The Bush administration has begun the traditional post election changes of regulations and executive orders that often accompany a change in administrations. On Friday, the president narrowed the scope of services for poor people who rely on Medicaid’s outpatient benefits. The administration claimed the purpose of the order was to clarified the definition of outpatient hospital services, a definition the current administration claimed was murky. It narrows the definition of outpatient services to eliminate those services that can be provided and covered outside of the hospital.

Clearly, services such as dental and vision will be affected, but it might also eliminate PSA screening, social work services, dietary consulting, and perhaps even the implantation of Lupron etc., all vital to the fight against prostate cancer These new rules conflict with congressional efforts to to increase federal aid to the states for Medicaid. President-elect Obama has endorsed the congressional efforts to increase aid to the states for Medicaid.

As a result of the economic decline, many more individuals are turning to Medicaid as a last resort for their medical coverage.

The new rule is scheduled to take effect on December 8, 2008, six weeks prior to Mr. Obama’s taking office.

This is bad for medical care for the poor as well as for younger (under 65 years) men with prostate cancer.

Joel T Nowak MA, MSW