The high cost of family collapse

The high cost of family collapse

Poor, unmarried women and girls who have babies are doing themselves and society inestimable damage.

It's pretty much undisputed that skyrocketing costs in Medicaid and public pensions are wreaking havoc with the Illinois budget.

Despite a mammoth income tax increase in January 2009 and the gusher of new revenue it produced, Illinois legislators will not have sufficient funds available to fund core state functions without dramatic cuts in Medicaid and pension spending.

That's why Gov. Pat Quinn has appointed two working groups made up of administration representatives and legislators to come up with a package of recommendations for cost savings in both programs.

There will be few, in any, easy choices when it comes to cost savings. Indeed, a recent Associated Press story illustrates the dilemma that legislators face with respect to Medicaid, the social welfare program that finances health care for the poor.

It's a dual problem that reflects both immediate exorbitant costs to taxpayers and social disintegration that lays the groundwork for bigger and more costly problems in the future.

In 2009, the last year for which complete figures are available, Medicaid paid for the costs of 89,621 babies in Illinois. That number reflected 54 percent of all births in Illinois, and the bill came to $890 million.

That's a stunning statistic. But here's an even bigger shocker. With respect to teen mothers, Medicaid paid for nearly 94 percent of deliveries in 2009.

Illinois is not disintegrating in a vacuum. On a national scale, Medicaid paid for four in 10 births.

The national cost, of course, is staggering. In 2009, Medicaid paid $27 billion for pregnancy and delivery services and another $24 billion for care for newborns.

Maternity related hospital stays make up more than a quarter of Medicaid's hospital charges.

Gov. Quinn has established a goal of cutting $2.7 billion from Illinois' Medicaid program. Without these deep cuts, Quinn has suggested the program is in danger of collapse, and that doesn't even count the collateral damage done when money allocated to Medicaid could have gone to K-12 and higher education, law enforcement, mental health or roads.

What can the state do about reducing its cost for Medicaid births? Thanks to President Barack Obama's national health care plan, the answer is nothing.

Obamacare rules forbid any reductions in eligibility requirements that might cut the Medicaid rolls. Indeed, over the new few years, many thousands more Illinois residents are expected to be added to the Medicaid rolls under Obamacare.

What's ironic is that Illinois' Medicaid rules are far more generous than they need to be. The federal government requires that those earning less than 133 percent of the federal poverty level are eligible for Medicaid. In Illinois, low-income earners who make anywhere from 200 percent to 300 percent of the federal poverty level are eligible for Medicaid.

What Medicaid pays each year for childbirth is, of course, just the up-front cost of the dangerous social pathology linked to single mothers who give birth, particularly teen single mothers.

Welfare statistics demonstrate clearly that unwed teenage girls who give birth have pretty much guaranteed themselves a lifetime of living in poverty. Even more disturbing are statistics that reveal that the children born to single mothers disproportionately fall victim to a series of negative social pathologies including a poor education and involvement in crime.

In other words, things continue to get worse for individuals who either trap themselves or their children in these circumstances.

It's a seemingly intractable problem that reflects a slow and steady cultural decline. The budget implications are catastrophic, and that's just the tip of the iceberg.

Sections (2):Editorials, Opinion
Categories (2):Editorials, Opinions

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motownmama wrote on March 13, 2012 at 3:03 pm

I was a poor, single teen mother at the age of 18 to a beautiful baby boy. I take extreme offense to the "writers" (and I use that term very loosely) statement, "things continue to get worse for individuals who either trap themselves or their children in these circumstances." An individual is only 'trapped' in a set of circumstances if she is unwilling to work her way out of them. This applies to ANY individual...single mother, married mother, gay man, or 20-something trying to find their niche in life.

I had this exact statement presented to me when I was told the only answer to my 'situation' was to have an abortion. I cannot imagine who or where I would be today without my son. He is my world and he made me the person I am today. And, to clarify for the "writer" who obviously feels single mothers do nothing but suck off of society:  I went from being on a medical card at 18, to working 3 jobs and going to school part time for 8 years to get a bachelors degree. I then worked and saved so I could return to school to earn a masters degree. I am now a professional in the work force, married and am very actively involved with my children, their schools and my community.

Do not think for one minute that public assistance defines a person. It is individuals such as yourself who are close minded and write off people because they don't have or can't provide as you may be able to at some point in their life. You should be ashamed of what you have written, and the News-Gazette just lost me as a subscriber for allowing such views in their paper.

Sid Saltfork wrote on March 13, 2012 at 5:03 pm

Wouldn't planned parenthood with provided contraception save young women from being on taxpayer paid medicaid, SNAP, child care, and educational costs?  It would allow them to develop necessary employment skills to become independent without costing others as much money.  It would not burden others with the cost of an individual's decision.  As a country, state, county, and municipality; the taxpaying citizenry cannot afford to keep subsidizing others including others who are not citizens.  This is not a conservative, liberal, or moderate issue.  It is an economic issue.  The money is just not there anymore.

Moruitelda wrote on March 14, 2012 at 9:03 am

This is not an immigration issue. The amount of money we spend educating and training illegal immigrants who want to stay here is well spent - we just need systemic reforms to ensure that they're paying their taxes. And we certainly don't want to take the extremist path we're on now. A high school valedictorian in Florida, who is an illegal, but has lived here since she was 4, is going to be deported. How does that make sense? Perish the thought that we have more motivated, intelligent, capable citizens. 

If you want to talk about the money our society cannot afford to spend, let's talk about how our society structures its medical spending. There's a systemic problem right now. Money is flowing from the young to the old. Student loan debt has overtaken credit card debt as the number one source of private indebtedness. Our young are being crushed under a burden of paying back $200,000 or more for degrees that secure them jobs paying $30,000 or less. 

In those circumstances, many (understandably) refrain from getting healthcare. They can't afford it. They put it off until things get better - or, at best, they get low-level coverage with high co-pays. Either way, they are effectively deterred from seeking care. So when you could treat a preventable condition (say, melanoma or heart disease) at low cost early through preventative care, they're not going to the doctor. They age, their health deteriorates, and as they begin to get quality health care, we start spending money to fix what we missed treating 10 or 15 years early. But the damage is done. 

Fast forward 30 more years. They're eligible for Medicaid Part D and Medicare. They have supplemental insurance. But they're at the end of their lives. Now we'll spend millions on hospice and expensive treatments to prolong their lives by a few years, or months; when we won't spend hundreds or thousands to extend the life of a young uninsured person by screening them for treatable conditions, and treating them before they become complicated. 

This is what our society cannot afford. We can't afford to keep spending countless billions of dollars on end of life care, with a negligible return. We need to make an investment on the health of our youth, on treating preventable conditions early, and on ensuring that we get the maximum return on our investment in care. If an 85 year old with an array of medical problems wants to pay out of pocket to pursue aggressive chemotherapy and to cover hospice care during that treatment - more power to them. But our society must recognize that this is a much poorer investment than providing screening care to hundreds of young people with the same amount of money. 

Our system is backwards. Ignore the inexpensive, high-return needs of the young; throw our resources at the expensive, low return needs of the elderly.

Sid Saltfork wrote on March 14, 2012 at 11:03 am

You forget one thing.  Each individual, or their family, makes a choice.  It is individual responsibility.  You can point to illegal immigration, children out of wedlock, age, gender, and any other criteria; but it come down to individual choice.  No, others should not be financially responsible for others educational loans, children, medical treatment, food, and shelter.  It was the individual's choice.  If you decided to borrow money to obtain a degree in Art History, that was your decision.  If you decided to have a child that you cannot afford, that was your decision.  If you decided to come to this country illegally, that was your decision.  You appear to want to make this a youth versus age issue.  It is not that.  The same applied to the aged in the past; as it does to youth now.  Society is not to blame for poor judgements made by individuals.  There are alternatives such as good health practices, birth control, and scholarships, and earned educational benefits by serving in the military.  Taxpayers do not owe you for your mistakes.  Take responsibility for your decisions.  There is not enough money to support all of the immature in this country.

Moruitelda wrote on March 14, 2012 at 9:03 am

I am an Obamacare supporter and disagree wholeheartedly with the premise of the article. 

Nevertheless, you cannot take issue with the FACTS that he's citing. The fact that you dodged a bullet does not change the fact that there is a very strong correlation between having children young, living in poverty, and violations of the law by the child. 

It's your right to choose when and if you take a child. The important part of this article, for me, is not its premise - that Obamacare is paying the poor to have kids - but the sociocultural issues that contribute to cycles of poverty: the poor are more likely to have children earlier; those who have children earlier are more likely to be poor; the poor are more likely to commit crimes. All unfortunate truths. 

I want universal, single payer healthcare. The GOP has polluted the waters such that too many Americans are opposed to necessary aspects of that (like looking at the return on investment of treatment - death panels? Please), but you must understand that I'm not against paying for the costs of having a child. 

However, I'm confused by the umbrage you take on the issues of poverty and crime. Yours is an exceptional case. You have a problem with the statistics. I do too. But having a problem with them doesn't mean they're any less true. 

motownmama wrote on March 14, 2012 at 11:03 am

I apologize for my lack of clarity about the statistics...I agree with you that they are irrefutable. My issue is with the message (or lack thereof) in this article. It is a typical News-Gazette written opinion which lists a bunch of complaints with no suggestion or even a hint of a solution (and by solution, I am not looking for another hand out or 'free' program).

Sacrophyte nailed it on the head. We need communities of mentors with compassion and understanding. Someone for a single parent to turn to for help or in times when the answer may not be clear for him/her. How can one claim this is impractical, inefficient or a waste of time when we are talking about a free solution to a very costly national situation?

It has been a dream of mine for YEARS to run a program for teen/single parents which provides a multitude of support from assisting with time management, locating daycare, applying for jobs, applying for scholarships, assisting with bathing/feeding/basic means of taking care of your child, and MOST importantly, reminding this parent that he/she has already proven his strength by asking for help.

sacrophyte wrote on March 13, 2012 at 5:03 pm

As a married, working father and husband, I very much agree with motownmama and am extremely offended!

You ask "[w]hat can the state do about reducing its cost for Medicaid births?"..I respectfully disagree that we can do nothing. In fact, we can do the opposite of nothing - doing nothing <b><i>is</i></b> the problem. We can surround these new mommies with love and compassion. We can try to understand their circumstances, we can try to help shoulder their burdens.

This sounds impractical, doesn't it? Sounds messy and inefficient. Difficult. Waste of time? Ask these young mothers if they think it is a waste of time. I would be curious what the answer is.


-- charles schultz

motownmama wrote on March 14, 2012 at 12:03 pm

Thank you Mr. Schultz. Having been that young mother I can answer your questions. Understanding, love and compassion are not messy, inefficient, difficult or a waste of time. On the contrary, they would give reassurance that people care.  It is that simple to change the outlook of anyone going through a hardship...just to know that someone CARES. Thank you

slanky wrote on March 15, 2012 at 11:03 am

So the rich, white, mostly male conservatives that run the NG think that human beings having babies is the issue. When really the problem is that it costs (on average, according to their own numbers) almost $10,000 to have a baby in a hospital.

Young, unmarried East Central Illinois mothers and mothers-to-be and their families just got Limbaughed by the NG.







Sid Saltfork wrote on March 15, 2012 at 5:03 pm

I did not take the NG opinion to be biased toward "young, unmarried East Central Illinois mothers and mothers-to-be and their families".   I read it pertaining to men, and women who make the decision to have children by disregarding contraception while having others pay for the bill.  We live in an age where contraception is available even to the poor.  Poor decisions by some should not be a burden put on everyone.  I am personally opposed to abortion; but I have no problem with people using birth control until they can support their children.

Carolan wrote on March 15, 2012 at 9:03 pm

Look at the N-G's own lead-in line for the editorial; they single out "women and girls" as doing "inestimatable damage" to society.  There is no admonition for the men who father children and then shirk their responsibilties, leaving the mothers to raise the children alone. 

Sid Saltfork wrote on March 16, 2012 at 5:03 pm

I agree.  It is the fathers fault also.  How many "fiances" are there now compared to "husbands"?  Sad; but it is not everyone's fault.  What about contraception?  Why aren't people practicing it?  With almost 50% of the people not paying taxes, and the top percent paying a lesser percentage than those who pay taxes based on employment; it falls on the shrinking middle class to pay the bills for everyone.  The situation is increasing, not decreasing.  Yeah, I know it sounds heartless; but when money drys up, individual responsibility has to increase.