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June 20, 2011 | Posted By David Lemberg, M.S., D.C.

The New York Times reported last year that virtually every state is making or planning significant cuts in Medicaid benefits.1 These actions are taking place while demand for Medicaid grows. This entitlement, originally conceived as a support for those in lower socioeconomic classes and disabled persons, now is a necessary lifeline for those formerly in middle income groups who have lost their jobs. Medicaid enrollment soared by 7.5% from June 2008 to June 2009 (3.3 million new enrollees). The 2009–2010 increase is expected to be even larger.

The American health care crisis is not a doomsday scenario concocted by shrill socialist Chicken Littles. State governments can’t afford to pay their health care bills. It’s not surprising that individual Americans can’t afford to pay for health insurance and are dropping coverage by the millions.

The Medicaid news is the canary in the coal mine. When the canary dies, it’s time to pack up your gear and get out. In terms of health care, the demise of Medicaid is the clearest possible signal that the entire edifice is about to come crashing down.

States can’t pay Medicaid bills. Hospitals and physicians will lose substantial revenues. Many hospitals will file for bankruptcy. Others will drastically reduce services, starting with community assistance programs. Physicians will discontinue participation in Medicaid in frantic attempts to regain financial solvency. In the worst case, hospitals and physicians will only accept new patients on the basis of proof of ability to pay. Health care policy in American will become “no cash, no care”. Tens of millions of Americans will have zero access to quality medical services.

We’re veering sharply in the direction of a society of medical haves and have-nots in which there is no middle ground, no available safety net. Public health disasters will rapidly befall such a society, disasters that will not spare those fortunate enough to have “good benefits”. As millions of Americans, particularly low-income children, become less well, they will become breeding grounds for bacteria, viruses, and parasites. The deadly diseases of the past — tuberculosis, diphtheria, and whooping cough — will return with great force.

New infections will arise as a weakened population makes it easier for microorganisms to take hold. Diseases with the pathogenicity of HIV will race through communities and cities, spreading from region to region. Neither Republicans nor Democrats, neither Red states nor Blue states, will be spared from this public health implosion.

American was formerly the land of opportunity. Thanks to congressional obstructionism and the national mood of me-firstism, American will soon be the land of opportunistic infections.

1Sack K, Pear R: States consider Medicaid cuts as use grows. The New York Times, 2-19-10, p 1, column 1

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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