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Here's the choice: Buy medicine or pay the rent?

By MARY JO MELONE, Times Columnist

© St. Petersburg Times, published April 15, 2003

Sixteen days.

They are bearing down on Carol DiSario like the cars of a fast-moving train.

DiSario, a cancer survivor who also has to cope with heart trouble, is one of those most unlucky people -- poor, old, disabled and living on a paltry government check. They have their medical bills and prescriptions paid for by the state's Medically Needy program. Or at least they will, until May 1.

That's when the bottom will drop out of the program.

DiSario, a retired secretary from Pinellas Park, will have to spend all but $450 of her monthly income before she'll get a nickel toward the thousands of dollars in drugs she takes to stay alive.

The Medically Needy law was changed last year, but its effect was put off until this year.

This was no accident.

An election intervened in November. If this change in the Medically Needy program had been widely debated, some people may not have made it back to their seats in the Legislature. Jeb Bush might have had a harder time keeping his job.

Now the debate over the Medically Needy program has begun. It stands as a symbol for Florida's budget crisis, in which there is simply too little money and a set of impossible choices to be made.

Here is the impossible choice Bush would make in the Medically Needy program, which covers not just prescriptions but doctor and hospital bills. The governor would stop paying hospitals to treat these people, but would cover the drugs. For a woman like Carol DiSario, who has been in the hospital three times since November, this would be hardship indeed. Presuming that doctors and hospitals don't turn her away, they'll have to eat the cost of treating her.

The governor's plan, unveiled in January, doesn't address whether people would have to pay down to that $450 limit. That has been the Legislature's choice. This way doctors and hospitals would get paid. But people like DiSario would be forced to choose between buying medicine or paying the mortgage.

So here you have it. Either she can't get into the hospital, under Bush's plan, or she'll be homeless, on the Legislature's plan.

"You know what upsets me?" DiSario said. "They don't have to worry about their medical (insurance). It's paid for. Who pays for it? Our taxes."

Compare that to the governor's calm and bloodless view. "Making tough choices is not easy," he told a Tallahassee TV reporter last week in what must be the bromide-of-the-month. "We're not cutting overall, we're cutting the growth of government."

In the 15 years of writing this column, I have not run across a subject like this. I have stopped counting the calls. The voices are angry, fearful, desperate, confounded, wondering why the government would seem to be going out of its way to hurt them.

It's up now to the governor and the Legislature to settle their differences over the Medically Needy program, as they must over the rest of the state budget. They face a terrible crunch.

The changes in the Medically Needy program take effect May 1.

The legislative session is to end the following day.

What would happen to the Medically Needy program -- if no budget is adopted on time -- is unclear. What Carol DiSario would do, whether she would still be able to get her medicines, is also unclear.

The governor would be obligated to call the Legislature back into session on the budget. Lawmakers would have until mid June to adopt one, and presumably during this period, the Medically Needy issue might be thrashed out.

The people who have called me ask what they can do, where they can protest. I do the usual, tell them to call their legislators or the governor. But I am not optimistic. Saving the Medically Needy program will cost money and -- regardless of the damage about to be done to vulnerable people -- there is not much will in Tallahassee to raise it.

-- You can reach Mary Jo Melone at or 226-3402.

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