NC Medicaid cuts

The struggle to save Pungo Hospital continues

Seeking help from the courts:

Last Thursday, in a Beaufort County Superior Court case that took place in Wilson, Judge Milton Fitch, Jr. granted the town’s request for a temporary restraining order, keeping Vidant Health and Pantego Creek, LLC, who objected to the ruling, from removing equipment from the building, shutting off the building’s utility service or demolishing the building, said Town Attorney John Tate.

“The town was concerned that equipment was going out of the building and they were preparing for demolition,” Tate said. “On Wednesday, a crane showed up at the hospital and that looked quite ominous to us so we filed for a temporary restraining order that will simply keep the hospital intact while we work out a solution.”

This conflict should force us to re-evaluate the way we approach the nexus of health care and the private sector. When your "business" has a major impact on the lives and health of a large percentage of the community, a P&L statement should not be sufficient evidence to plunge that community into a life-threatening crisis. This problem is screaming for a statutory solution, but I shudder to think what the GOP-controlled NCGA would come up with. They'd probably authorize Vidant to demolish Town Hall.

NC GOP cuts to Medicaid put elderly at risk

Taking the "assisted" out of assisted living:

The current budget will limit special assistance eligibility to people who earn below 100 percent of the federal poverty level ($11,670 for an individual annually, or $972 per month). Anyone looking to receive special assistance after Nov. 1 who earns more than that amount will no longer qualify.

“That could be extremely problematic,” said Jenny Gadd, the group home manager for Alberta Professional Services, which runs several group homes for people with mental health issues in the Triangle and Triad. “It’s hard to tell what the eligibility really is going to look like, but that could really affect people in group homes."

Once again, the people who would have been included in a Medicaid expansion are suffering unnecessarily at the hands of those navel-gazers who can afford premium care. Every legislator who supported this provision should have to take care of an Alzheimer's patient in their home for a couple of weeks, just to see what that entails. It's an eye-opener, believe me.

Duelling narratives on the plight of Pungo Hospital

The difference between "profitable" and "for the public good":

Instead, O’Neal welcomed the North Carolina NAACP to assist him in painting Vidant as a corporate bully more interested in huge profits than providing quick access to emergency care for the rural, mostly poor residents in and around Belhaven. That narrative simply is not supported by the political and economic realities that led to the closing of Pungo Hospital earlier this month.

The hospital has seen $5.7 million in operating losses since 2011. Federal grants designed to sustain health care services in poor, rural areas have been cut back. That, combined with North Carolina’s refusal to accept Medicaid expansion dollars, contributes largely to an unsustainable business model for a traditional hospital in Belhaven.

Proving that even though all your facts may be in order, you can still be wrong. The hospital was originally constructed to make sure low income folks could receive proper health care, regardless of whether or not said care would be profitable for whoever had the keys to the place. Vidant was well aware of the financial challenges when it purchased the hospital, and so were the people behind the sale:

Compassionate conservatism: cut Medicaid services to the elderly, blind and disabled

Sorry, but you're just not that important:

The possibility that some elderly and disabled people would be kicked off the Medicaid rolls has the long-term care industry mobilizing to fight it, saying the reduction would threaten the ability of some facilities to stay open.

“We’ve got a damn bunch of ignorant people in the state legislature,” said Chester Broadway, 73, who had his leg amputated as a result of an infection and uses a wheelchair. He moved into The Covington about a year ago.

“If they were in this position, they wouldn’t be doing it,” he said.

You're right, Chester. But they don't run in the same circles as you and I.

NC GOP looks to cut pay for Alzheimer's care

Taking budget-cutting to a disgusting level:

Families dealing with Alzheimer’s disease, and the care providers they hire, are sweating over proposed cuts to state Medicaid payments for elder care. The N.C. Department of Health and Human Services is looking for a $2.40 an hour decrease in what it pays for in-home and in-facility care. The new rate would be $13.12 an hour per person.

“There’s not going to be an easy answer and a painless answer,” Blust said. “And it is just chewing up the budget.”

The problem is, you would rather inflict real pain on those who are virtually helpless, instead of inflicting imaginary pain on the wealthiest of individuals in our state. Here's some scientific reality for you, Einstein: just as improvements in battlefield trauma treatment have created many more crippled (yet living) soldiers than we had from previous wars, medical breakthroughs that have extended the average lifespan of people have created a growing group of those who succumb to Alzheimer's and other brain-related diseases. And cutting the income of caregivers will only result in unnecessary suffering, and likely injuries that could/should have been prevented, which will eat up those labor-saving dollars. Don't do it.

Dueling editorials on Medicaid privatization

Adam Linker reads the tea leaves:

We have seen this exact plan play out in a number of states. In Kentucky, there is chaos. The state auditor there began a probe when he heard reports that small medical providers needed new lines of credit to stay open. In the first several months of implementation, the auditor discovered, managed-care companies received $708 million from the state and paid out just $420 million in claims.

When you have a multiple-tier system with a private entity disbursing public funds to other private entities, that pie is going to get sliced to death before it gets to the hands-on care provider. Again, it ain't rocket science. And it's not like NC doesn't already have a disaster of its own to reference:

NC GOP uncomfortable with its image

Even though it's a perfect reflection of what they are:

"They can have an eight-second sound bite that makes (me) look like an evil, cruel cold-hearted person, and the explanation of why 'no, this was the better of two bad choices' takes awhile, so we do have our necks out," said Rep. John Blust, R-Guilford.

Excuse me, but your neck is out? What about the tens of thousands of North Carolinians who will either not get the medical treatment they need or will be crushed with medical debt, simply because lawyers like you would rather see them walk through your private-practice door looking for bankruptcy help, than have NC's Federal tax dollars come back to this state? Your necks might be out politically, but that's what happens when you pull evil, cruel-hearted tricks on the people.

Let's make 2013 the year we start to #RebuildNC

TWO THOUSAND TWELVE was a difficult year for public investments in North Carolina. We saw even more cuts to vital services on which the entire state depends, and the inadequate funding so many of our schools and other public structures have suffered through since the start of the Great Recession has become the new baseline by which some NC lawmakers will judge future spending decisions.

Before and after: Republican dishonesty in action

That was just one month ago, when Dollar, Tillis and Berger promised everybody no cuts to Medicaid would be forthcoming. This is now:

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