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Originally published Monday, April 20, 2009 at 1:35 PM

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State should not turn off health care spigot

Every Washington state citizen will feel the effects of the Legislature's cuts to health and human services, say Don Brennan and Abbi Kaplan of the Washington Health Care Forum. Private-sector companies need to be part of the solution too, but the state should not turn off the spigot to health care.

Special to The Times

CUTS to health and human services will hurt every citizen in the state — either directly or indirectly. At the very least, state lawmakers should not consider any further cuts to these services. And federal stimulus dollars intended for health care should remain in health care.

Around 1 million people in Washington state receive health care that includes a state component. This includes state employees, teachers, individuals who subscribe to the Basic Health Plan, Medicaid, the Apple Health Program and General Assistance-Unemployable.

The state faces a $9 billion deficit out of a total biennial budget of $34 billion. The budget cuts to health care and human services, which total almost half of the proposed cuts, directly impact our most vulnerable citizens:

• People who can't work;

• People who work at low-wage jobs and can't afford insurance;

• Older adults who need varying levels of assistance; and

• Children who may have trouble finding a pediatrician with an open practice and who may find vaccinations no longer available.

Even if you have coverage and don't receive help from the state, these budget cuts will affect your health-care access and cost.

Citizens with insurance have a harder time receiving needed care and are less satisfied with the care they get, when the number of people who are uninsured is high, according to the Institute of Medicine.

With reimbursement cuts to doctors and hospitals from the Medicaid and Apple Health for Kids programs, it actually costs providers more to deliver care than they receive in payments. These underpayments show up in higher premiums for consumers and employers.

Underpayment of providers by public programs results in a "cost shift" or "hidden tax" on employers and consumers, according to a study conducted by Milliman, Inc., released in Dec. 2008.

Rising unemployment rates translate into growing numbers of individuals and families without health-care coverage and that means more people will get sicker and more people will die.

The proposed budget cuts 7,000 state workers, 3,000 individuals from the General Assistance-Unemployable program, and 40,000-45,000 individuals from the Basic Health Plan. That's more than enough people to fill Safeco Field.

Job losses across the state have been severe, unemployment is at 9.1 percent and it could go higher. Some estimates indicate that close to 1 million Washington state residents won't have health coverage by next year.

Without health insurance, people suffer from avoidable illnesses, worse health outcomes and premature death, according to the Institute of Medicine.

Individuals without coverage will still get sick and their only alternative will be hospital emergency rooms where care will cost more and people's conditions will have worsened.

"The evidence clearly shows that lack of health insurance is hazardous to one's health and the situation is getting worse because of the erosion of employment-based health coverage due to the current economic crisis," said Lawrence S. Lewin, an executive consultant in health-care policy and management.

Families suffer as well. Sick children don't learn.

Members of the Washington Health Care Forum recognize that the private sector must improve the care delivery and financing system so that more Washington state residents can access both affordable coverage and affordable care. We collaborate with state lawmakers, regulators and other organizations who share our goals.

At a time when more people are needing help, the state can't afford to turn off the spigot to health care.

Don Brennan is chair and Abbi Kaplan is executive director of the Washington Health Care Forum.

Copyright © 2009 The Seattle Times Company

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