St. Louis Post-Dispatch
Wednesday, Feb. 9, 2005
GOVERNMENT: Moral values judgment
By Eric Mink
Of the Post-DispatchUnder Gov. Blunt's budget, we would be forced to decide who should suffer most, when for just a few dollars we could be helping everyone.
It is the age of moral values. Here are some moral questions:
* Who is more deserving of our help, a 70-year-old diabetic man who needs a wheelchair after his second leg is amputated or a 2-year-old girl with multiple birth defects needing intensive therapy to help her learn to walk and talk?* Should we permit a vital 80-year-old woman to receive physical therapy after a fall, a hip fracture and a hip replacement, knowing that therapy will dramatically increase her chances of remaining active and independent? Or is a 35-year-old single mom with three kids more worthy of getting the asthma medicine that will let her keep working at her two minimum-wage jobs?
* Is a 63-year-old part-time store clerk suffering from terminal bone cancer entitled to hospice care to ease the pain and fear of his passage to death? Or should we, instead, grant a once-homeless 40-year-old woman the privilege of continuing to receive the medication that keeps her schizophrenia in check?
These are the sorts of things people have been wrestling with here in Missouri since Gov. Matt Blunt presented his first state budget proposal to the Legislature and the public last week.
Parents of infants and kids with severe disabilities argue, persuasively, that the proposed cutbacks could wreck their children's chances for a decent future. Adults caring for ailing senior parents argue, persuasively, that proposed cutbacks could force them to institutionalize the elderly. Advocates for the working poor argue, persuasively, that the governor's proposals would leave sick people to get sicker, with enormous human and financial consequences. Nonprofit mental health services argue, persuasively, that low-income people already find it almost impossible to find the help they need to get well and become productive, especially in rural areas.
The governor and his fellow ideologues in Jefferson City (and, indeed, in Washington) have reduced us to arguing over which needy people deserve our help and which we have to cast aside. What we should be doing, instead, is challenging this twisted defeatism. The governor says, in essence, that we can't afford to be the kind of caring neighbors we want to be. He tells us we can't afford to have the kind of compassionate community that lives according to the moral values we prize.
He is wrong.
The Medicaid programs Blunt wants to hack back are specifically intended to let poor people --including disabled people and seniors --get medical care they couldn't possibly afford. The programs aim especially at working poor people whose part-time or low-paying jobs don't include health insurance.
But merely living in poverty --an income of $1,571 per month for a family of two adults and two kids --isn't enough to qualify the parents for health benefits under one of the programs. Today, even without Blunt's proposed cuts, that family has to earn less than $1,178 per month for the parents to qualify. Last year, the Legislature tried but failed to reduce the cut-off point to $786. Blunt proposes to set it at $471.
Is this really what we've come to? Deciding how far below the poverty level you have to be before your state government will help you get health care? Twenty-five percent below isn't enough? You need to be 50 percent below, as the Legislature proposed last year, or 70 percent below, as Blunt now proposes?
In 2005, in the wealthiest nation ever to exist on Earth, this is a disgrace.
Americans are kind, compassionate, caring, humane people. When people need help, our instinct is not to turn away but to reach out. But instead of using these moral values as the basis for solving problems, ideologues on the right exploit the mistrust of government they've cultivated in people for decades and make sweeping accusations of fraud and abuse, as Blunt did in his State of the State address last month.
While there's no doubt that some people find ways to scam the system, overworked caseworkers at the state's Family Support Division already manage to review the eligibility of 70 percent of their cases every 12 months, according to department officials. About 120,000 people lose eligibility each year, they said, not because of fraud but because they've moved, landed better-paying jobs or acquired health care through their employers. Getting eligibility reviews up to 100 percent each year might improve the numbers a bit more, but not without hiring more caseworkers, whose ranks have been thinned by budget cutbacks and staff reductions.
Escalating health care costs intensify Medicaid problems, of course, but so does the combination of poverty and an aging population. In addressing these problems, Blunt says we have "put off the tough decisions for too long." But the governor's idea of a tough decision is choosing which poor person deserves help and which doesn't.
True leadership would start with a declaration that Missouri will live by the moral values of a caring community, that being poor is not a sin, that the right to life, liberty and the pursuit of happiness is meaningless if you don't have enough food to eat, clothes to wear, a safe place for your family to live --and health.
But instead of accepting the moral obligation to find ways to help those who need our help, Blunt ducks the test of leadership. Instead of bravely proposing to raise revenue, he meekly suggests cutting services. He reaches into the Republican trick bag of rhetoric and pulls out "job-killing taxes," a catch phrase invoked so many times during the 2004 campaign by elected officials and party hacks from coast to coast that it became as meaningless as "Whaaaas uuuppppp?"
Here's a thought: For 2003, individuals filed 2,612,472 state income tax returns in Missouri. If each of those returns brought in an average of just $5 more per week, we would have an additional $680 million to spend on health care. Poorer taxpayers could pay less; rich taxpayers more. How many jobs would that kill? Zero? Is $5 more a week really too high a price to pay for taking care of the poor, the elderly and the disabled?
Do the governor, the speaker of the House and the president pro tem of the Senate have the courage to lead us to answers consistent with our moral values? "Thou Shalt Not Raise Taxes" doesn't appear in my copy of the Ten Commandments. ###
E-mail: emink@post-dispatch.com
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