On Apr 18, 2006, at 2:03 PM, Jordan Hayes wrote:
>> The keener view IMHO is that this overcrowding is desirable
>> to the ruling elite because it will run the programs into the
>> ground and it will cleanse the population of the most ill
>> i.e., most costly.
>>
>
> This sounds like Yogi Bera's "No one eats there anymore, it's too
> crowded" ... how can encouraging overcrowding cleanse the
> population of the most ill? This is akin to eating until your
> stomach bursts to stop you from getting fat: along the way, you're
> going to be pretty big. And probably for quite a while!
That's ridiculous. Here is another case of people - you Jordan - not knowing what is actually happening on the ground. This will be a good lesson in public healthcare policy 101. I know most people on this list think public healthcare is the answer to the healthcare crisis and I have generally subscribed to that view but public financed healthcare is subject to the budget axe and political will. And now there are not enough people involved politically speaking to stop the axe from whacking away at Medicaid most everywhere in this country.
It's simple. In CA, for instance, the government keeps whittling away at MediCal benefits (regulations) because it wants to drive down the costs of the program which are growing due in large part to an increase in the numbers of persons on the program (overcrowding means inadequate increase in funding to compensate). One year it will pay for dental caps, the next year it won't. So you say people can live without dental caps. There's more. One year it will pay for oxygen to be delivered at home, the next year it pays distributors so little they won't deliver anymore. Those dependent on oxygen must then use their precious resources if they are even able to drive to get the oxygen themselves. One year it will pay MediCal docs enough so they will take MediCal patients, the next year it won't and so many docs will no longer take MediCal and the most chronically ill population on MediCal have fewer and fewer docs to care for them (this esp hits people in rural areas hard where there are fewer doctors). Or the MediCal docs rush their patients through so quickly to make a buck that the complicated cases often become victims of malpractice, only they are too poor or dead to sue over it. One year it will pay for hospitalization for certain conditions - say an extreme infection that requires an IV - and the next year it restricts hospital stays and transfers these people into nursing homes which are notorious places to die from neglect because they often don't pay attention to one's chart or one's needs. One year it will pay for people to live on their own with an attendant to help them out, the next year it cuts back on benefits like Tennessee did and sends its ventilator users into nursing homes where the quality of care is abhorrent. Such people are more likely to die prematurely in nursing homes from unnecessary sedation and other causes. In Missouri the state intends to completely eliminate Medicaid in 3 years. How many chronically ill people do you think will die when that happens? On and on.
Marta
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