Congress' Implicit Healthcare Rationing As an emergency physician and former governor, I am struck by the towering contradictions - and indeed the hypocrisy - in the controversy over the tragic plight of Terri Schiavo. On the same day that the US House of Representatives voted to involve the federal courts in her case, it also approved a 10-year $92-billion cut in Medicaid funding - $30 billion deeper than the cut recommended by President Bush.
The relationship between these two decisions - virtually unreported by most media - goes to the very heart of why we're unable to resolve the growing crisis in our healthcare system. While involving the federal courts in an attempt to save the life of one highly visible individual, Congress made a fiscal decision that will deny thousands of other Americans timely access to healthcare, some of whom may die as a result.
To understand this point is to understand the insidious form of implicit rationing practiced by legislative bodies throughout the nation - starting with the Congress. When the Congress cuts Medicaid funding, it is a direct cost shift to the states that administer the program. However, unlike Congress - which has run up a $7 trillion national debt over the past four years - states are required to operate within a balanced budget. So they respond to cuts in Medicaid by dropping people and/or services from coverage.
- posted by geoff @ #