The physical-economic collapse, destroying 5-700,000 jobs a month since last November, is digging a huge hole under the Medicaid program for healthcare for the poor, even as the Obama White House is determined to cut Federal healthcare programs and "let them die."

With exploding unemployment, about 15,000 Americans are losing their employer-sponsored or other health insurance every day — a 5 million-a-year pace. Many are falling on Medicaid whose spending requirements by states, just to keep the poor and unemployed with access to medical treatment, have risen by about $15 billion in the first seven months of 2009. But for the same reason — economic collapse — state Medicaid spending has not risen in 2009. Rather it has fallen by $30 billion or more, according to Health and Human Services and the Kaiser Foundation, as state tax revenues collapse, and governors and legislatures cut Medicaid and the children's program S-CHIP. [Medicare revenues are also falling, by about $25 billion or 4.5% from 2008 to 2010.]

So the implicit demand on the Federal government for Medicaid subsidies just to keep the unemployed and poor going, is $45-50 billion in 2009 so far. But the American Recovery and Reinvestment Act — the "stimulus" — contained $25 billion in increased subsidies, and the White House says that's it for the year. The net cut in Medicaid care available nationwide in 2009 may well be 10%-15%, in absolute terms of treatments, tests, etc.

President Obama told a black working man at his Raleigh meeting today, who asked "regarding his brother" about this predicament of the poor, "You're asking about Medicaid benefit levels. That has not been our focus [in Obama's healthcare "reform"]. We don't want people using Medicaid, for example, who could pay themselves. But we want to make both Medicaid and Medicare more efficient, and reduce costs for your brother [!]."

In other words, let them die.

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