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What Cutting Medicaid Actually Means - From a healthcare professional perspective
(medgremlin.substack.com)
this post was submitted on 03 Mar 2025
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politics
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Aren’t some of your healthcare staff on public assistance as well due to low pay? Money and capacity required. You can’t have capacity without personnel. You can’t have personnel if they’re not paid well so you also need money.
Over here, some of our mental health systems (corporate level) are robust because they make sure they have money making clientele alongside the money sink clientele, all under one roof. These systems generally pay well and stay in business. Other places try do one thing and specialize in that one thing, only to fail due to lack of money and personnel. There will be passionate players who want nothing more than to make it work, but at the end of the day staff need to pay rent, buy their kids shoes, and have money to spend on personal decompression. So you see these one trick institutions die off every year.
As much as we want health to run on altruism and good intentions, health personnel anywhere need to be paid an incentive level pay, and have enough left over to engage a work life balance to recharge their own mental health, or it will all crash and burn eventually.
There are many healthcare facilities here in America that would pay minimum wage if they could get away with it (and many of them do). Hospital administrators and managers hate the word "union" with a fiery passion and will fight tooth and nail to prevent their workers from forming or joining unions.
And this is part of the problem with the reduction in Medicare and Medicaid reimbursements. The community hospitals and clinics are already strapped for cash to pay their workers well enough, and if the majority of their patients are on government-funded insurance, then the cuts to that insurance will mean that the hospitals and clinics (and thereby the workers) get paid even less than before.
How will nursing homes even run? They’re built on Medicare and Medicaid. They take that check in exchange for care. They are notoriously understaffed because there’s a Medicare/Medicaid cap on how much money each patient can bring in.
If that goes away, then what? Where do the elderly go? Nursing homes have also been taking in a slice of homeless with physical situations that don’t allow for being discharged back to street. Usually paralyzed or partially paralyzed individuals. Where would they be placed?
A single mom working 2 jobs probably can’t take in a 24hr care, physically dependent, cognitively lost beyond their own first name, urine/poop leaking out as it happens, and/or physically violent Alzheimer’s parent.
Vice-dachshund Vance hinted at this on the campaign trail, once, that families should simply be taking in their own.
I worked in a nursing home/assisted living facility for a little while for minimum wage. I quit when I found out that they were expanding the memory care unit without increasing staffing requirements. Most of my 8 hour shifts were by myself caring for 9 adults with severe dementia that required help with everything....and they were talking about increasing that to 13 residents. I left because I did not want to be responsible for one of them falling and getting hurt while I'm stuck trying to clean up another one that forgot how to use a toilet about 10 years ago.
There is no proposed solution. The proposed solution is for the poor people to just die already.