There is no appropriate role for the federal government in providing either routine health care, or food outside of acute disaster areas (which admittedly might include the entire state of California). The reason that programs like Medicare, Medicaid, and SNAP aka food stamps are such disasters is because they are provided ultimately from a central, not local source. And once these bloated, corrupted, budget disasters were put in place, they attracted or grew all sorts of supporters who wanted some of the fallen fruit.
Enter the American Academy of Family Physicians. In its never ending mission to become the nation’s grandmother doling out vanilla soy ice milk to her children, the AAFP is squealing about potential cuts that might affect the poor.
“The AAFP strongly opposes any changes to the federal government’s definition of poverty that reduce eligibility for Medicaid, the Supplemental Nutrition Assistance Program and other federal programs on which many low-income Americans depend.” What cataclysm is in the offing? The Office of Management and Budget is considering basing the definition of poverty on a variant of the Consumer Price Index that controls for how people react to price increases: they buy cheaper stuff.
The AAFP is shrieking that “More than 300,000 children would lose comprehensive coverage through Medicaid and CHIP,” which amounts to 0.8% of those presently covered by those programs (over 34 million), according to Medicaid.gov.
“More than 150,000 consumers who buy coverage through the ACA marketplaces would see their deductibles go up by hundreds — even thousands — of dollars because they would lose eligibility for or qualify only for reduced cost-sharing assistance.” Ah yes, the boondoggle supported by the AAFP, which already punished tens of millions of citizens through encouraging premium increases by “hundreds –even thousands –of dollars.
As for food stamps, all money is fungible; they SHOULD be cut, and allow former beneficiaries to prioritize their cigarette money more effectively.
I am not here arguing for the revocation of all safety nets, which would be ridiculous. They should exist, devised, administered, and revised at the most local level possible. These programs need flexibility and accountability, features not readily available when attached to a central government, and lobbied for by special interests. The AAFP supports Big Government Medicine, and wants BGM to support its continued existence. Their position paper takes several rotting pages from the AMA’s busybody, achievement-free approach: cigarette taxes, residential segregation, and fear of crime are among the “risk regulators” that family physicians are supposed to mitigate.
How shall they perform such healing-at-large? Why through patient-centered medical homes (PCMH!! – subsidized, naturally), cultural competency, screening for socioeconomic challenges, and advocating for low-income neighborhoods and communities, of course! These are exactly the reasons why bright young medical students choose primary care, along with the ability to add up important metrics via their EHR’s to qualify for that extra 1% bonus, if they’ve been really, really good (save it up kiddies, those MOC fees aren’t disappearing anytime soon).
Bless the AAFP for their consistency in simultaneously ignoring the issues killing family practice, while passing out free butterfly nets and pointing to a government-blessed field of dreams.