We agree: Let the voters decide.
Hospitals across the state took $350 million in total cuts with the 2011-13 budget adopted earlier, according to Len McComb, policy director for the Washington State Hospital Association. Community health centers took another $301 million in cuts.
The financial problem magnifies with people showing up in hospital emergency rooms knowing that they will be treated – usually after waiting several hours. In 2009, hospitals provided $360 million in charity care and wrote off another $833 million in bad debt, McComb said. Hospitals and clinics are seeing a record number of patients – 2.5 million people in 2009.
People with insurance pay higher premiums and larger co-payments to cover the costs of charity care and bad debt. “Everybody with insurance pays for the uninsured,” McComb said.
Gregoire, in her spending proposal to lawmakers, is suggesting even deeper cuts to the medical safety net.
The governor has laid out a plan to save $49 million by eliminating the Basic Health Plan, which provides 35,000 people from working families with health insurance. At its peak, the Basic Health Plan was authorized to serve 180,000 clients, but the program has been cut repeatedly.
Gregoire saves $95 million by eliminating the Disability Lifeline medical program for 20,000 low-income individuals. Many of them are homeless and unable to work because of mental health, physical ill health or addictions. They haven’t yet qualified for Social Security disability payments and must turn to community clinics or hospital emergency rooms for treatment.
The governor is also proposing a $69 million cut in funding to the 38 rural so-called “critical area hospitals” such as Mark E. Reed Hospital in McCleary. That cut could doom some hospitals, according to Renee Jensen, chief executive officer at the McCleary hospital, which serves thousands of Grays Harbor County patients, many of them through the hospital’s clinic.
She said the hospital’s total budget is $9.5 million, but the McCleary hospital had $3 million in charity care and bad debt last year. Some critical area hospitals operate on a thin profit margin and the governor’s cut could spell the difference between some keeping the doors open and having to shut them permanently.
While Jensen admits that her hospital is in better financial shape than many hospitals of similar size, these rural medical facilities often are the economic engine for small communities. Imagine the impact on the McCleary community if Mark Reed Hospital/clinic and its 100 jobs went away.
The medical services safety net in this state is already stretched thin and additional budget cuts could create large gaps in that safety net. People will suffer as a result.
Gov. Gregoire understands that. That’s why she has suggested a half-cent increase in the state’s portion of the sales tax. It would require legislative action to go to a vote of the people. The tax increase would raise $494 million. Gregoire suggests closing other tax loopholes to profitable and out-of-state banks, for example, that would generate another $250 million.
The additional revenue would be used to save some of the medical programs such as the Basic Health Plan and Disability Lifeline, along with K-12 programs, college and university services and public safety programs.
We are encouraged that a “revenue coalition” is coming together in this state to pressure lawmakers to do the right thing by sending a tax increase proposal to the ballot as soon as March. Otherwise, all the horrible budget cuts will become a reality and people will suffer the consequences.
Between now and then we encourage South Sound residents to educate themselves and lobby their lawmakers. People must understand where the financial costs are coming from. The financial costs of a tax increase are pretty clear. But there are costs of inaction, too – costs in soaring unemployment, personal health issues, lost lives, and higher insurance premiums for the insured. There are costs of action and less apparent costs of inaction.
It’s appropriate, then, that voters weigh those options and have a say in crafting what kind of state and the kind of public services we want to provide the less fortunate in Washington state.
Let the voters decide.
