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Northwest Voices

Seattle Times letters to the editor

February 19, 2009 at 4:19 PM

Washington health care

Sickening symphony of slashing the budget

In 1729, during a period of great economic uncertainty in Ireland, Jonathon Swift wrote “A Modest Proposal,” in which he satirized the attitudes of those who devalue the poor by suggesting the poor simply sell their children as food. In these more enlightened times, our state lawmakers appear ready to dine on federal funding intended for the care of the poor.

On Feb. 2, the House voted to slash almost $5 million from the care of nursing-home patients for the remaining fiscal year (prior to July 1). By an 83-13 vote, Democrats and Republicans joined in a sickening symphony of praise for an all-cuts approach to budgeting.

The proposal went to the Senate and, on Feb. 13, the same Democratic Party that created Medicaid under Lyndon Johnson was united in its Senate vote to begin dismantling Medicaid’s vital protections for nursing-home patients.

This budget-cutting comes before the legislature even gets around to addressing Gov. Chris Gregoire’s biennial-budget proposal. Her no-new-taxes budget would cut 7.5 percent from nursing-home care as part of $130 million in Medicaid cuts to long-term care over the next two years.

Amazingly, state cuts to vital Medicaid care may occur at the same time the federal government increases its commitment to that care.

Indeed, even while it pillaged nursing-home funding, the House budget action assumed pocketing an additional $205 million in federal Medicaid contributions through July 1 alone and an additional $575 million for the following two years.

The actual increased Medicaid assistance to Washington from the federal stimulus package may be $2 billion.

Unfortunately, avaricious-state governments had united and defeated health-care advocates’ efforts in Washington, D.C. to push “maintenance of effort” requirements. Such requirements would have prevented the perverse phenomena of reduced funding as additional federal dollars intended for care roll in.

Rather than address our economic crisis with the sorts of thoughtful ideas we’ve already seen from the Obama administration, both parties in Olympia are seemingly competing to see who can kick over the most wheelchairs through mean-spirited, social-service cuts.

Medicaid spending primarily goes toward wages. That’s why it’s recognized by economists as one of the best means of economic stimulus. Because caregivers are hardly wealthy, their earnings generally go straight back into the economy as spending.

And every dollar cut from state Medicaid spending surrenders a matching federal dollar. Thus, through severe Medicaid cuts, state government may destimulate the economy faster than the Obama administration can restore it.

Beyond this economic reality is the fact that vulnerable citizens, and those who dedicate their lives to caring for them, stand to suffer. More than dollars and cents are at stake. Nursing homes do not manufacture widgets. We provide skilled nursing care — and life-transforming rehabilitation — to people with serious medical needs, who are often at the worst points in their lives. And, we do so amid constant uncertainty created by ever-changing, state-reimbursement policies for roughly two-thirds of the patients on Medicaid.

For the last few years I’ve worked alongside the union representing caregivers to fight for better respect for low-wage workers. Gov. Gregoire has been a great help. Yet, now I fear our hard-won gains may evaporate due to state politicians’ shortsighted reactions to this economic crisis. I fear Medicaid cuts will close facilities and displace both caregiver jobs and our state’s most vulnerable citizens.

— Jim Roe, San Juan Care & Rehabilitation, Anacortes

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