June 20, 2018
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‘Rationcare’ would worsen health care crisis

By Lisa Bondeson, Special to the BDN

Forty-five years ago this summer, Congress passed landmark legislation creating Medicare and Medicaid, thereby ensuring health care for millions of Americans. Although the politics behind the creation of these programs was decidedly liberal, the help of John Byrnes, a Republican, was essential in drafting what became a health care safety net for those most in need. Through wars and recessions, deficits and surpluses, Republican and Democratic administrations, these programs have stood as a redoubt for the middle class.

Today, as American families continue to suffer the consequences of an unrelenting economic crisis, Medicare and Medicaid are under attack. Millions of Americans are out of work, facing foreclosure and struggling to provide the basic necessities for themselves and their families. Wages have fallen or stagnated for much of the past three decades, eroding the American promise of a better life for our children. Yet rather than addressing the suffering that has pervaded our country, elected leaders in every state have decided that it’s time to cut the social safety net of Medicare and Medicaid rather than protect it, or dare I say, enhance it.

Under the federal budget passed by House Republicans, Medicaid’s guarantee of coverage would be eliminated and the federal contribution to the program would be reduced by nearly $800 billion over the next decade. Other changes proposed by House Republicans would allow states to deny coverage to seniors, individuals with disabilities, children and pregnant women. It also ends Medicare as we know it by taking away traditional Medicare benefits and replacing them with a voucher to purchase health insurance in the private market. In other words, the House Republican budget replaces Medicare with Rationcare.

The impact in Maine would be profound. Coverage for 49,400 dual eligible seniors and people with disabilities would be reduced. Nursing home care for 4,000 residents would be jeopardized. Health care coverage for 116,000 children would be compromised. Worst still given the state of the economy, jobs would be lost and economic growth would be stymied by the elimination of $4 billion dollars in Medicaid spending.

Gov. Paul LePage’s 2011 budget proposal included additional cuts to Medicare and MaineCare, Maine’s version of Medicaid. Thankfully his most extreme initiatives were defeated by the Legislature’s Appropriations Committee. Still, the governor says that he will continue to push for a substantial change in MaineCare by reducing eligibility levels, a move that opponents say will leave 30,000 Mainers without health care coverage.

This attack comes in spite of the fact that health care costs for American families have doubled in the past nine years and medical bills account for more than 60 percent of personal bankruptcies. For-profit insurance companies deny more than one-fourth of all claims and employers drop health coverage and shift more costs to employees.

Growing numbers of people delay basic medical care and our children show symptoms of diseases long associated with adults. Cutting the social safety net is not the answer. The only real solution is expanding and improving Medicare to cover everyone, with a single standard of care for all.

The American Health Security Act of 2011 does just that. It provides every American with comprehensive, guaranteed health care by requiring each participating state to set up and administer a state single-payer health program. Private for-profit health insurance companies can only exist to provide supplemental coverage. The cornerstone of the American Health Security Act is expanded Medicare for all with cost control and deficit reductions through fixed, annual and global budgets.

This too has been targeted by Gov. LePage who has ordered Maine’s attorney general to join a lawsuit challenging the implementation of the federal health care law.

All Americans understand that Medicare and Medicaid are essential programs that should be preserved and defended with common sense reforms. We need our representatives, Republicans and Democrats, to stand up in defense of Medicare and Medicaid. Don’t cut the social safety net. Expand Medicare to all.

Lisa Bondeson of Windham is a registered nurse with a master’s degree in health policy and management from the Muskie School of Public Service.

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