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Wednesday, August 31, 2011

Transplants and Politics

As I mentioned on Monday, today's post will be the last one here on The Sheepdog for a while. I'm gonna take a break, a "Sheepdog Sabbatical," to begin working on a new project in order to get up and running with it as soon as possible. However, before I sign-off for a while, I want to follow up on some posts I did several months ago. This is a post I've been meaning to do for a while, but I wanted to follow the story a little longer to see how it played out. Plus, it just didn't seem the time was quite right for running it. However, with the sabbatical beginning a new chapter for me, I feel like today's the day.

Jan BrewerFolks who have been following my blog for a while remember me "raising cain" over a decision made by Arizona Governor Jan Brewer (pictured upper right) and the state's legislature last year (click here to read earlier posts about Jan Brewer). Those jokers cut funding for organ transplants covered by the state's Medicaid program, officially named the Arizona Health Care Cost Containment System (AHCCCS), from the state's budget effective October 1, 2010. Specifically, the decision ended AHCCCS coverage of transplants for anyone 21 and older. It left 100 of the state's sickest residents unable to pay for their life-saving transplants if a match was found for them. In fact, two of those 100 died without getting the transplants needed after the atrocious decision was made.

Gov. Brewer and the Arizona legislature decided to cut the transplant funding due to the state's budget crisis. Brewer even went further by saying the funding was cut because, in her opinion, transplants don't work. Do what ? Other state and local governments currently find themselves in similar situations. However, the transplant funding cut only amounted to a little over $1 million. The state's projected budget deficit at that time was a little over a $1 Billion. Therefore, the cut to transplant funding amounted to only ... are ya ready for this ... approximately 1/1000th of 1% or .001% of the projected budget deficit. In other words, if I had a $1000 per month budget for household expenses but decided to cut that budget to only $999 per month, that would be the equivalent of how much Arizona was "saving" by cutting the transplant funding from AHCCCS. Another way of looking at it is that two Arizonians died in order to save $1 out of every $1000 spent by the Arizona government. Apparently, that's what a human life is worth in Arizona. The really troubling thing, though, is that the state left funding for a new coliseum roof, the study of algae, and other pork projects amounting to millions of taxpayer dollars in the budget. I guess "pork" is more important than people. I'd hate to think that this "budget cut" wasn't about saving money but rather due to a lack of concern for the poor and sick in Arizona. However, that appears to be the case.

Back in the spring, due to public outcry by the people of Arizona and elsewhere across the country, reports began to surface that Gov. Brewer and members of the Arizona legislature were looking for a way to restore the transplant funding. The truth is, though, that the members of the legislature who were trying to find a solution were the Democrats. Gov. Brewer and the Republicans killed those proposals on multiple occasions. Finally, around the first of April, it was announced that Gov. Brewer and the legislature had restored the AHCCCS transplant funding. However, a closer look showed that wasn't necessarily true, either, and even if it was, Gov. Brewer's three-pronged solution was gonna leave other Arizonians enrolled in AHCCCS as the ones paying the price.

The seal of the United States Department of He...First, Gov. Brewer asked The U.S. Dept. of Health and Human Services for permission to eliminate $500 Million of Federal funds from AHCCCS. Then, she would restore the transplant funding and not allow new enrollments of childless adults and others into AHCCCS. Doing this would prevent 160,000 Arizonians from being eligible to enroll. In addition, some 200,000 others would be forced to pay higher co-pays and other fees if they wanted to keep their coverage. Brewer's proposal would make transplant patients look like the bad guy - they would get coverage while nearly 400,000 others wouldn't. I guess this is her way of  "CYA'ing." It's stupid logic if you ask me. You screw 400,000 to save 100. Aren't 400,000 votes more than 100 ? She ain't the sharpest tack in the box. Oh, and did I mention that the legislature passed, and she signed a huge corporate tax cut ? Sorry. I forgot to mention that. Wanna guess the total amount of the cut ? It was $538 Million. Hey, didn't she ask HHS to cut $500 Million from AHCCCS ? Wow. That tax cut would've covered that $500 Million Medicaid cut. Imagine that. Must be election time.

Secondly, the actual language in the new budget was so vague that it does not automatically restore transplant funding to AHCCCS. It only says that the legislature "intends" to restore it "within available appropriations." In politician speak, it basically means that the money will be available to AHCCCS if the governor and the legislature don't have something else they would rather spend it on. Furthermore, if the funds are available, the transplant program is still only going to be funded through June 30, 2013. I guess they think that starting in July 2013 no one else in Arizona will ever need a transplant. Dang, if Arizona politicians are that good at prognosticating, I sure wish they'd help me out by telling me the next set of winning Powerball numbers.

Thirdly, Arizona's politicians have proposed a so-called "Fat Tax" to help curb the state's budget problems. It would mean charging a $50 tax on childless adults who are obese that do not abide by "a doctor-ordered weight-loss plan," are smokers, or not following a proper treatment regimen for a chronic illness, such as diabetes. The first problem I have with this "Fat Tax" is that it's discriminatory. It specifically targets "childless adults." What's the deal ? Does the state think adults who do not have children for one reason or another are bad or worthless people ? The other problem I have with it that it applies to people considered "obese." If the goal is to "encourage" or "nudge" people into healthier lifestyles (Cass Sunstein would be so proud), why are they only targeting folks considered "obese " ? Some people who are overweight have other underlying health problems that contribute to their obesity. The problem could be genetic and not a component of their lifestyle. Besides, who's gonna determine what "obese" is ? Is it gonna be some government bureaucrat or a doctor ? Furthermore, if the state is actually wanting to punish or discourage unhealthy lifestyles, they should have treated everyone fairly by placing the same "tax" on others, too, such as people who drink alcohol. But of course, they're are not gonna do that because it would hack off some of their largest campaign contributors, and they're more important than the "little people."

I first posted about Arizona's transplant funding cuts back on December 16, 2010. That day, I was pretty hot about the whole deal, and it still disturbs me. In that original post, I predicted that if these type of cuts were allowed to be made in Arizona, it was only a matter of time until similar cuts would happen in other states. Unfortunately, my prediction is coming true. The state of North Carolina is currently considering similar cuts. Last year, the state cut over $350 Billion from The Division of Medical Assistance, and they are needing to cut more. It may led to transplants being limited and the elimination of dental care, hearing aid coverage, mental health treatment, and home health care for thousands of North Carolinians. In addition, last night on the local news, it was reported that huge cuts may be forthcoming for the state of Tennessee if Congress makes significant cuts in the amount of Federal funds sent to the states. It includes a possible $2 Trillion cut from TennCare, the state's Medicaid program. A $2 Trillion cut to TennCare would have devastating effects on Tennessee's poor and residents considered "un-insurable." I suggest Governor Bill Haslam and the legislature put a reasonable plan together to make sure these folks are provided for. Otherwise, they'll be hearing a lot from The Sheepdog and others in The Volunteer State in the months to come.

As I wrap this post up and begin my break, I want to give notice to the wolves out there, such as Jan Brewer. Even though The Sheepdog is on sabbatical, his eyes and ears are always open and his mind is analyzing what's going on. I can always take a quick break from my break and hop back on the blog to report what I see. I guess it would be my version of, "I'll make ya famous," as Billy the Kid's character in the movie Young Guns would often say. I encourage you jokers to be on your best behavior.

I know today's post has been rather long. However, I felt like this issue was worth following up on and visiting again. I, for one, am sick and tired of uncaring, selfish politicians who only worry about getting re-elected. They were hired, by us, to serve us - not themselves. It's high time that they got their priorities straight, stopped wasting our tax dollars on pet pork projects, and starting having some respect for human life. Personally, I'm beginning to think that maybe it's time for some transplant recipients, cancer survivors, heart attack survivors, and others with what could be considered chronic health conditions, who are now able to live fairly normal lives, to run for and get elected to political office. Then, we'd have some public servants representing us that understand how precious life and health really are. It's something we as a group need to give a lot of thought, prayer, and consideration to. Then, one of us who is courageous, bold, well-spoken, and not afraid of anything needs to go for it. That person must be one who will not compromise their values and one that people will get behind and work hard for in order to put them in office. That person or persons are out there, it's time for them to step up.

Well, all that being said, it's time for The Sheepdog to cut out of here and hit the trail to work on his new "project." I'll see y'all and update later in the fall.

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