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The Cruelest Cuts
Published on Wednesday, February 8 2006 by the Boston Globe
The Cruelest Cuts
by Derrick Z. Jackson

President Bush said in his State of the Union address, ''we strive to be a compassionate, decent, hopeful society."

The next day, he and his fellow Republicans ambushed the poor.

The majority-Republican House last week narrowly passed $39 billion in budget cuts for Medicaid, Medicare, student loans, and child support. The Republican-majority Senate had already passed the cuts. Roy Blunt of Missouri, the former acting Republican House majority leader, declared, ''Once again, House Republicans are on record as defending budget discipline. We have achieved $39 billion in savings, while streamlining government."

It was a cutthroat lie. Everyone knows the cuts are meant to fund $70 billion in tax breaks for the rich. Bush repeated in the State of the Union that he wants to make the tax cuts permanent. As the government streamlines and disciplines the poor, hope springs eternal for entitlements for the rich.

The nonpartisan Congressional Budget Office estimated last week that the cuts in Medicaid would result in 13 million people paying higher prices for prescription drugs by 2010 and 20 million people by 2015. It estimated that federal cuts would force states to impose cost-sharing requirements for at least one nonprescription health service or raise them for 13 million people by 2015.

The CBO predicts that cuts at the federal level would force already strapped states to impose premiums on 900,000 Medicaid enrollees by 2010 and 1.3 million by 2015. Similarly, 900,000 enrollees would see their benefits cut to take care of their teeth, eyes, and mental health.

The CBO estimates that higher healthcare premiums will result in 45,000 enrollees -- more than can fit into Fenway Park -- losing coverage by 2010. By 2015, the number would be 65,000 by 2015, equivalent to the number of privileged people who just packed Detroit's Ford Field for the Super Bowl.

The particularly vicious nature of the Medicaid cuts comes in three particular sentences in the CBO's report. On prescription drugs, it said, ''About one-third of those affected would be children and almost half would be individuals with income below the poverty level." On cost-sharing for nonprescription services, it said, ''half of those enrollees would be children."

On the people who would be driven out of coverage altogether, the report said, ''About 60 percent of those losing coverage would be children."

The cuts are a prescription for making the exploding crisis on healthcare much worse. When Bush ran for president in 2000, the nation's uninsured numbered 39.8 million. It rose to 45.8 million in 2004. Todd Gilmer and Richard Kronick, medical researchers at the University of California at San Diego, projected the number to increase to 56 million by 2013.

In June 2003, when the official number of uninsured was 41 million, the National Academy of Sciences' Institute of Medicine published a major report that estimated that ''the diminished health and shorter life spans of Americans" who lack health insurance have cost the nation between $65 billion and $130 billion a year. The study estimated that the human toll of uninsurance amounts to 8 million people with chronic illnesses not getting full services and 18,000 people dying prematurely.

The nation is already at a state where, according to the Centers for Disease Control, uninsured children are 10 times more likely not to have a usual source of healthcare and three times more likely not to have seen a doctor of any kind in a calendar year. Of course, uninsured children are more likely than insured children to get their care in more expensive emergency rooms. This is hardly what we need in a nation where child obesity and diabetes are out of control.

No matter how much Congress tries to make the poor disappear, it still comes back to hit us even more profoundly in our wallets. The Institute of Medicine study noted that 600,000 to 700,000 people with severe mental illness are jailed each year, a ridiculously more expensive option than healthcare itself. A study by the health advocacy group Families USA found that unreimbursed care for the uninsured ultimately finds its way into our private premiums, to the average tune of $922 for families and $341 for individuals. By 2010, care for the uninsured could add an average of $1,502 and $532, respectively, to family and individual premiums.

Bush said that we strive for a compassionate society. But the Institute of Medicine report concluded, ''we cannot excuse the unfairness and insufficient compassion with which our society deploys its considerable healthcare resources and expertise." The rich get compassion and tax cuts. The poor get no compassion. They just get cut.

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© 2006 The Boston Globe


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