Thursday, October 20, 2005

Good News/Bad News

The first article I read in today's NY Times gave me some hope that today's Congress would tread lightly around social programs when it came to cutting federal spending. It was clear that such programs as Medicaid and other programs to support the poor and vulnerable would likely be the number one target, followed closely by cuts in programs to insure clean air and water. The House Republicans soon discovered that as we near the formal election season, such cuts could be damaging:

Acknowledging that they were short of the necessary support, House Republican leaders Wednesday abruptly put off a vote on their plan to cut federal spending by $50 billion and said they would go back to the drawing board to draft a fuller proposal that could win majority backing.

"Obviously we want to do everything we can to ensure that we successfully bring about cuts," said Representative David Dreier, the California Republican who is chairman of the Rules Committee, after an evening meeting of the leadership to try to find a way out of their budget struggle.

Mr. Drier and other leaders said the vote initially scheduled for Thursday would be delayed until next week. They said lawmakers would be presented with a new plan that would include not only $50 billion in cuts in major programs over five years, but also a pledge to enact later this year an across-the-board cut of current federal spending and eliminate some federal programs.

However, the next article I read dispelled my initial good cheer. This regime doesn't let a little thing like Congress get in the way of lopping off funding for social programs.

The Bush administration approved a sweeping Medicaid plan for Florida on Wednesday that limits spending for many of the 2.2 million beneficiaries there and gives private health plans new freedom to limit benefits.

The Florida program, likely to be a model for many other states, shifts from the traditional Medicaid "defined benefit" plan to a "defined contribution" plan, under which the state sets a ceiling on spending for each recipient.

Children under the age of 21 and pregnant women will be exempt from the limits.

The Florida plan says, "The state will set aside a specific amount of money for each person enrolled in Medicaid," based on the person's medical condition and historic use of health care.
[Emphasis added]

The warning tocsin sounded in my uncaffeinated brain just as soon as I realized that a lot of the decision making would be left to the private insurance companies who are essentially taking over the Florida Medicare program.

Joan C. Alker, a senior researcher at the Health Policy Institute of Georgetown University, said: "Florida's proposal is one of the most far-reaching and radical proposals we've seen to restructure Medicaid. The federal government and the states now decide which benefits people get. Under the Florida plan, many of those decisions will be made by private health plans, out of public view."

For each beneficiary, Florida will pay a monthly premium to a private plan. Insurance plans will be allowed to limit "the amount, duration and scope" of services in ways that current law does not permit.

Conveniently, the Bush regime has waived those sections of the law so that the Resident's brother, Governor Jeb Bush, can accomplish what Congress has blocked the regime from doing. It is clear that Medicare does need restructuring and tinkering, but to do it on the backs of the most vulnerable of our population rather than on the medical industry which is responsible for the stunning growth in medical care costs is scandalous.

Nope, no surprises here.


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