There is no doubt that the recession is wreaking havoc on families and communities across the nation. To make matters worse, as the brunt of the economic crisis is being felt most acutely, the programs that provide much-needed assistance are under attack for cuts or elimination. The countercyclical nature of the economy is not a new problem but one that millions of American families are confronting directly as cash-strapped states lay off teachers, close libraries, shutter public health clinics and seek other avenues to reduce spending.
No one disagrees that eliminating unnecessary programs is essential when budgets are tight but essential safety net programs for our most vulnerable citizens should not be on the chopping block at the times when they are needed most.
This week we learned that Texas, facing a $25 billion budget shortfall, is considering a proposal to eliminate its Medicaid program. Created in 1965, Medicaid is a joint federal-state program that has ensured that our nation’s poorest and most vulnerable – including mostly children, the elderly and the disabled – have a medical provider of last resort. In Texas, 65 percent of those on Medicaid are children. Almost 3 million kids in Texas are able to see a doctor, get vaccinations, eyeglasses, medication for asthma or antibiotics when they have ear infections, and other basic medical services because of Medicaid.
No, Texas hasn’t found a cure for the common cold or cancer. Children are still getting sick and breaking their arms when they fall from the monkey bars. Texas has simply decided to stick its head in the sand. It just costs too much to make sure poor people can get medical care. They want out of the safety net business.
This plan may look great on a spreadsheet but the facts tell a different story. The evidence is clear that it is much cheaper to pay for preventive care than to pay for care that is delayed and requires more expensive treatment in the hospital. For example, in Harris County, the cost of treating a child for asthma in a doctor’s office is about $100 versus $7,300 for an emergency room visit and a hospital admission.
Put simply, Medicaid ensures access to cost-effective, preventive care that keeps kids healthy. They can attend school. Their parents can be at work. It just doesn’t make sense — morally or financially – for Texas or any other state to seriously consider dismantling the health care safety net. No matter what the Texas Legislature does, poor people will still get sick and will require medical care. Without Medicaid, those who require medical treatment will turn to hospital emergency rooms and these providers will turn to the state to pay for this so-called uncompensated care. So instead of paying for more cost-effective preventive care through Medicaid, the state will be compensating hospitals for far more expensive ER care and otherwise avoidable hospital admissions.
Texas will pay one way or the other, like it or not. An honest assessment of the health care system in Texas will show that Medicaid is a necessary program that ensures cost-effective care for millions of low-income kids. It is an important investment in Texas’ children that pays off in the long run. Balancing the budget on the backs of Texas’ most vulnerable kids cannot be the answer to the state’s budget woes. These are difficult economic times but Texas’ kids deserve better.
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