Dispatch. Get in line for a trim


    — from reports to Mouth by a number of readers

Reports from our readers agree: the bottom is rushing up at us faster than Wiley Coyote can say Tha-Whump.

The National Governors Association laments that one out of five state budget dollars goes to Medicaid a 13 percent increase. Costs must be cut.

"Michigan's financial news," says one reader who asks we not use his name, " is grim a golden opportunity our local bioethicists have long awaited.

"The huge increases in Medicaid spending incurred and projected are not caused by problems inside Michigan Medicaid unless you feel that allowing poor people access to medical care is a problem." The writer attributes budget trouble to "devastating federal tax cuts; a diversion of funds to foolish wars, internal and external; federal decisions to reduce the flow of Medicaid dollars to states" and calls poor, old, and disabled people "scapegoats" precisely the targets bioethicists had in mind.

From Washington state, we heard acrobatic semantics. The state's assistant secretary for the Medical Services Administration admitted that his state's new Medicaid cuts "would result in more morbidity, but would not cause deaths."

The problem, he said, was that Medicaid recipients are not "thrifty with medical care." The rich, as usual, are far less costly to maintain, and consider it unfair when they must shoulder the burden of higher health care prices now that the federal government has cut what it pays for health care for the poor. "At the rate Medicaid is growing right now," Sen. Charles Schumer (D-NY) said, "it's spending like a teenager set loose in a mall with an American Express card.



On the theory that an informed consumer of nursing home services will spend Medicaid dollars more wisely, the U.S. Centers for Medicare and Medicaid Services now has web pages where nursing homes are rated by how often they use physical restraints, how many pressure sores, infections, and losses of basic abilities are reported. For some states you can also get ratios on UTIs, hepatitis, wounds and other standard nursing home sequelae.
as others see us: bingo wombats