I believe that one of the things that makes the United States and other developed nations great is that they are welfare states. Consider this definition of a welfare state from the Britannica Encyclopedia:
“(A) concept of government in which the state plays a key role in the protection and promotion of the economic and social well-being of its citizens. It is based on the principles of equality of opportunity, equitable distribution of wealth, and public responsibility for those unable to avail themselves of the minimal provisions for a good life. The general term may cover a variety of forms of economic and social organization.”
Certainly with significant economic challenges being faced in Arizona it is seems easy and simple to cut entitlements. Indeed, those who have need of said entitlements are the most disenfranchised politically and have the least access to lawmakers, in part this is largely due to the daily struggle for survival. When one is concerned about the basics that many of us take for granted, issues in the political spectrum seem incredibly distant and inaccessible, and yet these political decisions shape their lives in incredibly important ways. For lawmakers, this population is an easy target because of misinformation and stigmatization that plagues the poor. People often believe that individuals are poor by choice, that they are simply lazy and take advantage of the system to get everything for “free.” This intolerance and stigmatization only increases in times of economic struggle, as resources lessen and the innate human instinct for survival rears its head, people begin to look out for themselves and remain ignorant of the struggle of the silent poor.
Therefore, it comes as little surprise that Governor Brewer decided to cut AHCCCS (Title XIX) funding for all single Arizonans. This funding cut to healthcare started back in July/2011 and has gone through a series of court rulings since then. Brewer believes that this initiative will save the state a significant amount of money, but my question is at what cost?
A significant amount of funding that our non-profit receives is through Title XIX funding that is allocated through the Regional Behavioral Health Authority (RBHA), which in Maricopa County is Magellan of Arizona. For this fiscal year, all programs that are funded by Magellan took relatively large funding cuts. For our program, it was a 10% contract cut off of the top, and a sort of back door cut by cutting our rate repayment amount. This concept is a bit complicated and certainly outside of the scope of this blog, but nonetheless behavioral health took some huge hits. This did not come as a surprise to our program and we certainly understood the conundrum that both the RBHA and the State of Arizona was/is facing. There are no easy solutions to complex systemic problems. While we are fortunate enough to have a brilliant CFO who was able to preserve all of our jobs (with a pay freeze, not even a cost of living raise), most programs had to lay off people. I mention this because these cuts are to help the state save money, but laying people off during a repressed economy results in those folks being out of work for some time and likely collecting unemployment. This is also a significant cost to the state. And while NCADD has had to operate more efficiently and become more creative with finding funding sources and opportunities, our agency has been deeply concerned with the medical consequences of the healthcare cuts.
Beginning in July, we began to receive single women into treatment who did not have healthcare and were well below the federal poverty guidelines. These women had chronic medical conditions like diabetes, high blood pressure, etc. and the circumstances have not changed. Many of our women are in need of psychiatric assistance and cannot receive needed mental health medications because of their lack of healthcare coverage. We began to see the human cost of the political decision and it has been challenging to overcome. It is important to consider what the ultimate cost is to the state by not approving those in poverty conditions to have healthcare interventions. Consider this: if a diabetic is without insulin for too long, that individual is going to have more significant complications that could, and likely will, lead to hospitalization to stabilize. In addition this population has been forced to misuse the emergency room for routine or non-emergency health concerns due to not having the resources to access medical professionals. These individuals do not have the funds to repay the hospital and the hospitals cannot deny emergency treatment. Thus, while costs may be somewhat cut in the short term, the long term consequences of this decision are highly costly economically, socially, and morally. Consider that the income for a single person living below the federal poverty guideline is $10,890 a year. That equates to $209.42 per week. Could any of us survive on that little? Could you meet your health needs? Do we live in a world where someone who is this poor ought not be helped?
So, what was the ruling of the high court? Well, the high court decided that the answer to my last question is yes and yet, it also decided that the legislature is acting unconstitutionally by acting against a voter approved ballot measure, but that the cuts stand. A strange decision indeed. Take a look at some of the political details in the following article.
http://www.azcentral.com/arizonarepublic/news/articles/2012/02/15/20120215medicaid-issue-before-arizona-supreme-court.html
I am interested in hearing all of your thoughts.
No comments:
Post a Comment