Screwing the Poor

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It should come as no surprise that Republican budget cutting fever focuses pretty heavily on programs for poor people. Republicans don’t care much about poor people, after all, and Exhibit 1 is their preferred set of targets for cost cutting in the healthcare arena. Suzy Khimm reports on this, for example:

Leading Republicans in Washington and in the states have set their sights on the federal health care program for the poor, aiming to slash funding and roll back Medicaid, just as Democrats are preparing to expand it to millions more Americans….”I’m sure that’s what [Republicans] are going to do,” said Sen. Mary Landrieu (D-La), “and they won’t be the first group that, when first the sign of trouble appears, they want to gut programs for the sick, the elderly and the children.”

Medicare is for old people, and old people vote Republican. Medicaid is for poor people, and poor people don’t vote Republican. So naturally Medicaid is in the crosshairs. And Jon Cohn has this:

Republicans are also proposing a more immediate reduction in spending […] for the health clinics known as “federally qualified community health centers.” And it’s a change that would take effect in the very near future, since it’s part of the House Republican proposal for financing government operations through the end of this fiscal year….How big is the cut? On paper, House Republicans propose to reduce clinic funding from current levels by $1 billion, or roughly a third of their total federal funding.

….Well, but maybe this program has a lot of waste in it? I don’t think so. Having visited literally dozens of these clinics around the country, I can tell you that the people who run these clinics not only do the lord’s work. They also do it efficiently. Precisely because the need for their services always exceeds the resources at their disposals, they know how to squeeze the most health care value out of every dollar, all while providing the kind of support services that their low-income communities need. 

….If the case for funding these clinics seems a bit too bleeding heart for your sensibilities, consider that uninsured people who don’t get primary care tend to end up in the emergency room, contributing to overcrowding and generating bills that hospitals eventually pass onto everybody else. That’s one reason community clinics have traditionally enjoyed bipartisan support. In fact, it was the one health care program for low-income Americans that the Bush Administration endorsed consistently and enthusiastically, with dollars as well as words: “This is a really good use of taxpayers’ money,” Bush said at one point. “It makes a lot of sense to have Community Health Centers so that we can cut down on unnecessary visits to the emergency rooms. Health centers help lower the cost of health care for everyone.”

This is, of course, a classic case of going after weak claimants rather than weak claims. After all, both Medicaid and community health centers serve a population that needs health services desperately and they do it more cheaply than any other healthcare program you can name. There’s really no excuse for trying to cut either one, and there’s certainly no excuse while low-hanging fruit like crop subsidies and giveaways to oil and gas firms are still on the books.

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