National Budget Cuts Effecting Mental Health Agencies

Introduction

Estimates suggest that 10 to 40 percent of healthcare budget may be lost to fraudulent activities each year. In dollar terms, this means that billions are lost annually to criminal actions by fraudulent providers. It is important to note that the distinction exists between Medicaid/Medicare fraud and Medicaid/Medicare abuse. Fraud generally refers to instances where the provider intentionally steals from healthcare system, while abuse refers to instances where providers accidentally or unintentionally misuse insurance systems. These distinctions are recognized in various state laws (Robertson, 25).

The program serves all eligible beneficiaries regardless of income or medical history. The Medicare program plays the vital role in ensuring health of beneficiaries and elderly population by covering critical healthcare services, including the newly implemented prescription drug benefit. The program is pivotal to U.S. healthcare system and integral to global healthcare market. Medicare accounts for 14 percent of total U.S. federal budget and is largest payer for health services in world. Medicare has four distinct parts—A, B, C, and D—each of which is administered and financed differently. Parts A and B, two primary components, were established with original passage of Medicare in 1965. Parts C and D were created by subsequent legislation, Balance Budget Act of 1997 and Medicare Modernization Act of 2003, respectively (Robertson, 26).

Among states there was concern that creation of voucher systems would increase administrative costs. There was also anxiety about the backlash from treatment providers because of perception that new faith-based and community-based providers would be competing with them for resources. In addition, some states were anxious that ATR could represent first step in conversion of Substance Abuse Prevention and Treatment Block Grant into the voucher program. In end, ATR has come to be viewed by many as the exceptional vehicle for driving development of recovery-oriented systems of care. However, in face of successive federal fiscal year 2008 and 2009 budgets that propose slashing core CSAT programs while adding close to $100 million in ATR funding, program continues to receive the mixed reception (Herman, 10).

Discussion

Demand reduction funding (prevention and treatment) has declined under administration of George W Bush. Despite revised accounting methods that inflate demand reduction activities relative to prior year reports, most recent NDCS shows that, under Bush administration, demand reduction funding has declined by 3% while supply reduction increased by 42%. Overall, supply reduction funding increased from 55% to 64% of mental health funding while demand reduction funding went from 45% to 36% of overall mental health budget (Fischer, 115) .

In 1999, during Clinton administration, the coalition of drug policy organizations released, as the counterpoint to NDCS, Effective National Drug Control Strategy, which recommends that two thirds of mental health budget be directed to treatment and prevention. Written from the public health and harm reduction perspective, alternative strategy was developed around two primary goals:

(1) Reducing harm caused by drug abuse

(2) Reducing harm caused by existing mental health policies.

Advocates have argued that current interdiction policy ignores lessons learned from Alcohol Prohibition, misdirecting resources ...