Tuesday, August 07, 2007

Why more medicaid births?

How many questionable assertions of fact can you cram into one news article? Let's count the affirmations of faith in this one about the large percentage of births in Wisconsin paid for by Medicaid. The percentage of total births covered by Medicaid rose to 44% in 2005.

The state Department of Health and Family Services attributes the rise to an economic downturn that led to an increase in women of childbearing age whose incomes qualified them for state health care programs. There was no economic downturn in 2005. In fact, the accompanying chart seems to show that the increase accompanied the recession following the dotcom collapse, but continued right through the more recent robust economy.

"It's understandable, since families are struggling more and more to meet basic needs, so they become eligible for those programs," said Charity Eleson, the council's executive director. But the poverty rate rose slightly from 2000 to 2004 and not at all between 2004 and 2005. Yet births covered by Medicaid have increased at a stunning rate. The relative increase in Wisconsin from 2000 to 2004 seems to have been more significant than nationally so that may explain some of what we see. Still, it seems unlikely that some generic group called "families" have "struggled more and more" in the past few years.

Eleson said that people with lower levels of education are slower to benefit from an economic resurgence. This is closer to reality. But even if that's the case, it wouldn't an explain an increase in the number of Medicaid births.

"If those women who are low income and engaging in sexual behavior and don't have access to these facilities, we absolutely think there's going to be more unintended pregnancies," (Christine) Taylor (public policy director for Planned Parenthood of Wisconsin) said. This statement is apparently a commend on proposed changes in the way in which family planning activities are going to be funded. It's not clear to me how these changes (taking money from groups like Planned Parenthood and giving it to counties) is supposed to hide birth control. I can hardly go into a men's room these days without having "access" to contraceptives. I understand that access requires putting a few coins into the machine, but even poor folks manage to have access to all sorts of things that cost something. And I rather doubt that we lack for free birth control. More fundamentally, it's got nothing to do with the rise in medicaid births because the changes are proposed. They haven't happened.

If teen pregnancy rates are going down and the economy is improving and eligibility requirements haven't changed and there is "access" to birth control, what's going on here?

I am not suggesting that Medicaid should not be available to pay for these births. If children are about to be born, they and their mothers need to be taken care of. Nor am I big on prohibiting distribution of birth control. That cow seems to have taken leave of that particular barn. But these numbers raise all sorts of questions that no one interviewed for the article seems willing to ask.


Anonymous said...

"continued right through the more recent robust economy"

Remember the liberals don't believe we've ever had a robust economy since Bush took office

Anonymous said...

From the same news bureau that brought readers the Amber Alert and Kathleen Vinehout stories.

Dad29 said...

It's understandable, since families are struggling more

Families? or Single Moms?

vuong said...

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Joseph G Nelson said...

"Still, it seems unlikely that some generic group called "families" have "struggled more and more" in the past few years". You actually said this!
Why don't you think about classifying families as lower middle and upper class, or even by income categories. then you might, if you look, find some groups of "family types" have "struggled more and more" in the past few years. Thats the way its done in public health, we stratify the group, to get a better understanding of the data.
Superficial examinations and hasty generalizations fail your audience, and shows gaps in your understanding.