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Copyright © 2001 The Seattle Times Company
Editorials & Opinion: Tuesday, January 23, 2001
Guest columnist
The travesty of choosing roads or public health
By Kathleen O'Connor
Special to The Seattle Times
In this time of some unprecedented economic growth and prosperity, we are forced into making choices about whether we will fix transportation systems or assure that our elderly have access to home care, adult health care and other services.
We are making choices between programs for children and seniors when we have funds to meet both needs. Why? Because we have become hostage to an initiative process that makes public policy.
Gov. Gary Locke's new, biennial, "Moving Washington Forward" budget does so at the expense of the poorest and most vulnerable-- the destitute, the elderly and the chronically mentally ill. We are better than this as a state and a community. Well-intentioned people have voted for programs without realizing the consequences of their decisions at their polling places.
With spending cap initiative I-601, we are limited in what we can spend on state programs. In reality, transportation and education were seen to be higher public priorities over health and social services. The choice became either/or because we are locked into simplistic formulas.
What no one meant to happen, I am sure, is that by giving other issues the highest priorities, we are ripping away services away from our most vulnerable residents.
The governor's proposed budget would mean a $270 million cut in services for the elderly, the poor and the chronically mentally ill.
Home health agencies will close. Some already have. Others are reducing staff which means frail elderly people will go without services.
Reductions of $12 million are proposed by moving mental health patients from in-patient care to out-patient settings, when we already know that is not the best care choice for many patients. Our correction facilities have already become the provider of last resort for people with chronic mental illnesses. What we will save in state mental health services we will either shift to the cities and the counties or the jails.
Cuts of 40 percent are proposed in funds that hospitals rely on to help care for the uninsured. Hospitals are at their lowest operating margins in years because of managed care and Medicare cutbacks. Ditto for the doctors whose practices verge on insolvency.
We need a joint, public education campaign led by the governor and the Legislature - by the Republicans and the Democrats - spelling out the need to change the state's I-601 spending limit.
As parents, we have all had to give the lesson to our children that actions have consequences. Legislators know what those consequences are and it is their responsibility as elected leaders to carry messages to their constituents about the consequences of the initiative process and what it means for social and health services in this state.
We need to adjust the 601 spending limits so we are not forced to make choices between children, seniors and transportation. Or give to teachers automatic pay increases while we ignore those who care for parents who can no longer bathe themselves, or dress, or who are ravaged by Alzheimer's or Parkinson's disease - conditions not of their choice or the result of personal irresponsibility.
It's time for elected officials who have to make the final choices to step up to the plate and let the electorate know the monster it has created and put it to rest.
If they can campaign for office, then they can campaign for the good of the state.
Kathleen O'Connor is publisher of the O'Connor Report and is a health care industry analyst, consultant, speaker and writer based in Seattle. She can be reached at www.oconnorhealthanalyst.com.
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