20 Jun 2012
By Bill Britt
Alabama Political Reporter
MONTGOMERY—While pundits and politicians debate the wisdom of funding Medicaid with money from the Alabama Trust Fund a looming health and financial catastrophe is knocking at the door.
However flawed the decision to raid the ATF to fund Medicaid, however broken and wrong the welfare system is, there comes a time to put aside our quarrels, ideology, posturing and pretense and look reality in the eye.
The calamity that confronts us is greater than that which divides us. If we choose to flirt with disaster rather than deal with the single issue at hand, shame and remorse may be the legacy of our decision.
Or as Mike Warren the CEO of Children’s Hospital has said, “How foolish can we be to cut our nose off to spite our face.”
There is not anyone with an smattering of common sense that does not realize that Medicaid and the accompanying welfare state is unsustainable. But it has taken years to bring us to this level of crisis and it will take years to dismantle and reconfigure the system. There are those who wish for a firm, blunt knife to cut clean the legacy of the welfare state. But we should be careful that the same blunt instrument is not laid to the whole healthcare system and the state itself.
Like most American I believe everyone should work hard and make their own way but there is no denying that there are those who will always need a helping hand. Is it the government job to do so? I have never thought that the government was responsible to provide for citizens needs but I do understand that at times like these we cannot walk away from such problems. Sure, we can work on reform, yes, we can work to live within our means but there are greater issues and greater consequences immediately at hand.
Governor Bentley's words point to the factual place we find ourselves, “The health of Medicaid effects every person in Alabama, if you have ever been to a doctor, if you have ever been to a hospital or ever had a loved one in a nursing home then you have been impacted by Medicaid. The reason is simple, the health services that depend on Medicaid for funding services to all patients.”
The hard fact is that if Medicaid fails all health services in Alabama will began to fail. I am not a man that deals in Chicken Little politics or is prone to hyperbole but enough smart people are pointing to a coming tsunami of pain that I am paying attention. Medicaid may be the problem but the repercussions will be felt by all.
Yes, past and present leadership has not dealt with the problem wisely. But asking for Solomaic wisdom now is folly, the die is cast.
Governor Bentley, Dr. Williamson and others have made the case clear--act now. However there is still a choir that wants to relive the mistakes of the past or bemoan the horrors of the welfare class.
According to Warren, last year Children's Hospital saw 55 thousand children in the ER alone. Over half the kids in Alabama receive their medical care through Medicaid, do the math.
On April 27, 2011 a series of tornadoes devastated many part of our state. That night Children’s treated 60 children from over 14 counties in Alabama, eighteen lifesaving neurosurgeries were performed. Warren warns that if Medicaid is not fully funded the next time their is a catastrophe of that magnitude there may not be physicians to perform the lifesaving measures that were administered on that fateful night.
There are over a 150 thousand jobs directly and indirectly supported by Medicaid in our state. Our current unemployment is still at a terrible level, is this a wise time to add more to the jobless rolls?
At a time when we are energetically working to recruit new business to Alabama is this a time to see hospitals closing across the state?
Our economy is so inextricably entangled with Medicaid that there is no one that can undo the Gordian Knot swiftly.
So, the choices before us are a gun and a bitter pill, the question is are people knowledgeable enough to take their medicine?
Of course I worry more about our political class than the voters, if politicos use this as an occasion for grandstanding rather than bowing to their noble noblesse we will see catastrophic failure. If the political class will take courage and work toward funding and future fixes we can be successful.
I am no fan of the welfare state, I know that we must fix Medicaid, while demanding personal responsibility from thousands of Alabamians. But I also don’t want to be so foolish as to think that we can remedy these ills before Medicaid runs out of money.
To this end, over the next 13 weeks we will offer a series of articles that will lay out the current state of Medicaid, what happens if it is not funded and what may be possible fixes going forward. Join us on this quest.
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