Legislators have been screaming about Medicaid and how it's eating up the budget in North Carolina (the same is true in other states), and it's easy to make people think it all comes from abuse of the system, but that's false.

Medicaid serves children, impoverished adults and elderly people who can't afford to pay the nursing home they need to be in. It serves people with mental illnesses and severe disabilities.  To qualify for Medicaid, Mike had to leave his wife; otherwise he wouldn't have been able to have the second round of chemotherapy.

Some would have you believe people who are on Medicaid are lazy and dishonest, and that we're all paying too much to give these bums better medical care than we can afford ourselves.

Medicaid is the last shred of our health care safety net, and it pays so little that most doctors can't pay their overhead and so have to limit the number of Medicaid patients they can take; that's why two-thirds of children on Medicaid who needed specialized care in a recent study were turned away.

Opponents of "socialized" health care would have you believe we're spending half our state budget on Medicaid, but the real figure is about 15 percent.

When you cut Medicaid, you deny a child her asthma medicine or someone with diabetes the medicines and supplies that help prevent expensive and dreadful complications. When people can't get care, they die from simple, treatable things, and it costs us a lot more.

Medicaid was supposed to be about preventing poor people and people with disabilities from suffering needlessly. Now, to try and get rid of it, opponents have villified the people who use it as being on the take somehow, just like they're doing with people who collect unemployment benefits.  In reality, it's about giving more to people who already have much, much more than they need by taking it away from people who have a genuine need.

People with serious mental illnesses can live relatively normal lives if they get the care they need. Mental illnesses are chronic and can be managed, if the person can get the medical attention he or she needs. Instead, we let the illness progress to a crisis and then hospitalize the patient for a few days. Often, patients are released to the street, and all too frequently, they die.

So, what happens when the people with severe disabilities who live at the Irene Wortham Center lose their "optional" Medicaid services because of these cuts? They lose their homes and all the activities and therapies they need. They will be warehoused in nursing homes, cared for by people who aren't trained to deal with their specific needs.

What happens when some little girl in Raleigh can't breathe and can't get asthma medicine?

What happens when your grandmother needs glasses or a new hearing aid, or God forbid, can't pay the bills for her nursing home bed?

What happens to the young mother with diabetes who would never be able to afford her medications and glucose meter and strips?

These people are only faceless because no one is defending them and they don't have the money or the energy to advocate for themselves.

Do we really want to take basic care away from them and give it to corporations in the form of tax breaks because "we can't afford" Medicaid?

There is enough to go around. We are not broke. It's time to start chanting that at all the naysayers in the NC General Assmebly.

No matter what anyone tells you, there are disparities in health care, and poor children have less access to care, even when they have Medicaid or the Children's Health Insurance Plan (CHIP).

According to a new study in the Journal of the American Medical Association, 66 percent of children with public health care (Medicaid or CHIP) who had medical needs -- severe body rashes, obstructed breathing during sleep, Type 1 diabetes, uncontrolled asthma, severe depression, new onset seizures or a fracture that could affect bone growth -- were turned away by medical specialists, while only 11 percent of children with private insurance were denied care.

The study also found that Medicaid and CHIP-insured children who received an appointment faced longer wait times. Their average wait to see a specialist was 44 days, while privately-insured children with similar urgent conditions waited 20 days. Federal law, however, requires that Medicaid recipients have the same access to medical care as the general population in their community.

It appears that federal law doesn't matter here.

For the study, volunteers called physicians practices asking for an appointment for a child who had one of the conditions listed above. The only difference in the script was the answer to what kind of insurance the child had. In more than half of the calls to clinics, the caller was asked for information about the child's insurance type before being told whether an appointment could be scheduled. In 52 percent of these calls, the type of insurance coverage was the first question asked.

And with "austerity" budgets being passed in so many states, Medicaid and CHIP are facing severe cuts. Children are being booted from the system already and wait times to get CHIP are growing longer every day.

So,  the next time Rep. Heath Shuler tells me that "our children are cared for," I'll cite this study and see what he has to say.

Medical practices are full, which is why some kids can't get an appointment, even if they do have insurance.  But to turn away two-thirds of children with real medical needs because their parents can't afford insurance is inexcusable.



I've been obsessing about the NC state budget the last few weeks. People I know have been arrested protesting the proposed budget, and when it passed on Sasturday morning, my friend LisaRose called me to make sure I was OK.

I still have the hope that the governor will veto the budget and two of the five Democrats who voted in favor will change their votes. If not, we're in deep trouble in North Carolina.

The budget slashes early childhood learning, higher education and a mental health system that's already so bad it's being investigated by the US Justice Department. It guts Medicaid for people with severe disabilities.

According to fiogures from the NC Justice Center, the House budget would cut state spending on Medicaid by $225.4 million, which would cause the loss of $1.2 billion in federal matching funds for Medicaid. That alone could have a ripple effect that would cost more than 19,000 North Carolina jobs.

And that's just the jobs impact. Think about the number of people who will lose access to health care because of these cuts, and how many of them will die as a result.

Much of this could be restored by continuing the 1/4 cent sales tax that the Legislature is determined to cut.

This cuts-only approach to the budget is backward and harmful.

I'm trying not to obsess on it too much; instead I'll look ahead to 2012 when we can throw these callous people out. In the meantime, I'll keep telling the stories of people who are suffering because of this mess.

As Mike always said, focusing on the negative will only hurt me.