More Money For The Rich While The Sick Die

   NOTE: The GOP Agenda,  The Wealthiest Americans Receive An Extension On The Bush Tax Cuts which adds to the deficit while the rest of us  languish.  I find it Morally Reprehensible that there always seems to be money for Corporate Welfare, Tax Cuts for The Filthy Rich but never  anything for the struggling American Families.  The GOP are forever attacking Social Service Programs. This sickens me beyond words.

 By CARLA K. JOHNSON, AP Medical Writer Carla K. Johnson, Ap Medical Writer

CHICAGO – In Illinois, a pharmacist closes his business because of late Medicaid payments. In Arizona, a young father's liver transplant is canceled because Medicaid suddenly won't pay for it. In California, dentists pull teeth that could be saved because Medicaid doesn't pay for root canals.
Across the country, state lawmakers have taken harsh actions to try to rein in the budget-busting costs of the health care program that serves 58 million poor and disabled Americans. Some states have cut payments to doctors, paid bills late and trimmed benefits such as insulin pumps, obesity surgery and hospice care.
Lawmakers are bracing for more work when they reconvene in January. Some states face multibillion-dollar deficits. Federal stimulus money for Medicaid is soon to evaporate. And Medicaid enrollment has never been higher because of job losses.
In the view of some lawmakers, Medicaid has become a monster, and it's eating the budget. In Illinois, Medicaid sucks up more money than elementary, secondary and higher education combined.
"Medicaid is such a large, complicated part of our budget problem, that to get our hands around it is very difficult. It's that big. It's that bad," said Illinois Sen. Dale Righter, a Republican and co-chairman of a bipartisan panel to reform Medicaid in Illinois, where nearly 30 percent of total spending goes to the program.
Medicaid costs are shared by the federal and state governments. It's not just the poor and disabled who benefit. Wealthier people do, too, such as when middle-class families with elderly parents in nursing homes are relieved of financial pressure after Medicaid starts picking up the bills.
Contrary to stereotype, it's the elderly and disabled who cost nearly 70 cents of every Medicaid dollar, not the single mother and her children.
In California, Medicaid no longer pays for many adult dental services. But it still pays for extractions, that is, tooth-pulling. The unintended consequence: Medicaid patients tell dentists to pull teeth that could be saved.
"The roots are fine. The tooth could be saved with a root canal," said Dr. Nagaraj Murthy, who practices in Compton, Calif. "I had a patient yesterday. I said we could do a root canal. He said, `No, it's hurting. Go ahead and pull it. I don't have the money.'"
Murthy recently pulled an elderly woman's last tooth, but Medicaid no longer pays for dentures.
"Elderly patients suffer the most," Murthy said. "They're walking around with no teeth."
States can decide which optional services Medicaid covers, and dental care is among cutbacks in some places. Last year's economic stimulus package increased the federal share of Medicaid money temporarily. But that money runs out at the end of June, when the federal government will go back to paying half the costs rather than 60 to 70 percent. So more cuts could be ahead.
During the Great Recession, millions of people relied on the Medicaid safety net. Between 2007 and 2009, the number of uninsured Americans grew by more than 5 million as workers lost jobs with employer-based insurance. Another 7 million signed up for Medicaid.
Just when caseloads hit their highest point, the nation's new health care law required states not to change the rules on who's eligible for Medicaid. That means states can't roll up the welcome mat by tightening Medicaid's income requirements.
So states have resorted to a variety of painful options.
In Arizona, lawmakers stopped paying for some kinds of transplants, including livers for people with hepatitis C. When the cuts took effect Oct. 1, Medicaid patient Francisco Felix, who needs a liver, suddenly had to raise $500,000 to get a transplant.
The 32-year-old's case took a dramatic turn in November when a friend's wife died, and her liver became available. Felix was prepped for surgery in hopes financial donations would come in. When the money didn't materialize, the liver went to someone else, and Felix went home. His doctor told him he has a year before he'll be too sick for a transplant.
"They are taking away his opportunity to live," said his wife, Flor Felix. "It's impossible for us or any family to get that much money." The family is collecting donations through a website and plans a yard sale this weekend, she said.
The choices are difficult for states that have already cut payments to doctors and hospitals to the bone.
"If we don't see an economic recovery where state revenues rebound, they're really going to be very strained on how they can make ends meet," said Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured.
States may consider lowering payment rates to nursing homes or home health agencies or further reducing payments to doctors, Rowland said.
"The problem here is the program is pretty lean, and payment rates are pretty low," she said. Patients can't find care because fewer doctors accept the low payments.
Prescription drug coverage in states is an optional benefit, another possible place to cut, Rowland said. "But if you cut back on people's psychotropic drugs, is that penny-wise and pound-foolish? Do they end up in institutions where Medicaid pays more for their care?"
In Illinois, late payments became the rule.
Tom Miller closed his pharmacy in rural southern Illinois this summer and is going through bankruptcy, largely because the state was chronically late making Medicaid payments to him. Most of his former customers are in the program.
With the state sometimes months behind in payments, he couldn't pay his suppliers. Five workers lost their jobs when his business closed.
"You can only fight it for so long," said Miller, 54. He now works as a pharmacist in a hospital. He misses his old clients, the families he grew to know.
"I was in my third generation. I've had moms who had kids. I saw the kids raised, and they had their own children," he said. As a neighborhood pharmacist, "you're their friend. You're family."

5 Myths about hunger in America

http://www.washingtonpost.com/wp-dyn/content/article/2010/11/19/AR2010111906872.html


By Robert Egger
Sunday, November 21, 2010; B02

No one goes hungry in America.

1 Hunger is supposed to happen in other places - in distant countries where droughts or storms or famine compel us to donate money and oblige our government to send relief workers and food aid. In reality, hunger also hits much closer to home.
According to a new report by the U.S. Department of Agriculture, 17.4 million American families - almost 15 percent of U.S. households - are now "food insecure," an almost 30 percent increase since 2006. This means that, during any given month, they will be out of money, out of food, and forced to miss meals or seek assistance to feed themselves.
Even those who get three meals a day may be malnourished. Americans increasingly eat cheap, sugary foods whose production is underwritten by government subsidies for the corn and dairy industries. As the New York Times reported this month, the USDA loudly promotes better eating habits while quietly working with Domino's to develop a new line of pizzas with 40 percent more cheese.
Obesity is related to hunger, too, thanks to our poor food choices and the lack of healthy food options in many communities. Many of us may be packing on the pounds, but they are life-threatening. According to the Centers for Disease Control and Prevention, more than 30 percent of adults are obese. The number of children who struggle with their weight is increasing, particularly among Latinos. Diet-related illnesses such as heart disease and diabetes are now on the list of the leading causes of death in America. We are dying not because we aren't eating, but because we're eating the wrong things.

Ending malnourishment is merely a humanitarian concern.
2Hunger threatens our economic future and our national security. An astonishing one in four American children - close to 17 million - live in food-insecure homes. A kid who is hungry cannot learn. A kid who can't learn drops out of school. A kid without an education can't get a job and help America compete in a global economy. A kid without a job may turn to crime, get arrested and cost taxpayers $40,000 a year to sit in prison.
Those children who become obese adults, meanwhile, limit our armed forces' ability to protect our nation. Military officers recently warned that more than 9 million young adults - 27 percent of Americans ages 17 to 24 - weigh too much to enlist, shrinking the pool of candidates for service.
Meanwhile, more than 9 percent of medical spending, $147 billion annually, is devoted to treating obesity, and obese people spend $1,500 more per year on health care than people of average weight. The costs of poor nutrition help drag us further into debt and leave us vulnerable. America simply can't afford malnourishment anymore.

Children are the only ones who go hungry.
3The person most likely to be hungry is a single, working mother. Federal programs ensure that low-income children can get free meals at school, but their mothers - many of whom are single and work low-paying jobs in the service sector - often have to make tough choices between food, rent, gas for the car, health care or new shoes for their kids. Millions of American women who face this predicament will feed their children and go without meals themselves.
Another tragedy in America is the rapidly growing number of seniors who have to choose between food, medicine and utilities. Though few of our elders will admit to needing help, a 2007 study by Meals on Wheels indicated that as many as 6 million are going hungry. Meanwhile, that free food-delivery service has waiting lists in many cities. The 80 million baby boomers approaching retirement are expected to live longer than any previous generation, but not all have set aside enough resources for their final years. When that silver tsunami strikes, hunger will come with it.

The food that America wastes could feed everybody.
4According to Jonathan Bloom's new book, "American Wasteland," up to 40 percent of the food we produce is ultimately thrown away. Much of it, such as household waste or decomposing fruits and vegetables, is unfit to eat or impractical to collect. Unnecessary expiration dates, particularly on canned foods, condemn millions of pounds of food to landfills. Logistically, we just can't feed everyone with leftovers.
Still, that doesn't mean we shouldn't use them. Since President Bill Clinton signed the Bill Emerson Good Samaritan Food Donation Act of 1996, initiatives around the country have retrieved millions of pounds of great food from restaurants and hotels and have used it to feed the hungry and provide culinary job training for the unemployed. Food banks have redistributed hundreds of millions of pounds of nonperishable items, and food activists called gleaners have taken to farms to forage for crops that won't make it to market.

Hunger is about food.
5Ever since President Lyndon Johnson declared war on poverty in 1964, the government has worked diligently to ensure that no American goes hungry. For years, the USDA flooded communities with surplus commodities such as cheese and butter. Enrollment in the food stamp program (now called the Supplemental Nutrition Assistance Program), the front-line federal weapon in the fight against hunger, is at an all-time high, with 42.4 million people receiving support.
Yet the number of Americans who struggle to put food on their tables has never decreased. This is because hunger isn't about food. It's about jobs and wages.
The passage of living-wage laws, tariffs that protect U.S. jobs and comprehensive public health care - coupled with consumer support for businesses that pay good wages, reinvest in their communities or embrace green polices - would do more to combat hunger than anything charities have tried in the past five decades. Incentives for local food production would keep us healthy and our local economies thriving.
For example, D.C. Central Kitchen, which I founded in 1989, provides locally sourced, made-from-scratch meals for public and charter schools in Washington as well as for clients of Fresh Start, our catering company. In the middle of a recession, we just added 30 well-paid employees who receive benefits, many from our own job-training program. Last year, 80 of our graduates, many of them felons or former drug addicts, earned more than $2 million in salaries and paid more than $200,000 in local payroll taxes. And while learning new skills, they produced more than 1.4 million healthy meals for shelters and food programs.
What we are doing isn't unique. It's happening all over America, and it isn't charity - it's rock-solid business.
Robert Egger is the founder and president of D.C. Central Kitchen and the Campus Kitchens Project.

Poverty In America Is Of No Concern In Washington

Capitol Hill reaction to poverty figures sidetracked by political concerns

By Michael A. Fletcher
Washington Post Staff Writer
Friday, September 17, 2010; 10:59 PM

Deborah Weinstein, a longtime advocate for the poor, calls the news that one in seven Americans is living in poverty "a national emergency."

But for much of Washington's political class, the shocking new poverty numbers provoked not alarm about the poor but further debate over tax cuts for the middle class.

"We know that a strong middle class leads a strong economy," President Obama told reporters in the Rose Garden on Friday, as he used the new census report, which also showed that middle-class income has dipped slightly over the past decade, to continue making his case for limiting the cuts to family incomes under $250,000.

Meanwhile, Republican leaders in the House and Senate had no reaction to the poverty report. But earlier in the week, Senate Minority Leader Mitch McConnell (R-Ky.) took the Senate floor to argue for extending the tax breaks to everyone, saying, "We can't let the people who have been hit hardest by this recession and who we need to create jobs to get us out of it" be subject to a tax increase.

McConnell's spokesman later clarified the statement, saying that McConnell indeed believes the economic downturn has hit the poor harder than it has high-income business owners, who also have suffered.

The reluctance of political leaders on both sides of the aisle to directly confront the fact that growing numbers of Americans are slipping into poverty reflects a stubborn reality about the poor: They are not much of a political constituency.

"We talk to many people on Capitol Hill who do believe poverty is important and is a blight on our nation," said Weinstein, executive director of the Coalition on Human Needs, an alliance of national organizations that advocates for the poor. "But we are also up against a general recognition that poor people don't vote in great numbers. And they certainly aren't going to be making campaign contributions. That definitely puts them behind many other people and interests when decisions are being made around here."

Rep. Jim McDermott (D-Wash.), who counts among his legislative accomplishments bills to extend unemployment insurance and to provide housing for people suffering from AIDS, said that the current downturn has expanded the definition of the poor. No longer are the poor the chronically impoverished who scrape along at the bottom of the economic pecking order in good times and bad. They now include many working people who have been thrown out of their jobs by a brutal recession.

"The fact is, increasingly, we are talking about people we know," McDermott said. Still, he said, "For most elected officials, there is nothing politically in talking about the poor. In fact, they don't vote very well and they are not very participatory in political life. Politicians tend to talk to people who get involved."

McDermott said he has been urging his colleagues to take a fresh look at poverty. The new report showed that the ranks of the American poor soared to their highest level in half a century in 2009. Meanwhile, millions more are existing just beyond the poverty line, which is about $22,000 a year for a family of four.

The official poverty rate is just one aspect of the economic upheaval unleashed by the recession. Since 2007, the country has lost almost 4 million wage earners. And for the first time since the government began tracking health insurance in 1987, the number of people who have health coverage declined, a circumstance destined to change when the Obama-led health-care overhaul fully kicks in by 2014.

With foreclosures continuing to rise and long-term unemployment at record levels, McDermott said, the legacy of the economic crisis will affect society in a way the country has not experienced since the aftermath of the Great Depression.

Even amid the devastating downturn, Americans seem ambivalent toward the needy. The instinct to help those in tough straits is often constrained by a lurking feeling that the poor are to blame for their own problems. Or, that what helps the needy might take something away from everyone else.

The debate over extending unemployment benefits, which now last as long as 99 weeks, generated increasing commentary that the benefit was sapping people of the desire to work.

Andrew Kohut, president of the Pew Research Center, said that more than two decades of polling shows that a solid, if fluctuating, majority of Americans believe government has a responsibility to care for the poor.

"But as you begin to ask more specific questions, you get lower levels of support for specific programs as people worry about costs, taxes and the rise of government," Kohut added. "Plus, there is a great deal of political polarization of this."

A 2009 Pew survey found that 63 percent of Americans believed government should take care of those who cannot take care of themselves. But that number fell to 48 percent when people were asked whether government should help the needy even if it increases the debt. Nearly two in three Democrats, 43 percent of independents and 29 percent of Republicans agreed with that statement.

All of which explains why even many staunch Democrats have not talked much about poverty.

On Thursday, hours after the Census Bureau released the poverty numbers, Obama issued a written statement that quickly broadened the discussion beyond the poor.

"Today, the Census Bureau released data that illustrates just how tough 2009 was," the statement said. "Even before the recession hit, middle class incomes had been stagnant and the number of people living in poverty in America was unacceptably high, and today's numbers make it clear that our work is just beginning." 

Being Poor in a Sinking America

Laura Flanders: Being Poor in a Sinking America

Where are the Lifeboats?


By LAURA FLANDERS

Last week in New York authorities announced that at Harlem Hospital Center, the largest health facility in that historic neighborhood, doctors had failed to read 4,000 heart tests -- for three years -- and that 200 of these patients died. These were not simply routine tests, but echocardiograms, ordered when patients showed severe symptoms. That does not happen in affluent neighborhoods.

Among other reasons, heart sickness is elsewhere an enormous profit opportunity -- heart valve and bypass surgeries are a go-go business. But not for sick, poor people. Their Medicaid coverage fails to fully incentivize America's insatiable medical industrial appetite.

According to a cardiologist brought in on an emergency basis to start reading the long backlog of tests in Harlem, approximately half were abnormal and 20 to 30 percent needed immediate medical care. "This is very, very appalling," he told the New York Times.

And it's not just in Harlem.

Across the US, poor communities are grossly under-served: education, nutrition, housing and health care. To a large extent, this explains the chasm in life expectancy between white people and so-called minorities.

How much worse does it get? A Brandeis University study recently underscored the growing wealth divide. According to the Federal Reserve, for every dollar of wealth owned by a white family, a black or Latino family owns just 16 cents.

And as this -- the great marginalization of America marches on -- Democrats, including the president, wrestle with Republicans for smidgeon of reform. Is it anywhere close to enough?

For all the talk of Wall Street reform, and new consumer protections, and talk of alternative energy policy, the fact remains that for most people, America is a sinking ship. And minority communities are the first to be thrown over the side.

Where are the lifeboats?

Laura Flanders is the host of GRITtv, which broadcasts weekdays on satellite TV on cable, public television and online at GRITtv.org and TheNation.com. Follow GRITtv or GritLaura on Twitter.com.