State lawmakers should keep mitts off health-care stimulus money

Sometime today a chunk of the federal economic stimulus package targeted for health-care spending will arrive in our state coffers.

President Barack Obama promised governors convened in Washington, D.C., this week that the money would be waiting when they returned home. I just hope the loud applause didn't obscure the words that followed, which include the president's warning to spend the money judiciously and as federal budget writers intended. Vice President Joseph Biden has been tasked with tracking how states use the money.

I want state lawmakers to remember this as they begin rubbing their hands together over the prospect of $2.02 billion in new money, much of it for Medicaid recipients.

Anticipation is shared by health-care advocates who see the money as a life preserver. A couple of billion would be like manna from heaven. It would be enough to reverse the cuts made in the state's basic health plan where enrollment continues to rise as more and more people lose job-based health coverage.

The money would breathe life back into the General Assistance Unemployable program, which provides coverage for people who cannot work because of mental or physical disabilities. Gov. Christine Gregoire has proposed eliminating GAU to save money.

It is over how to spend the health-care portion of the stimulus money that visions collide.

The governor already appropriated some of the money to plug holes in other areas of the state budget. Health-care advocates aren't happy about that. They're likely to be unhappy with me because I'm willing to let the governor's siphoning slide. The state has a deficit the size of Mount Rainier. A good leader makes ugly, but necessary, decisions.

But another dismal budget forecast makes the remaining $1 billion and change look mighty tempting to state lawmakers predicting they'll have to carve another chunk out of the hide of health care.

If only the stimulus money came with this warning: Mitts off.

In lieu of that warning, legislators ought to agree to a split. You've got practically a billion. Keep it. Now let health care have a billion.

The money will sustain, barely, community-health clinics and health-care access until we regain our finances and our sense of what's important for our few budget dollars.

Community-health clinics are critical because they're at the nexus of health care delivery. Outside of emergency rooms, they are the option for low-income people and rural communities. From 2000 to 2007, the number of uninsured patients at health clinics increased by 42 percent. Obviously, there's a need.

Hospitals are hurting right now because they get the folks who tried to do without health care until they couldn't avoid it any longer. Those include people in the emergency rooms and those at clinics discovering a suspicious ailment is going to require specialists and expensive lab tests.

Sure, the economy is in tatters, but spending on health-care access is countercyclical. When things are most dire is when the public needs those programs the most.

If the stimulus plan is about jobs, health care has jobs. Good-paying ones, from workers dishing up food in the cafeteria to doctors making their rounds.

Here's a big, not-so-quiet secret about providing health care to the poor: We pay one way or the other. When hospitals see patients who cannot pay for their care, the losses are spread among the rest of us. As the cost of health-care services and insurance plans rise, employers begin to narrow choices in their health-care plans or cut the plans altogether.

I'd rather the state maintain these programs than to pay a much higher cost later.

Lynne K. Varner's column appears regularly on editorial pages of The Times. Her e-mail address is lvarner@seattletimes.com