Reportedly in the interest of reducing the budget deficit, Congress passed a budget reconciliation bill that was signed into law in early February. The budget reconciliation included “changes” in many domestic programs with an apparent special attention to healthcare programs, e.g. Medicaid. Days before it was passed, the Congressional Budget Office (CBO) issued an analysis of the Medicaid “changes”, analyzing the “savings” that would accrue from the increased co-payments and premiums contained in the bill. What really caught my eye was the opinion of the CBO (cited in the Psychiatric Services journal and at CBPP) that 80% of “savings” will come from decreased use of medical services. They did point out, as well, that some of those “savings” would be off-set by increased emergency department use.
What a plan for saving money and reducing the budget deficit. As I mentioned, the CBO did recognize that decreased use of regular medical care would result in increase ER use, some of which will be “inappropriate” and some will be forced by medical deterioration. What they didn’t comment on is the increase in Coroner’s services that will result. Avoidance/non-use of medical services also contributes to medical deterioration unto death.