Sickness in Health Care - A True Fable

If you were lucky enough to get the word and have the availability to attend a recent lecture by Ralph Martire of the Center for Budget and Tax Accountability, you got a real faceful of yucky-tasting-but-very-good-for-you info.  And excellent economic analysis.  No chewy, hard-to-digest economese, just plain talk and the facts to back it up.  It's a wonder he hasn't been drone-targetted yet.

One side comment was a particularly nasty piece of news.  Ready?  I don't think you are:

So Ill-annoy is famously in a budget crisis.  A manufactured one, created by years of toadying to the rich by suck-up politicians, but a crisis nonetheless. One of our less-than-inspiring "Democrat" governor's latest ingenius schemes, you may have heard, is to cut Medicaid - and reduce Medicaid payments to hospitals.

Background flash: Illinois earns big bucks through Medicaid by the following unbelievable (unless you're an Illinois-news-watcher) shell game: local governments pay the State money for services to Medicaid patients.  The State then pays the exact amount back to local governments.  Why?  Because, the instant they pay out, the State is eligible for federal MATCHING FUNDS.  No shingle.  Really.  So the State makes millions by pretending to pay for services to poor people. 

This game is smarter than some politicians, however, who routinely cry publicly about how much the State's Medicaid obligations are costing.  So how do Medicaid cuts actually help the State when it means that we lose federal matching funds?  Oh, you naive little things!  It 'helps' the State only if the State = the rich.  That is, people with lower incomes are required to serve the rich in any capacity the rich need at the time.  But if they have a certain economic safety net, they will - well, not exactly refuse to serve, but they will draw a line - say, at leaving small children at home to go out and slave for pennies in dirty jobs that destroy their health.  Things like that.  But if the State reduces their benefits ... ah, now you begin to see, my pretty, eh?

But this is only half the healthcare skullduggery deal currently unfolding in the halls of power and influence in Springfield.  Hospitals, you see, are unhappy with their rates being cut.  And the hospital associations get access to political ears about a million light years ahead of the poor who stand to have their services cut.  After all, what's a mere loss of life or health, compared to a negatively impacted corporate bottom line?  (You see, we do understand them!)

So how do politicians get the hospitals to go along with this plan? Hmm... Aha!  What if the hospitals were offered something else they want?  Like an easing-up on their charitable obligations, their obligation to treat a certain volume of charity cases in order to keep their tax-exempt status? Hmm... 

It would be a double-whammy on the poor, in other words, an extra bonus for the rich!  Ta-da!  Nothing up the sleeves.

Background flash: for Urbana residents, we know all about this, don't we?  Our hospitals have been failing to meet these obligations, and face a big fat tax bill (ironic, and giggly for anyone who has ever been badgered by them for not paying a bill to the hospital).  But now, there's an opportunity to make it all go away.  And all the hospitals have to do is screw its neediest patients.  Easy choice there.

Yep, you guessed it.  They're bringing out the big stamp of approval for this one.  It's a little-known exception to the Hypocratic Oath: you can kich whoever to the curb if it means big bucks for you and your identified social class.

And that, children, is how a state budget crisis is a VERY useful thing to have around and why you'd really, really want one (if you're filthy rich).  Welcome to reality.  Sorry it sucks.