This message has been cross posted to the following Discussion Forums: Center for Civic Leadership and Academy of Architecture for Health .
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As some of you know, these three subject matters are intimately related and have a significant impact on the healthcare design community. For those that have not connected the dots, please allow me to assist. For instance, the 2013 Sequester led to many cuts in federal spending. One of them happened to be a 2% funding reduction to Medicaid. This turns out to be essential dollars that hospitals and other related institutions, including the CDC, use to strengthen their bottom line and allow for research, new equipment, technology and replacement of aged facilities.
When the 2014 Federal Budget was passed it included much of the same funding cuts negotiated via the 2013 Sequester. So it continued the severe cuts established and continues to hamper the development of our healthcare system.
Now with the Affordable Care Act (ACA) came the opportunity for all states to accept an increase in Medicaid funding. However enticing this sounds some states (almost half) have found this to be not to their liking and have rejected the funding increase. Also included with the ACA was the deletion of disproportionate share funding or DISH payments. These payments are made to healthcare facilities for the treatment of those unable to pay for services. It was deleted because the ACA was now going to cover those unable to secure healthcare previously by providing access to health insurance. However if the Medicaid funding is not accepted, the funding whack now has been a double whammy. There is no Medicaid increase and no DISH payment to offset the cost of others who simply cannot afford to purchase insurance. As noted previously, these funding cuts have had and will continue to have a significant negative effect upon the ability to provide services, do research and build.
In addition to the effects upon the design community, many in our society continue to be shut out of the healthcare system due to the governance being parlayed causing hospitals to be shut down at an alarming rate. The AIA has a significant voice. I strongly suggest that it's time for us to make our voices heard for the good of all on these important issues and consider adding these issues to our agenda and the upcoming Grassroots Day.
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Lawrence Witkowski AIA NCARB ACHE LEED
Principal Owner-Healthcare Architect
Witkowski & Co. Architecture
Atlanta GA
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