by the other contributor to Medicaid, the federal government.

The joy he must experience in seeing or knowing of the suffering of others must continue still, as the Missouri House of Representatives rejected a bill to expand Medicaid coverage greatly needed due to the actions of the governor those years ago.

Medicaid is also a necessity for the over 500 nursing homes in Missouri. The Nursing Home Inspectors already are accused of ignoring deficiencies in these nursing homes, which may include malnutrition and bed sores of the residents, and their inappropriate use of pharmaceuticals as well. Further unsettling is that such inspections normally take place only once a year. The inspectors should be more monitored by the GAO because of safety issues in nursing homes that continue and appear unresolved. For example, around 25 percent of Missouri nursing homes were found to have deficiencies recently. The rest of the nation only has a rate of 15 percent. Also, the Nursing homes in the United States are only covered by Medicaid.

Typically, Nursing Homes cost each patient there over 5000 dollars a month without Medicaid support. Yet patients tend to experience loneliness and displacement due to staying at such facilities, aside from noted neglect of these patients in other obvious ways.

Dementia is a common disease as we get older and is seen in Nursing homes. Basically, it is a disease of cognitive and brain dysfunction that usually is not reversible. If it’s the cortical kind, it is combined with Alzheimer’s disease. If it is the subcortical kind, look for Parkinson’s disease to be experienced for these patients. Such patients are inappropriately prescribed and given medications, such as atypical anti-psychotics, which cause high rates of pneumonia and premature death in the elderly population.

To complicate Missouri’s health care situation further, because close to 90 percent of Missouri counties are rural, with most lacking hospitals, there is only one doctor for every 3500 or so residents in such counties in this state. There is something to help called a Certificate of Need, or CON. Issued by regulatory agencies, they authorize healthcare facility creation and expansion as determined by the perceived needs of any community.

5 million people in Missouri are and have Medicaid. Missouri pays 20 percent of that bill, with the government paying the rest. While the states manage Medicaid for their state, CMS monitors and regulates the states, but that does not mean that this DHHS division actually does this. In 1990 Medicaid came out with the drug rebate program, which helped many. The Missouri Healthnet Division is responsible for making the best of the MO Medicaid funds, with frequent drug utilization reviews to determine the level of access to covered pharmaceuticals.
With Medicaid, over 6 million people in the U.S. also have Medicare, and they are known as ‘dual eligible’s’. In the U.S., over 40 million people have Medicare. Medicare costs 300 billion per year as well.

With seniors, government health care programs pay for quite a bit. Long term care costs Missouri about 2 million dollars a year. About 10 million elderly U.S. residents are in LTC. Only Medicaid pays for this as well, as mentioned earlier. Homecare is one form of LTC, and preferable to many.

The Medicaid for children is called SCHIP, and was created over 10 years ago. This program is facing funding shortfalls in many states, with Missouri topping the list thanks to the governor. Of course, Bush vetoed a bill for SCHIP expansion and reauthorization recently, and the House was unable to over-ride this veto and some others he has implemented for the benefit of the U.S. citizens. The cost for this program for children is around 4 billion dollars a year, and residents are concerned about children not receiving medical attention, perhaps in Missouri in particular. Some governors, however, appear to be void of such concern.

MO Health Dept. Head: Jane Drummond
MO Medicaid Director: Steven Renne

Dan Abshear

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