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Bush's budget ax strikes fear in hearts of medically needy

By MARTIN DYCKMAN
Published January 23, 2005

TALLAHASSEE - We read from time to time that Americans are the most churchgoing, God-fearing people on earth, but there is another message in those statistics.

It is that we are hypocrites who should tremble at the sound of thunder.

There is not a religion among us that would answer "yes" to the following question: Is it moral to let people sicken, suffer or die because they can't afford the health care that most others take for granted?

As someone remarked recently, our greatest national disgrace is not that some 44-million Americans have no health insurance, but that so few of the rest seem to care.

Gov. Jeb Bush proposed a budget last week that sets aside money for tax cuts but not to continue Florida's Medically Needy program, which sustains some 36,000 chronically ill people.

If your heart did not skip a beat at that news, you are not one of them.

For those who are, it was like reading that the governor had signed your death warrant. Again. The ax gets poised every spring.

"Walk half a mile in my shoes and maybe you will get it. Maybe you will understand," said Mary Ellen Ross, of Delray Beach, a liver transplant patient who depends on Medically Needy to cover what Medicare doesn't, which is a lot. "It's like having a knife at your throat. It's not right. It's not what our state ought to be about.

"I'm 52," Ross said when asked her age. "I'd like to be 53."

"There's no way to describe the fear you have when you read that," said Elizabeth Ashcroft of Pierson, who has had 40 operations and will need more to keep her jaw from fusing or spend the rest of her life sucking through a straw.

People like Ross and Ashcroft could not buy insurance even if they could afford it. This is why Ross' Medicare gap is the practical equivalent of being uninsured, and why the governor's proposal to continue only prescription coverage for the Medically Needy is the moral equivalent of nothing. It would leave Ross responsible for 20 percent of the cost of hospitalization and for the cost of blood tests to determine whether her antirejection drugs are still working. Bush's budget would allow nothing for Ashcroft's X-rays and surgeries.

Prescriptions account for less than half the $400-million Florida spends - the larger part of which is federal money - on the Medically Needy.

Americans eagerly open their hearts and wallets in response to foreign disasters. What makes us so insensitive to hardship at home?

It is probably because we figure the government will take care of it.

But our government does not take care of it. Unlike France, Britain, Canada, Germany, Spain, Italy, Japan and every other economic powerhouse, the United States takes care of only some of it.

There is Medicare for those who are old enough or permanently disabled. There is Medicaid for those who are desperately poor enough. But there are huge holes in both those safety nets. The injustice to those uninsured Americans who are neither old enough nor poor enough is compounded by the requirement that they pay taxes to support health care for those who are.

The governor, like many, is probably counting on local governments, charities, and health care providers to fill in for Medically Needy - at your expense, by the way, without any of the federal aid he'd send back to Washington. But it would be uncertain and inconsistent. A study for the Kaiser Family Foundation found that people who are uninsured for one year average only half as much health care as the rest of us. For $48-billion, it said, we could insure everyone.

This country is spending $1.6-trillion a year, 13.3 percent of gross domestic product, with less good health to show for it than others that spend proportionately less. Universal coverage is not only more efficient to administer; it also discourages price-gougers like the pharmaceutical companies that own our government. The governor is correct that Medicaid costs need to be controlled, but all wrong on how to do it. It has to be a part of a comprehensive national universal health care plan into which everyone is required to pay, just like Social Security.

That cannot be expected from a national administration whose scheme seems to be to convert even Social Security into a private investment plan and ultimately into one that is voluntary. But the 22nd Amendment still applies, which leads to words of hope: Only four more years.

Martin Dyckman's e-mail address is dyckman@sptimes.com

[Last modified January 23, 2005, 00:14:21]