Local View: Will state protect – or abandon – vulnerable residents?



The health care safety net is precariously perched on the edge of a cliff. Gov. Chris Gregoire’s proposal to close our state’s budget shortfall put it there. Our state Legislature will decide whether it’s moved to more solid ground or forced over the edge. All of us in Clark County have a stake in which direction it goes.

The cuts to essential health care services that are being proposed for the 2011-2013 biennium literally threaten the lives of hundreds of thousands of Washingtonians. And they threaten the existence of the community health center system, whose funding would be reduced by $590 million, as a result of being affected by every single health care cut.

Low-income health care programs have already suffered more than $1 billion in cuts over the past two years, while the need for our services continues to rise at unprecedented rates. In 2010, SeaMar’s Vancouver Clinics provided primary medical, dental, and behavioral health services to over 25,000 people in Clark County, most of whom are low income and uninsured or on public insurance programs for which alternative community providers are scarce. The current and proposed Washington state budget cuts will have a profound impact on SeaMar’s ability to serve our patients. These include cuts to our Medicaid reimbursement rates, loss of funding for providing care to uninsured patients, elimination of non-emergent adult dental care, elimination of Disability Lifeline and elimination of the Basic Health Plan.

Vulnerable populations — the very poor, children, seniors and the disabled — will bear the heaviest burden. Individuals like Jacqueline, who cares for her ailing mother while supporting her two little girls. The entire family is seen at SeaMar. Jacqueline recently signed a request to “Save health care in Washington” as she says she wouldn’t know what she’d do without medical care for her children and mother from SeaMar. Her mother is fragile and suffers from Alzheimer’s, while her youngest daughter struggles with asthma that sometimes requires urgent care visits to the clinic.

Proposed cuts to public health coverage programs would create at least 100,000 new uninsured people in Washington overnight, including 27,000 children, the majority of them patients at community health centers. Clark County would see at least 4,500 more people without insurance.

Additionally, cuts will lead to a decline in quality of hospital care for everyone because of fewer staff, less opportunity for patient education, longer wait times, overcrowded emergency rooms, and more difficulty getting essential follow-up care.

Losing proposition

In truth, these decisions will cost Washington more. Our state will lose tens of millions in federal matching funds with the elimination of Medicaid programs, the Basic Health Plan, and Disability Lifeline. When kids and low-income adults lose their health coverage, they miss regular checkups and forgo medications for chronic conditions, leading to more serious health problems and more expensive care. For the cost of a single hospital stay for a preventable condition such as an ear infection, the state could provide a child over two years of Medicaid coverage.

Meanwhile, as we slash billions in funding for our kids and communities we continue to fund tax subsidies for special interests without giving lawmakers a chance to determine if they indeed present a public benefit. State tax breaks escape the public scrutiny that other expenditures, like health care, must undergo.

With a budget deficit still threatening our state, cuts are inevitable. But before proposing them, the Legislature and governor must prioritize the impact these cuts will have and make moral decisions that represent our state values: Will people die? Are low-income, vulnerable populations disproportionately affected? Will people become disabled? Will people lose their ability to work? Will cuts create greater expense?

If these questions are answered honestly and clearly, they should lead our government toward a more balanced and responsible approach to managing the budget shortfall and prioritizing cost-effective health care programs. One that will provide a safety net for our most vulnerable citizens, instead of pushing them off a cliff.

Carrie Vanzant is clinic manager at SeaMar Community Health Centers in Vancouver. E-mail: CarrieVanzant@seamarchc.org.