Imagine your family facing the prospect of a drastic loss in income. Imagine that for every $1 of household expenses, you could lose 94 cents of every dollar.
It's scary to think of this scenario to say the least. As the family breadwinner, you might lose your mind.
In the real world, this is a looming potential crisis that the Guam Department of Public Health and Social Services could be burdened with starting just months from now or at the beginning of the new budget year on Oct. 1.
Public Health usually needs upward of $11 million a year to pay for the Medically Indigent Program. This program is 100% locally funded and has become the health care safety net for thousands – approximately 9,000 in 2017 – low-income Guam patients every year who don't have health insurance access from work, who don't have money for health insurance or who don't qualify for federally funded Medicaid.
For Guam residents who don't qualify for Medicaid, the insurance of last resort would be to get covered by MIP. Certain immigrants or people who don't meet residency requirements fall out of eligibility for the Medicaid safety net.
But Public Health has chosen to reduce MIP funding by as much as 94%.
Public Health has chosen to underfund MIP to get a better bang for its limited buck by allocating as much money as possible for the local matching fund for Medicaid. The more money it dedicates for Medicaid, the more federal health care dollars it frees up for Guam.
This decision, however, leaves indigent patients who don't qualify for Medicaid to possibly run out of options. It's already tough to get private doctors or clinics to accept patients under MIP because the government has had a record of not paying doctors and clinics on time.
With Public Health planning to drastically cut MIP spending from almost $10 million to less than $1 million this coming budget year, or a nearly 94% reduction, can you imagine what the situation would be like for MIP patients?
The other loser in this battle for government of Guam health care dollars is the government-run, financially ill Guam Memorial Hospital. Each year, tens of millions of dollars in patient care that GMH provides to patients are left unpaid.
With a drastic cut in MIP funding, indigent patients will still go to GMH, which is required by law not to refuse patients in need of lifesaving care. However, GMH would then be left with an even bigger burden of unpaid hospital services.
Things are getting tougher for GMH, especially with private hospital Guam Regional Medical City's decision to cut urgent care services on top of other services it had previously ended. GMH keeps losing money every year.
And GMH will lose more as it gets an even larger number of patients who can't pay or who go to the hospital with a dire condition.
Guam taxpayers will eventually be asked – maybe forced – to bail out GMH through the imposition of taxes. It's not good all around for our community.
It's a problem our elected officials know is heading our way, but their recent actions have not been as urgent as they should be.
What are our elected officials waiting for?