Budget Cannot Be Balanced on the Backs of America's Most Vulnerable People

Many older people have no one to care for them. As head of an organization that provides health care and housing to low-income seniors, I take very seriously the reality that for many vulnerable Americans, we have become their family.
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When I hear the debate about entitlement programs and trimming spending from the federal budget, I think of my late mother. She was a Dallas hairdresser who eventually opened her own beauty shop and worked hard her whole life to support her family. In her later years, when her health started to fail, I became largely responsible for her care. But despite having close relatives who could provide for her day-to-day needs, she still depended on Medicare and Social Security to provide for her healthcare and other expenses.

My mother was lucky. Many older people have no one to care for them and no savings to rely upon. As head of an organization that provides health care and housing to more than 30,000 low-income seniors daily, I take very seriously the reality that for many of these vulnerable Americans, we have become their family... they are certainly ours.

As the family members responsible for their care, we rely on Medicaid, Medicare and Social Security to assist in financing their services. These proud and dedicated Americans are not looking for a handout. Rather, they have been hard working men and women who guided the country through World War II and then built us into the strongest nation and democracy on earth. They helped defend and secure for future generations most of the freedoms we enjoy.

For these reasons, it seems unthinkable that our country could adopt any fiscal policy that would balance the federal budget on the backs of these great -- but now elderly and vulnerable -- Americans. I, for one, can not face them everyday unless we've let it be known that this outcome is unacceptable.

While we know that it's necessary to control spending, we must take a prudent and even-handed approach. Currently, a disproportionate share of proposed budget cuts focus on vulnerable and low-income people who depend on government-funded services. Medicaid, Medicare and Social Security cannot fall victim to shortsighted efforts to cut the budget.

One proposal would convert Medicaid into a block grant system, pushing the burden of the program from the federal government to the cash-strapped states. The nonpartisan Congressional Budget Office has stated that turning Medicaid into a block grant will greatly reduce the number of people who can be served by the program and will cause some services that are currently mandatory to be reduced or eliminated due to budgetary shortfalls. We and other like-minded organizations are very concerned about the impact this would have and are working to oppose this form of funding.

It has also been proposed that Medicare move away from its traditional form and move to a voucher-based program. However, these open-market programs typically cost more, not less, per beneficiary. Payments to existing voucher-based plans are an average of 13 percent higher than traditional Medicare costs.

Additionally, Social Security has become an integral and necessary component to the American economy. For decades Congress has borrowed against the surplus Social Security had in its coffers. In the 1950s, things were working well -- people paid into the programs, funds were drawn down for beneficiaries and there were 16 workers per beneficiary.

Years later, the funds Congress borrowed from Social Security in the past are needed today since there are now only 3.3 workers per beneficiary. Seniors are also more reliant on these funds than in the past, as Social Security provides the majority of income for more than 60 percent of senior households. For the poorest 40 percent of seniors, Social Security makes up more than 80 percent of total income. These funds also go to organizations like Volunteers of America to help provide much-needed care.

There are both moral and fiscal reasons to preserve these services. If the shelter and care needy people receive is taken away or delayed, they will end up sicker and in more distress. The proposed options to delay the immediate and short-term costs for these people will only exacerbate the situation and increase total costs in the long run. This will do more harm to the future fiscal health of the entire country.

A balanced, thoughtful approach must be taken to ensure proper support for the most vulnerable while protecting the long-term fiscal position of the nation. Older Americans, and all vulnerable people, deserve the dignity provided through the care funded by programs like Medicaid and Medicare. We're all one big family -- we can't turn our backs on them when they need us most.

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