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Hurting kids

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Poor children would suffer most from proposed cuts in state budget.

By Charles Willson

[06.21.04] — With a $200 million state budget surplus predicted, I assumed I wouldn’t need to bombard my legislators this year with all the reasons why providing quality medical care North Carolina children is worth the cost.

Why then, are legislators again on the verge of cutting funding for programs that serve our most needy and vulnerable citizens?

The most damaging cuts proposed in Gov. Mike Easley’s budget and being considered by the House budget subcommittee on health and human services would:

* Eliminate $1.1 million in Medicaid coverage for people ages 18, 19 and 20.

* Eliminate $6.3 million in coverage for pregnant women from 185 of federal poverty level to 150 of federal poverty level.

* Eliminate $131 million in coverage for the medically needy.

* Eliminate $16.5 million for adult optometry, dental, podiatry, chiropractic, optical and private duty nursing.

* Reduce $10.9 million in medical doctor payment to 90 percent of Medicare.

* Reduce $4.5 million in HealthChoice payment rates to Medicaid rates for kids through age 5.

* Eliminate $4.5 million in HealthChoice coverage vision, dental and hearing coverage.

* Reduce $6 million in funding for early childhood intervention/child development service agencies.

When a preventive service or outpatient treatment is eliminated, the result is deteriorating health of the patient leading eventually to an emergency department visit, hospitalization or nursing home admission, a much more costly intervention.

For an uninsured pregnant woman, the result is a low birth weight or premature baby and declining health for the mother.

The downstream cost of caring for extremely low birth-weight babies and children with undiagnosed and/or untreated disabilities will quickly wipe out any “savings.”

Should the citizens of North Carolina be the ones paying for these programs and services for our most economically challenged families?

Our nation needs a universal health-care program for all.

In the meantime, we need to continue funding these proven program that serve as a hand up for our children, not a hand out.

Community Care of North Carolina, a partnership between the state Division of Medical Assistance and local healthcare providers, has shown that well planned outpatient care saves money and improves health status.

Cutting provider reimbursement violates this partnership and will cause many to stop seeing Medicaid patients because they will lose money on each patient.  These cuts will be especially severe for rural practices with a high percentage of Medicaid patients and our medical school primary and specialty clinics.

Prevention and early detection plus treatment of health problems are always more cost-effective than pretending they don’t exist until the dying patient ends up in an emergency department or a long-term care facility, or a pregnant mom delivers an extremely low birth weight baby, or the impaired teenager drops out of school.

In North Carolina, we have a proud tradition of caring for “our own.”

We can’t afford not to fund these programs.


Charles F. Willson, a faculty member at the Brody School of Medicine at East Carolina University in Greenville, is president of the North Carolina Pediatric Society.

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