Medi-Cal Cuts Mean Job Losses When We Can Least Spare Them
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By Pat Person
California Pharmacists Association
It is both ironic and tragic that while every politician, from president to city council, is focused on job creation and our economy, the state and federal governments have made a joint decision that will cost California jobs right now, when we can least afford to lose them.
Because of the decision made by the governor and the state Legislature, and approved by the federal Centers for Medicare & Medicaid Services, to yet again cut back reimbursement rates in Medi-Cal by 10 percent, physicians, dentists, optometrists and pharmacists throughout our state will have no choice but to stop participating in the health care coverage program. Worse, many clinics and pharmacies servicing rural communities will have to close their doors altogether.
The reason for that is simple: after years of reductions in the reimbursement rates the state pays to medical providers through Medi-Cal, it's no longer economically feasible to continue treating Medi-Cal patients.
The Sacramento Bee reported recently on just one example where jobs will be lost -- the Mayers Memorial Hospital District in Shasta County, where the health care industry is the top private-sector employer. At Mayers' skilled-nursing facility, 97 percent of patients are Medi-Cal enrollees, and administrators there are already contemplating what would happen if they had to shut down.
Similar problems are facing the Central Valley. The chief financial officer of the Kaweah Delta Health Care District, which operates two skilled-nursing facilities in Visalia and one of the three hospitals in Tulare County, told The Bee, "The natural thing is to close but where do we put the patients then?" The closest hospital-run nursing facilities are several communities and miles away from each other.
That would mean the loss of jobs, and there are similar stories at rural hospitals all through the state. The California Hospital Association conducted a survey last year when the cuts were being contemplated that showed that half of all the state's skilled-nursing units within hospitals would be forced to close, and an additional 35 percent of them would reduce their number of beds or stop treating Medi-Cal enrollees. That means tremendous numbers of job losses, not to mention skilled health care practitioners.
The economic tragedy would also strike small pharmacies in nearly every community. No one expects pharmacists to get rich from treating Californians insured by the state, but the reimbursements should at least cover the cost of the medications being dispensed. With this latest round of cuts, that's no longer the case. At Ming & H Drugs, we will be filling prescriptions and getting reimbursed below what it costs us to bring the medication into our store. We are being asked to, literally, pay out of our own pockets to provide services to Medi-Cal patients. This will force us to make decisions, not just about filling the prescriptions, but whether or not to continue to provide some of the services that we offer (free delivery, specialty prescription packaging), and these cuts may also result in employee hours being cut and/or layoffs.
As a result, our pharmacy may stop accepting new Medi-Cal patients and/or be forced to reduce staff. Unfortunately, some pharmacies serving Kern County Medi-Cal recipients may be forced to close down.
Paul Rohrer, president and chief executive officer of the Professional Pharmacy Alliance of California, recently stated that, "If the state action is granted, both rural and urban underserved communities across California will be adversely impacted as independent pharmacists are often the only access these Medi-Cal patients have to the medications they need and it will become too costly for many pharmacies to remain open."
Now that the state's action has been granted, we will unfortunately experience all too soon more closures affecting millions of Californians and costing us even more jobs.
There are more than 7.5 million Medi-Cal enrollees. That is equal to nearly 1 in 5 Californians. The program is therefore one of largest employers and economic drivers in our state. It is absurd to reduce its funding without considering the effect the cuts will have on job creation and our overall economy.
At a time of record-high unemployment, one would think that elected leaders would be scrambling to support good-paying, quality jobs in the health care profession, not cutting them.
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Pat Person, incoming president-elect of the California Pharmacists Association, is a registered pharmacist at Ming & H Drugs in Bakersfield. This article originally appeared in the Bakersfield Californian.
What can I say? It is unfortunate for sure. But, the state is becoming broke. They have squeezed on taxes to the point that the productive middle class is leaving. Who is left to pay the bills?
If they raise taxes even more, it will just accelerate the flight of the productive.
Since it seems you're the same moron that commented on the millionaires tax...I'll just include my response to those Fox news talking points...with facts...I know, facts to right wingers is like garlic to vampires, but here we go:
California is in the budget hole it is because of all the TAX CUTS (and the housing bubble caused by Wall Street) instituted over the past couple of decades, including for corporations. The fact that we have the disastrous Prop 13 AND that we're only 1 of 3 states in the nation that require a super majority to raise taxes at all BOTH DISPROVE your "argument".
A few basic points based on numbers crunched from the California Budget Project...as there is PLENTY of money to provide health care to sick and elderly:
The Share of Corporate Income Paid in Taxes Has Fallen by Nearly Half Since 1981
Tax Cuts Enacted Since 1993 in CA Cost $11.7 Billion in 2008-09 alone...
Lowest-Income Households Pay the Largest Share of Their Income in State and Local Taxes: Bottom fifth pays 11.7%, top 1% pays 7.1%.
Tax policies and economic trends are largest contributor to the state’s budget problems:
Corporate income taxes have declined over time as a share of General Fund revenues and as a share of corporate profits. If corporations had paid the same share of their profits in corporate taxes in 2006 as they did in 1981, corporate tax collections would have been $8.4 billion higher.
Extending the Bush tax cuts (overwhelmingly for the rich) alone cost California $14 billion this year...
Add to that the recession caused by Wall Street induced housing bubble and you have the other piece of our deficit puzzle.
Its of course also a myth that those poor rich people (this would tax only what people make ABOVE $1 million a year)are leaving the state...in fact, last year alone, the number of millionaires in California increased by 27%...even as they are taxed at a lower proportional rate than the poor.
Think Mitt Romney...taxed at less than 14% on the over $20 million he "made"...by doing nothing.
As we know (not you, but as educated people know), the rich are taxed at the lowest rate in 60 years yet have a larger share of the wealth than at any time in 80 years. This, at a time we are devastating education, health services, infrastructure and public safety?
Why in the world would we not tax the super rich a tiny bit more to keep our state competitive and the economy growing?
The top 1% in this country have more wealth than bottom 90% combined (YET they pay half the tax rate on ordinary income prior to 1981)....and the 6 Walton children from Walmart have more wealth than the bottom 30% of America COMBINED....yet are taxed at about 17%.
As the California Budget Project notes, "In response to sizeable budget shortfalls, lawmakers have repeatedly cut state spending in recent years. The Legislature reduced General Fund spending from $103.0 billion in 2007-08 to $87.3 billion in 2009-10 – a drop of 15.3 percent – as policymakers responded to the dramatic decline in revenues caused by the most severe economic downturn since the 1930s. In 2010-11, General Fund spending is estimated to be lower as a share of the state’s economy than in 33 of the prior 40 years, and expenditures will fall further under the spending plan approved by the Legislature in March."
A CBP analysis of state data shows that the cumulative impact of these cuts amounts to $2.7 billion between 2008-09 and 2011-12. These cuts require Californians with Medi-Cal coverage to pay more out of pocket for health services, reduce patients’ access to health services, and require seniors and persons with disabilities to enroll in managed care plans. This has led to Reduced funding that counties use to operate the Medi-Cal Program; Eliminated state support for community clinics; Required seniors to pay Medicare premiums; Reduced payments to medical providers by 10 percent; Required Medi-Cal enrollees to pay more for health services; and Eliminated coverage for adult dental care and other benefits."
A millionaires tax is exactly what's needed if we are to make the most basic public interest investments at a time they're needed most. Or, we can continue to go the Banana Republic route...with the rich getting richer, investments in our future getting smaller (and the safety net that provides a lifeline to growing numbers of Californians), and the poor (new study shows 1 in 2 Americans qualify as poor now) increasing.
Thankfully, polls show about 70% support for this tax...and remember too, the economy never did better than when taxes on the rich were at its highest (1950's through 1970's).
Its about priorities...your priority is to cut taxes for the rich and big business at the expense of human beings and our future...wonderful...we get it.
As an obvious sociopath I do have one question for you: how many lives are you willing to sacrifice to protect the massive wealth of the super rich?