Grandma and Grandpa won’t be making it to Thanksgiving this year. They, along with many working families, are instead on the menu.
At a table in our nation’s capitol, the congressional super committee is weighing a cornucopia of cuts to reduce the nation’s deficit. With a looming Nov. 23 deadline to come to agreement, the debate is heating up and the stakes are getting higher.
What’s under the carving knife? Vulnerable seniors and working families, not to mention key public programs and the community-based organizations that support them.
In Los Angeles, cuts to these programs would have a far-reaching impact. Medicare supports health care services for more than 700,000 Angelenos; Medicaid subsidizes care for 2 million L.A. residents.
For the more than 200 private non-profit community clinics and health center sites that serve Los Angeles County’s vulnerable communities, these cuts to Medicare and Medicaid would limit their ability to provide high-quality, cost-effective care. This care saves the system money: Health centers nationwide serve 14 percent of all Medicaid beneficiaries while costing only 1 percent of total Medicaid spending.
These providers also offer employment and training, an engine of economic growth, to the communities they serve. In the county, cuts to Medicare and Medicaid would put more than 5,000 jobs in jeopardy.
With the implementation of health care reform on the horizon, these clinics should be expanding their work forces. Cutting these programs, at this critical time, would constrain providers’ ability to create jobs and prepare for the promise of health reform.
The Medicaid cuts could also have a devastating ripple effect: By loosening restrictions on state Medicaid programs, the super committee may leave the door open for states to reduce eligibility for this essential program. California has already cut Medi-Cal, our Medicaid program, to the marrow through elimination of dental and other needed benefits, reductions in provider payment rates and introduction of administrative barriers to care.
Despite the federal economic stimulus package’s incredible investments in health care infrastructure, L.A.’s community clinics and health centers suffered a $7 million net loss due to state budget cuts in the same year. These continued cuts are simply unsustainable for these non-profit providers that serve nearly 1 million patients per year.
Carving up these programs will ensure a glut of rising costs for doctors; curb patient access to providers; and overstuff county facilities, clinics and community health centers with patients without the ability to pay.
Even those who don’t rely directly on these programs benefit from their preservation. Delaying and deferring care due to inadequate coverage clogs ER waiting rooms and reduces access for all. Patients who forego prescriptions or critical preventive care end up costing the system more in acute care in the long run. This drives up system costs, which are passed on to individuals and employers, in particular small businesses.
Nationally, the super committee is considering cuts that would strip as much as $600 billion from Medicare and Medicaid to the bone. From increasing the age for Medicare eligibility to shifting program costs to beneficiaries, the potential ingredients of the proposal are a recipe for disaster.
What isn’t on the menu? Unfortunately, certain members of the super committee have adamantly refused to consider any form of increasing revenue, such as closing tax loopholes. Without these types of solutions, they would instead starve key programs and put our most vulnerable on a fasting diet.
For Grandma and Grandpa, cuts to Medicare and Medicaid constitute a double helping of pain: In addition to the critical coverage Medicare provides seniors, two-thirds of Medicaid dollars are spent on the elderly and disabled. And they couldn’t need these programs more: In 2010, half of all Medicare beneficiaries had incomes below $22,000, and 3 million seniors were living under the federal poverty level, making less than $11,000 per year.
Everyone benefits when care is available in the most cost-effective manner. In an era where resources are limited and need is great, it is crucial that care be available in the most cost-effective manner. The price of cutting Medicare and Medicaid would be far greater than the benefit of temporarily addressing the short-term budget.
If critical health programs are forced to take a holiday, the millions of people who rely on these programs for medical treatment will have very little for which to be thankful this season.
This time of year, families across the nation gather for Thanksgiving. Sadly, thanks to our congressional lawmakers, many families this year will be praying for mercy instead of giving thanks.
Let us hope that Medicare and Medicaid patients can give continued thanks for access to a primary care doctor. Let us hope that charities won’t be holding medication drives in place of turkey drives.
Leaving the vulnerable out in the cold is not an act anyone can be thankful for.
Louise McCarthy is the chief executive of the Community Clinics of Los Angeles County.
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