Even though this seems like a successful defense of medical education funding, med ed has been compromised, particularly in primary care. We do appreciate the timely letter (from AAMC).
Our clinics in primary care training residents have 35, 50, 67, and higher percentages of patients on Medicaid. They will likely be coming to us for care even though they are one of the 16,000 that the state plans to cut from Medicaid. The only thing missing will be the reimbursement.
The training institutions had to cut unspecified deals with the state to keep the federal funds matched and coming. You can bet that this means cuts in areas at the medical centers or in future dollars lost.
I got a call from a patient on Friday. She has breast cancer and asthma. Her son has severe asthma. Her situation is such that she cannot hold a steady job. Even with a steady job she could not get insurance, due to existing conditions. With Medicaid, she still owed on utility bills and faced eviction. Without Medicaid and state help, she is now at the Salvation Army. Her son, age 11, is extremely bitter about the life he is forced to live and does not respect his mother. She suffers from constant depression. She was cut before the state made this decision. She is the face of what is to come in this and other states. If she had any family worth having, she would pull them down with her, as many others are doing in underserved communities. The picture is not a pretty one now, and for the next few generations.
Robert C. Bowman, M.D.
UNMC Department of Family Medicine Director of Rural Health Education and Research
983075 Nebraska Medical Center
Omaha, NE 68198-3075
(402) 559-8873 or fax at -8118
Email: rcbowman@atsu.edu
http://www.ruralmedicaleducation.org