Friday, December 05, 2008

Cruel budget wipes out medical care for poor

Posted by The Dean of Cincinnati

Photo courtesy of here.

Cincinnati’s recurring budget nightmare

Guest article by Paul Komarek

In December, every other year, the City of Cincinnati’s biennial budget process arrives, a messy political jumble sale of wringing hands, tough rhetoric, competing ideologies and pet programs. Every time it comes around we see at least one new nightmare “loser idea.” In 2004 it was rotating fire station shutdowns. In 2006, Council hammered out a budget compromise involving human services funding in an overnight session– only to disagree, months later, over whether certain Council members were negotiating in good faith, or dreaming, or sleepwalking. In 2008 the issue getting all the press is the so-called “garbage tax.” But the “garbage tax” is a red herring. It conceals the cruelest “loser idea” we have seen so far.

Eliminating healthcare for the poor

This time, the City Manager has eliminated funding for primary health care for our most vulnerable citizens –children and families without health insurance—who receive basic medical care through neighborhood nonprofit health clinics such as the West End Health Center. The 2004 city budget funded this care at close to a million dollars. In 2006 it was cut to $450,000. And now the amount is zero.

Zero dollars for neighborhood health care centers at the worst of all possible economic times. When more and more people are losing health insurance coverage, arriving sicker than ever when they enter the health clinic door.

City-owned clinics cannot meet the demand for the care these neighborhood clinics provide. The Babies Milk Fund closed several pediatric clinics in November because Medicaid reimbursements could not cover operating costs.. Federal programs do not cover the costs neighborhood clinics incur when they serve uninsured persons. Local subsidies, foundation grants and donations keep them afloat –covering, for example, over $10.00 in non-reimbursed cost every time a clinic fills a prescription for an uninsured person – on top of the cost of the medicine itself.

Mayor Mallory killed the garbage tax, but disregarded the medical needs of the vulnerable poor. The budget the Mayor has recommended to Council wipes out funding for this care.

Fortunately, City Council still has an opportunity to set things right. The hard part will be deciding what programs will get cut instead.

Where to find the money

Paging through the budget document discloses some $495,000 in candidates for cuts. Some of these items qualify as “loser ideas.” Others are just not as important as doctor visits and medicine for the poor. The page numbers are from the City Manager’s budget proposal.

These items do not involve choosing healthcare over safety. The city needs a strategy that supports both health and safety, and supports employment, and promotes the general welfare of its citizens.

Medical care for the poor certainly qualifies as a critical part of the right sort of strategy.
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Paul Komarek is a member of the Board of Directors of the West End Health Center, which celebrated its 40th Anniversary in 2008.

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Garbage In Garbage Out says:
05 Dec 2008  at  10:18 am | #

The Garbage Tax is a way to raise funds.  In the down economic climate, the city is generating less income.

If we don’t increase income, we have to cut something.

What do you propose we cut?

JenEdwards says:
05 Dec 2008  at  10:20 am | #

The City Council Finance Committee (for the Budget)
meets for Public Hearing
THIS COMING MONDAY, December 8, 2008
at 1 PM in Council Chambers.
Citizens who want to speak for two minutes
need to arrive approximately half and hour early to sign up (by 1230 PM)
http://www.cincinnati-oh.gov/noncms/council/uploads/monthly.htm

Citizens have fed into Council for the last two years,
along with input to the Mayor’s office and City Manager Dahoney. 
The process seems a bit backward, with the CM leading off, the Mayor batting second, and council bringing up the third spot BUT,
just remember, CITIZEN INPUT IS CRUCIAL AT ANY TIME.
If e-mailing or writing,
it is always a good idea to include a great strength for citizens with council, our well versed members under the Clerk of Council’s office.
Just super folks serving us. Send them a copy, or say, “with copy to the Clerk of Council’s office I’d like this to be listed for public record”.

The listing of feedback to Council, Mayor and CM via e-mail is:

David Crowley <david.crowley@cincinnati-oh.gov>,
Laketa Cole <laketa.cole@cincinnati-oh.gov>,
Jeff Berding <jeff.berding@cincinnati-oh.gov>,
Chris Bortz <chris.bortz@cincinnati-oh.gov>,
John Cranley <john.cranley@cincinnati-oh.gov>,
Leslie Ghiz <leslie.ghiz@cincinnati-oh.gov>,
<chris.monzel@cincinnati-oh.gov>,
RQualls <roxanne.qualls@cincinnati-oh.gov>,
Cecil Thomas <cecil.thomas@cincinnati-oh.gov>,
Mayor Mark Mallory <mark.mallory@cincinnati-oh.gov>,
Mr. Milton Dahoney <citymanager@cincinnati-oh.gov>,
<clerkofcouncil@cincinnati-oh.gov>,il is:

Prefer to Phone or send a letter instead? Great!!  Here’s the vitals from the City of Cincinnati itself:

Vice Mayor David Crowley
801 Plum St. Rm 352
Cincinnati, OH 45202-1979
Phone: (513) 352-2453
Fax: (513) 352-2365


Y. Laketa Cole
801 Plum St. Rm 351
Cincinnati, OH 45202-1979
Phone: (513) 352-3466
Fax: (513) 352-3957


Jeff Berding
801 Plum St. Rm 350
Cincinnati, OH 45202-1979
Phone: (513) 352-3283
Fax: (513) 352-3289


Chris Bortz
801 Plum St. Rm 348
Cincinnati, OH 45202-1979
Phone: (513) 352-3255
Fax: (513) 3264


John Cranley
801 Plum St. Rm 356
Cincinnati, OH 45202-1979
Phone: (513) 352-5303
Fax: (513) 352-4657


Leslie Ghiz
801 Plum St. Rm 354
Cincinnati, OH 45202-1979
Phone: (513) 352-3344
Fax: (513) 352-3277


Chris Monzel
801 Plum St. Rm 346B
Cincinnati, OH 45202-1979
Phone: (513) 352-3653
Fax: (513) 352-4649


Roxanne Qualls
801 Plum St. Rm 346A
Cincinnati, OH 45202-1979
Phone: (513) 352-3604
Fax: (513) 352-3621


Cecil Thomas
801 Plum St. Rm 349
Cincinnati, OH 45202-1979
Phone: (513) 352-3499
Fax: (513) 352-3218


Office of the City Manager
801 Plum St. Rm 152
Cincinnati, OH 45202-1979
Phone: (513) 352-3243
Fax: (513) 352-6284


Office of the Mayor
801 Plum St. Rm 150
Cincinnati, OH 45202-1979
Phone: (513) 352-3250
Fax: (513) 352-5201
Email:

says:
05 Dec 2008  at  04:02 pm | #

Paul thanks for bringing the truth!

says:
06 Dec 2008  at  05:10 pm | #

First, we have two budgets: the city and the county and it is distracting to have both budgets at this time and it is distracting because there is an overlap of services and responsibilities. I am assuming this thread is concerned with the city budget.

This is not a cruel budget but it is a stupid budget for the above reason as well as other reasons.

There is a similarity to the dilemma that Mt. Airy Forest is not filled with money trees and some feel a responsibility for the plight of their fellow men even though they really have no real love for the unfortunate. It is only that they can imaging that they might sometime be down and out.

When a family has no money, it doesn’t go to the children asking them what they want for Christmas. Now that would be cruel. The parents do the deciding as to what the family needs most. Why are we talking to city workers and citizens, who want more than others? The council should be making the decisions, but of course there is the problem that the citizens have a system that elects idiots. It the people would have taken seriously their responsibility to be informed, etc. we might have a council that exudes confidence. BUT WE DID NOT!

Now we have a bunch of people without health insurance and guess what folks many of them have no jobs either. Had we have been really concerned about the wealth disparity in our society, we would have devoted more effort in getting these people product productive so they could have wealth.
BUT WE DID NOT!

Why is the city responsible for health care? This is a responsibility that should be at the state or federal level. Why are we applying band-aids when proper health care is needed? Why are we tolerating the many little agencies seeking funding for one niche or the other when a comprehensive approach would be more effective. Instead of assuming responsibility for these feel-good efforts, we should have demanded that the federal government be responsible as they are the supreme tax recipients. BUT WE DID NOT!

The biggest part of the budget is concerned with what is called public safety (the police and fire department) but we are only looking at non-public safety issues for the cuts. We could have a volunteer fire department and we could not enforce drug laws and get rid of a lot of police. Hell, let the sheriff provide the services and Leis’ ego would love that.

And the Cincinnati Public Schools could be dissolved and the abutting school systems would have to absorb the kids. The kids would be better off because they would be able to network and possibly raise their expectations. We should be transferring the city costs to the more affluent state and federal government.

We should reform our city government so that new ideas can be forthcoming from within the citizenry . We need to have a more transparent and accountable district government.

So now you want us to write city council? Why? What solutions do you expect? Robbing Peter to pay Paul is not solving the problems. Doing the same thing over and over when it is not working is a definition of insanity. And copying what another bankrupt city government is trying is not going to work either.

The bottom line is that if you don’t have the money, you simply don’t spend it.

komarek says:
07 Dec 2008  at  02:15 pm | #

The bottom line is that if you don’t have the money, you simply don’t spend it.

Large institutions seldom “don’t have the money.” The usual problem is that people in charge make disappointing choices involving resources institutions do have. These choices deliver consequences that ripple out across our society.

In this case, if not fixed by Council, the City Manager and Mayor’s budget choices would surely deliver a significant dose of sickness and suffering to hundreds, perhaps thousands of Cincinnati residents.

Some City Council members do understand this, and are working to restore neighborhood health center funding to the Cincinnati budget.

--pk---

Vera Z says:
07 Dec 2008  at  05:16 pm | #

Hey, I for one plan to be at the City Council Meeting at City Hall Tomorrow at 1:00PM, or 12:30 PM if you wish to speak.  See you all there. Vera Z.

komarek says:
16 Dec 2008  at  01:19 pm | #

Here’s an update on the City budget

Council’s current budget motion restores $350,000 in funding for neighborhood health clinics. The Neighborhood Support Program was changed to a City-administered program instead of contracted out. Net savings: About $50,000. The Arts Consortium funding was re-directed to other arts programs.

The totality of this is a much better outcome for people who will be depending on neighborhood clinics for their health care.

--pk---