By Linda Riddell and Thomas Wilson
Recent discussions on the clippings of the Medicaid budget invite us to look more deeply the houses that, when they collapse, will affect the United States and low -income households. But we will all be damaged.
Some states obtain 80% of their Federal Government Medicaid funds, as a recent article by Wall Street Journal, “Medicaid assures millions of Americans. He pointed out how the health program works, on the lists.” Even states that depend less on federal funds will have difficulty changing their resources to replace federal participation. The effects of the wave are clear: states are likely to reduce the registration of Medicaid, which forces low -income persons to omit care or find free care, and hospitals will change resources to cover the attention that is not paid. The dollars cut from Medicaid do not disappear; They simply change to different corners of the health system. Oh!
A deep immersion in facts
Fact 1. low -income households already spend more than their income in medical care: The recent data of the consumer expenses survey reveal that the 20% lower than households that correspond to those registered in the Medicaid measurement.
Fact 2. The places of need consume the majority of low -incomme incomme income from Housholds: Low income households spend about 57% of their income on essential elements such as food and homes (blue in the figure). This leaves little or nothing for other expenses. These families have an almost inelastic budget where any additional expense, also one as critical as medical care, forces the different compensation. In contrast, high -income households are 38% to 53% of their income (purple in the figure) that remained after complying with all basic and other costs.
Fact 3. The Law of low price health care led to reduced ED visits without insurance: In 2016, two years after the effect of the provisions of the Health Care Law at a low price: many Medicaid states and all health insurance exchanges introduced. These changes reduced visits to the emergency department of patients without insurance in half from 16% to 8%.
Fact 4. Uncompromising obligations in hospitals: According to the US Emergency and Work Medical Treatment Law (Emala), hospitals should treat and stabilize each patient who arrives, regardless of their ability to pay. With about 70% of all hospital admissions through the ED, an increase in uncompromising care in the Emergency Department will directly affect the entrance rate, the central function of the hospital.
Examine key inferences
Inference 1. Rising populations without insurance: It is likely that cutting Medicaid’s budgets leads to states that are reduced to registration and increase the number of people without insurance.
Inference 2. A resurgence in emergency service visits without insurance: If Medicaid’s budget cuts reduce registration, reductions previously achieved in De Sin Sin Insurance could at the high rates observed before ACA.
Inference 3. Hospitals trapped in crossfire: Budget cuts will force hospitals to provide more attention not to be compensated. The response is likely to reduce the staff, the largest cost center in the hospital, a movement that directly affects the quality and punctuality of primary and specialized services. The state of Washington sacrifices a warning story, where hospital leaders predict longer waiting times and lower service levels due to state budget cuts.
Broad impacts beyond numbers
The health system must collect the $ 880 billion slack, not creating money magically but changing the resources of other programs. The health system has its priorities established by the budget struggle: memorandum for community health needs. Health shootings between the rich and the poor will be expanded, and the progress made to have more insured people will be reversed.
The staff cuts will extend the waiting times and reduce the quality of the service, not to mention that they will burn more people outside their health service work. The undulating effects of Medicaid cuts touch all those looking for medical care and pay health insurance.
A call to political and community action
Now, more than ever, it is time for political stakeholders to recognize that the real cost of Medicaid cuts is not only for states but also for communities. Interested parties, those in charge of formulating policies, community leaders and the general public must defend their own interest in having a sustainable medical care financing approach.
Towards a more equitable future
The case against medical budget cuts is not just about dollars and cents, but it is the future of our health system and the health of millions of Americans. Cutting Medicaid’s benefits can create short -term savings on paper, but undermines the health infrastructure that serves everyone.
A reflective and balanced approach would protect vulnerable populations while guaranteeing that hospitals remain viable care centers, especially for rural areas. In rural communities, the health sector creates 14% of jobs; Rural hospitals are generally the largest employer and, since they serve more patients in Medicaid and Medicare, they will be the most affected by these budget cuts.
The change in which medical care dollars can be spent could each layer of medical care provision, from the increasing responsibility of urgency to hospitalized admissions to minor primary care resources. It is a call to all of us to rethink how medical care is based and stay solidarity with those who run the risk of running out of medical attention.
Looking to the future
Beyond the immediate fiscal challenges, this problem invites a broader discussion about health reform. How can we restructure funds to improve efficiencies? Could community health cooperatives or extended telesalud services help the effects of the advertiser? These questions deserve a solid debate and a decisive action.
In turbulent times, each interested party, from local communities, federal policies is necessary to find solutions that prioritize human health over short -term budget tactics. The bets are high, and the options made today will shape the access and quality of medical care in the coming decades.
Linda Riddell, ms He is a health scientist of the population specialized in poverty and is the founder of Ghettin ‘byA training tool that helps teachers, doctors, case administrators and others work more effectively with students, patients and clients who experience poverty. Thomas Wilson, PhD, Drph It is an epidemiologist focused on real -world issues and president of the Board of the Institute for the Health Impact of the non -profit population
