Performing liposuction on a skeleton is a foolish waste of time. But that's what state Sen. Bob Beers is proposing to do when it comes to cutting out the so-called fat in our state's Medicaid program.
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Medicaid in Nevada is a bare-bones program with few optional services. Medicaid, funded jointly by the state and federal government, is a lifeline to poor kids, our grandparents and the disabled. The few optional Medicaid services that Nevada provides are less expensive than the mandatory services they replace.
For example, hospice care is an optional service at between $120 and $160 a day for a senior or a disabled person. However, if hospice care were not provided, that person would qualify for mandatory services, such as in-patient hospital care at around $1,350 a day.
In a May 4 editorial ("Cut here ... for starters"), the Review-Journal recommended: "Eliminate every Medicaid 'add-on' (optional service) not absolutely required by the federal government." That would be foolish fiscal policy. As the above example noted, cutting add-ons does not translate into saving money.
Sen. Beers claims that by eliminating 32 optional services, the state can cut Medicaid expenses by $210 million. He's mistaken. The white paper prepared by the Nevada Division of Health Care Financing and Policy, which Sen. Beers cites as his source, concluded that eliminating optional services would increase Nevada's Medicaid budget. Sen. Beers failed to mention this conclusion to the Senate Finance Committee -- a rather significant oversight.
More than $100 million in optional services Sen. Beers proposes to eliminate would come from pharmacy coverage. What would happen if we actually did this? A poor kid suffering from asthma would go to the doctor (covered as a mandatory Medicaid service). The doctor would order a prescription that cost $75, which the kid's parents cannot afford to pay. The kid doesn't get the prescription, but he does get seriously ill. He ends up in emergency room (mandatory care), which cost 10 times as much as the prescription.
Not a single state has eliminated the optional service of pharmacy coverage. It is fiscally irresponsible and morally reprehensible to cut prescription medications to the poorest of the poor.
Another optional program provides community-based services to low-income elderly, the chronically ill and the disabled in an effort to keep them out of nursing homes. Again, this optional service is less expensive than the mandatory hospitalization.
Everyone in society benefits when people get basic health care. Healthy workers are more productive, and healthy children learn more. Medicaid helps our kids stay in the classroom and out of the emergency room.
Some politicians, such as Missouri Gov. Matt Blunt and Nevada's Sen. Beers, want to cut Medicaid in a misguided effort to control runaway health care costs. The real problem is not Medicaid, but our national health care crisis. Instead of targeting Medicaid recipients, they should develop a strategy about how to control skyrocketing medical costs.
Medicaid recipients are real people. They're poor kids with asthma, grandmothers in nursing homes and the disabled in hospices. And they're anything but fat and happy. Cutting the so-called fat in these "optional" programs will make their lives miserable and actually cost taxpayers more money.
Jon Sasser
CARSON CITY
THE WRITER IS THE STATEWIDE ADVOCACY COORDINATOR FOR NEVADA LEGAL SERVICES, CLARK COUNTY LEGAL SERVICES AND WASHOE LEGAL SERVICES.
Follow Guinn's lead
To the editor:
When considering any rebates for taxpayers, I would suggest that the Legislature follow the governor's plan to refund vehicle registration fees. It is fair to Nevadans who register their vehicles in this state and to businesses.
The plan to allocate the monies based on driver's licenses does not credit business owners any tax overage and it gives much more money back to those households with multiple license holders. A household with five drivers could receive $1,000 to $1,500 in rebates while a single-license household might receive $200 to $300.
This is hardly an equitable distribution. The governor's plan is the most equitable plan and should be supported.
Joe Pitts
HENDERSON
Property tax rebates
To the editor:
I am about to get an ulcer listening to the various ways our elected officials are discussing how to refund $300 million of the budget surplus to Nevadans.
Because Nevada property owners have suffered large increases in property taxes over the past few years, why don't legislators give them the money? If they give $300 to everyone with a driver's license, the refunds benefit transients and cons who are in and out of Nevada and take more than they give.
Cheryl Nowka
LAS VEGAS
Reward for voting
To the editor:
We elect our legislators, and they, in turn, levy our taxes. Now they are faced with the pleasant dilemma of having a budget surplus created by their overtaxing legislation. Apparently, most agree that a rebate is an equitable solution. But there is wide disagreement as to how to make the rebate equitable.
Why not use this windfall tax surplus to reward those citizens who have taken responsibility for our elected officials and rebate the surplus to registered voters?
After all, what better way to ensure that we are encouraged to participate in our democratic process than to reward those citizens who made the effort to elect our officials?
Stacy Standley
LAS VEGAS
Brittney Bergeron
To the editor:
Family Court Judge Gerald Hardcastle's attitude toward young Brittney Bergeron's wishes confirms my contention that we live in a patriarchal, big-brother-type society ("Paraplegic girl's words raise hard questions about mom's parental rights," Saturday's Jane Ann Morrison column).
If any kid on the planet has a reason to be bitter, nasty and evil, it's Brittney. Yet she is kind, friendly, and a genuinely nice kid, despite what she's been subjected to at the hands of her mother. She is now living in an environment that is stable, supportive and predictable. She has been in therapy, both mental and physical, and has had ample time to make a rational decision about her own welfare, as she should be allowed to.
Yet Judge Hardcastle would throw her back into chaos and probably expects thanks for it.
I really think that one opportunity to kill your children is enough. Just because the mother, Tamara Schmidt, is physically able to bear a child, she doesn't deserve another chance to screw up the one living child she has. Brittney is a human being, not some lab experiment.
