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Wednesday Oct 09, 2013

WIC One Example of How Shutdown Could Hurt Our Patients

On Monday, we told you how the government shutdown is affecting health careas well as how it is affecting the Academy's advocacy efforts in Washington. Today, I offer one example of how the congressional stalemate could cause millions of our patients to suffer simply by affecting one vital, time-tested program.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides supplemental foods, infant formula, breastfeeding support, health care resources and more to nearly 9 million mothers and young children who live near or below the poverty line. The WIC program has been essential in helping to improve health and nutrition for mothers and children and lowering health care costs

But, the government shutdown has affected funding for this essential program. There was immediate speculation that state WIC programs would run out of money within a week or two, but state reserves and contingency funding from the U.S. Department of Agriculture are expected to keep programs running through the end of the month.

The question, however, is will Congress act before then? Faced with an Oct. 17 deadline to raise the federal debt limit, legislators and the White House have made no progress in preventing the country from defaulting on its debts, which could trigger a national -- and possibly global -- economic crisis and create chaos for the beneficiaries of government programs.

That's the big picture.

Practicing just outside the Beltway in Maryland, I'm thinking about my own patients. A national radio host made headlines last week when he said WIC wasn't "doing anybody any good." The four years I spent working in a community health center showed me otherwise. I've seen countless families who benefited from the program.

In the past week, I've been thinking a lot about one patient in particular, who we'll call Linda. She has six kids. Linda already was a mom when her birth control failed, leading to triplets. Linda and her husband both work full-time jobs, leaving them with significant daycare expenses for their four children who are not yet in school.

WIC not only helps people like Linda and their families make ends meet, it encourages healthy choices. You can't buy junk food through the WIC program, which means children are more likely to get fresh apples than french fries. If WIC funding isn't restored, unhealthy food will be a cheaper choice for the millions of moms who rely on the program.

Sequestration already will cut WIC funding by more than 7 percent, and a proposed House Budget Resolution would remove 1.7 million mothers and children from the program next year. (The House recently passed a bill that would fund WIC for two months, but the Senate and the National WIC Association deemed that stop-gap measure unacceptable.)

So how else is the shutdown affecting government nutrition programs?

The Supplemental Nutrition Assistance Program (SNAP), which provides food stamps to roughly 47 million Americans, is not affected by the shutdown. (As a side note, the House passed a bill in September that calls for $40 billion in cuts in the next 10 years.) However, the USDA school lunch program, which provides reduced-price and free meals to more than 30 million children, could run out of funds in a few weeks, according to USA Today. The USDA reimburses schools on a monthly basis, which means schools could be handed a tremendous challenge in November if the government remains gridlocked.

Millions of our patients rely on programs such as these to help them when times get tough. These nutrition programs determine how well people eat -- and sometimes whether or not they do eat. People shouldn't have to choose between paying their bills and putting food on the table.

Kisha Davis, M.D., M.P.H., is the new physician member of the AAFP Board of Directors.


Thanks, Kisha: Great article. A major problem is that we do not have the political will in Congress or the White House to deal with our overspending. If your health system, medical school or private practice spends more money than it takes in, it goes out of business. Higher taxes are one approach, but DC has shown that with more tax dollars, they just find new ways to spend the new money, not pay off the old. Many important programs are indeed at risk, and in part are at risk because of the poor management of Congress and the administration. I strongly agree with your example of WIC as being an effective program at risk. But I also believe until we get a plan to really reduce spending and manage our income better, perhaps we need to see the government shut down NOW rather than wait until it shuts itself down when you are in the full course of your practice. At least this could force the issue when we have some semblance of an economy left. It is tragic to see the political posturing on both sides while little of substance and sustainability is getting done.

Posted by Kurt Elward on October 10, 2013 at 07:00 AM CDT #

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