David Keith - The Brotherhood of Vigilance

At the Republican convention, Senator Rick Santorum told a story I could have told. At birth, he said, his daughter’s hands were “just a little bit different and I knew different wasn’t good.” At birth my son’s hands were clenched and quivering in seizure.

Now I know the Senator and I share the brotherhood of vigilance. We have known the long nights watching hospital monitors for reassurance that our baby is still alive. I know how much, admirably, he left unsaid—the change in expectations, the frustration over pains that can’t be soothed, the exhaustion of constant concern.

The Senator told his story as an anti-abortion message. “We didn’t let go,” he said. He thanked God America still has one party that says that “each of us has dignity and all of us have the right to live.”

But which party is that? Paul Ryan’s budget, which candidate Mitt Romney has said he supports and the Republican House already adopted, would deeply cut funding for Medicaid, the very program that supports the medical costs of disabled children. For the mother who has been told she is carrying a child who will face difficulties, Medicaid provides the financial security to choose not to let go. Medicaid protects disabled children, but also most of the residents of nursing homes. The Congressional Budget Office has estimated that by 2050 the Ryan Plan would reduce the projected federal spending on Medicaid by over 70%.[i]

Instead, the Ryan Plan shifts Medicaid costs to states, more so each year. States are not likely to be able to make up the lost federal money except by cutting people from the program. The Kaiser Foundation estimates that in just nine years, the Ryan Plan would force states either to cut payments or to reduce enrollment by almost half.[ii]    

A few years ago, my child had a fall at school. He hit his head and developed that staple of television hospitals, an epidural hematoma. Bleeding under his skull was increasing pressure on his brain with each heartbeat. Without immediate surgery he would have died. Our insurance paid for a helicopter ambulance to take him to a trauma center. Our insurance paid for the surgery and hospitalization. Medicaid helps us pay for that insurance.

Once my son was well enough, we moved from intensive care to a shared room, which had many beds. Changes to Medicaid were being debated then as well and I remember wondering who among the politicians calling for cuts would be willing to come to that room and tell parents precisely what their child would no longer be able to afford.

The Ryan cuts are far deeper. So I wonder again, is Paul Ryan himself going to walk into a room of ten beds and push half of them back into the hallway? Will he clip the IV drips? Deny the pain meds? Will he pull the respirators?

There is a deeper kind of dishonesty than saying things that aren’t true. Paul Ryan’s proposed cuts to Medicaid can have only two outcomes. Either the unreimbursed costs will be passed along as ever higher medical fees. Or children will die. They will miss preventive care, they will wait too long, they will be denied care. Pretending to value children while withdrawing the supports they need is unforgivable dishonesty.

David Gilbert Keith is a father and independent researcher living in Deerfield, Massachusetts.

[i] March 2012 “The Long-Term Budgetary Impact of Paths for Federal Revenues and Spending Specified by Chairman Ryan,” Congressional Budget Office:  http://www.cbo.gov/sites/default/files/cbofiles/attachments/03-20-Ryan_Specified_Paths_2.pdf  Accessed 9/10/12

[ii] John Holahan, Matthew Buettgens, Vicki Chen, Caitlin Carroll, and Emily Lawton “House Republican Budget Plan: State-by-State Impact of Changes in Medicaid Financing,” Kaiser Commission on Medicaid and the Uninsured, 5/2011  http://www.kff.org/medicaid/upload/8185.pdf  Accessed 9/10/12