Wellness Check by Geoff Carter « The Pen in Hand Blog

Illustration by Michael DiMilo

By Geoff Carter

I spent last Saturday night in the emergency room, sitting with a family member who wasn’t in dire shape but still needed immediate treatment. Because it was a Saturday night, things were busy. There were probably about twenty people in various stages of distress waiting for care. A young guy grimacing with lower back or leg pain was sitting just across from us with his significant other who was providing him an endless supply of vending machine chips. A middle-aged couple sat about a row over. The guy was obviously in some sort of pain and his wife—or girlfriend or whatever—sat next him, trying hard not to look bored.

We all took our turns going into intake to get vitals taken and were then promptly ushered back to the lobby—to wait. We ended up spending two hours in the waiting room—before they even started treatment. During that time, an older man in a blue and white striped shirt came in complaining of chest pain. They ushered him in immediately. I didn’t see him come out—hopefully, he got admitted. A woman wheeled in an older man who sat muttering to himself in Spanish. One mother had a child with a low fever. Another one had a bad cold.

But then I noticed a whole other set of folks coming in that the security guards and receptionist seemed to know. Apparently, they were regulars. I realized after seeing a few of them come and go that these were people with nowhere else to go. Some seemed to be homeless. Some came in to get warm. Some were disoriented. Others simply wanted company. Although the staff and security treated them with respect, it was easy to see their presence was not encouraged. They weren’t supposed to be there.

I figured that if these guys needed care and were indigent, they would be treated no questions asked; that they would be covered by Medicaid, the health safety net for those unable to care for themselves.

As I watched these people circulate in and out of the emergency room, I wondered what might happen if Congress would get its way and make its massive cuts to the budget—cuts that would (because of the sheer dollar amount) include Medicaid, cuts that would be used to fund Trump’s massive tax cuts for his billionaire buddies. I had a lot of time to think about this as I watched an old lady pushing a walker laden with at least half a dozen plastic bags, I wondered where she would be—where all of us might be—after these proposed cuts.

Medicaid is a public health program jointly funded by state and federal programs. According to Wisconsin Aging Advocacy Network, over 1.2 million (or 18% of Wisconsin’s population) rely on the nineteen programs that provide Medicaid to the elderly, the disabled, and children, including a variety of programs providing in-home care, nursing home care, or Badger Care, a health insurance program for those unable to afford it. Most of these million Wisconsinites depend upon Medicaid to survive.

According to The Wisconsin Independent, House Republicans passed a resolution calling for a $2 trillion cut to federal budget, including an $880 billion dollar cut to be determined by the committee that oversees Medicaid. While Republicans have been relentlessly promising that these budget cuts will not touch Medicaid, Medicare, or Social Security, analysts say cuts of this size would be impossible without decimating these social services.

So where does that leave Medicaid recipients in Wisconsin? And who will get hit hardest? The Wisconsin Independent says that over 64% of nursing home residents in Wisconsin receive help from Medicaid, and according to the Wisconsin Department of Health Services, Medicaid covers a majority of nursing home costs for most eligible patients.

Lisa Davidson, the president and CEO of LeadingAge Wisconsin, a group that represents long-term care providers states, “If you were to take away that payer, where would those people go? They would go without care. And when you’re talking about skilled nursing, that is a very high level of medical, and at times, very complex care needs that need to be met.” (Wisconsin Independent)

It is not only the elderly who are at risk. According to The Wisconsin Board for People With Developmental Disabilities, Medicaid recipients also include children, low-income pregnant women, people with physical or intellectual disabilities, and people with mental health conditions. Medicaid programs cover one out of three children, four out of seven nursing home residents, and one in three people with disabilities. At the present time, the federal government covers 60% of Medicaid costs while the state covers the rest.

Medicaid provides funds for these programs through hospitals, nursing homes, counties, home and community-based providers, and institutions. Should Medicaid be cut, rural hospitals would be one of the hardest hit facilities. Many would have to close without federal support, forcing residents to travel significant distances for emergency care.

Another population that would face significant difficulties are the Native American communities who rely on Medicaid to supplement federal funds from Indian Health Services. Although understanding the matrix of federal funding entities servicing the tribes is a bit like trying to untangle snarled fishing line, it’s clear that Medicaid cuts would hurt. According to Debra Danforth, the director of the Oneida Comprehensive Health Division, 40% of the 15,000 patients enrolled at the Oneida Community Health Center are on Medicaid. A cut there would be “devastating”.

Aside from the human cost to the most vulnerable of our society, these proposed cuts to Medicaid would be economically devastating. Cuts to nursing homes would mean job losses, layoffs, and closures. Programs could be limited or cut entirely. Rural hospitals might be faced with entire shutdowns. The loss of skilled nursing facilities would force families to care for loved ones at home, disrupting jobs and budgets. Some family members might have to quit their job to be a stay-at-home caregiver.

The developmentally disabled and mentally ill would have to fend for themselves once their group homes or community care centers close. How many more of them would end up visiting their local emergency rooms in the dead of night?

The sheer cruelty and inhumanity of these proposed cuts is staggering. And the cluelessness of some of these politicos would be laughable it wasn’t so pathetic. Trump aide (and billionaire) Howard Lutnick, when asked about Social Security cuts, said his 94-year-old mother-in-law wouldn’t miss a Social Security check. She would just wait until next month. He added that only “fraudsters” would complain. (The Daily Beast).

Granted, Social Security and Medicaid are two entirely different entities, but our most at-risk populations depend on both to live. They can’t live without government assistance. To men like Donald Trump, Howard Lutnick, and others who’ve never wondered where their next meal is coming from or how they’re going to pay for their meds, these programs—and the people they serve—might seem expendable. They are not.

If these programs are cut, people will die. It’s that simple. And no matter what, we cannot let that happen.

Fight for Medicaid. Fight for the most vulnerable citizens in our society. Fight for those who gave and worked their entire lives so they can live out their lives in peace.

Here’s how.

Go to protests. Check out https://indivisible.org or https://www.fiftyfifty.one to find where, when, and how to join organized protests aimed at the draconian cuts—including Medicaid—proposed by the Trump administration.

Write to Wisconsin senators Ron Johnson and Tammy Baldwin. Go to Disability Rights Wisconsin or NAMI Wisconsin to find an email to send your representative.

Get the word out. Talk to friends, neighbors, or guys you meet in the bar. They’ll listen—especially if Grandma’s in a nursing home.

After all, a society is judged by how well—or how badly—it treats its weakest members.