Drowning in Grover Norquist’s bathtub


Asheville Citizen-Times, October 21, 2006

The collapse of New Vistas-Mountain Laurel Mental Health Services is not the first major failure in North Carolina’s recently privatized community mental health, substance abuse, and developmental disability system. It won’t be the last. And this is as it should be.

Since the days of Ronald Reagan, tens of millions of us have dreamed of the day government would be off our backs and out of our pockets. With Grover Norquist, we imagined starving the federal budget until it was small enough to drown in the bathtub. We voted for politicians who railed against social spending and entitlement programs such as Medicaid and Medicare. Privatization, they cried, and we listened. We demanded tax cuts. Federal, state, and local politicians complied, but the relief is still not enough.

Forty-six million of us haven’t yet saved enough in taxes to afford health insurance. That number can only rise as private employers reduce health benefits or eliminate them entirely, as Wal-Mart is doing, by hiring more workers part-time. Those of us who do have private coverage are seeing increases far above the rate of inflation for premiums and prescription drug costs. Give us a Taxpayer Bill of Rights! Throw the bums out who bleed us for property taxes!

Enough. I’m sorry, but those who believe this stuff will have to speak for themselves from here on. It’s just that they’ve been so thunderously silent about taking public credit for an inevitable result of their efforts. Republicans, Libertarians, and free market Democrats wanted a privatized system; they’re getting it. It’s no accident that New Vistas-Mountain Laurel was the first local outfit to fold. It was the provider of last resort for the uninsured. Not much profit in taking care of those folks. RIP.

The public funding burden for healthcare is rolling downhill. In Washington they choke Medicaid and Medicare budgets, citing deficits caused by tax cuts and the $500 billion spent so far in Iraq and Afghanistan. Raleigh doesn’t want increased financial responsibility for healthcare costs. Let the locals take care of themselves. So now indigent care will presumably be funded by increased health insurance premiums (allowing those who treat the uninsured and underinsured to recoup their losses) and by increased property taxes.

But local governments can also punt. This has been Buncombe County’s approach to funding indigent mental healthcare. In Fiscal Year 2006, it ranked 76/100 among North Carolina counties in per capita general fund allocations for mental health, substance abuse, and developmental disability services. In effect, this shifts more costs to the private sector and back to the state budget. Troubled kids can be cared for in the public schools. Troubled adults can go to jail or prison.

I’d love to vote against Bruce Goforth this fall, but I can’t. His opponent, Eric Gorny, is in favor of a Taxpayers Bill of Rights (TABOR). If enacted, state spending could only be increased to reflect inflation and increases in population. Anything extra would require a popular vote.

The State of Colorado pioneered TABOR in 1992. It was extremely effective. By 2001, Colorado had dropped from 35th to 49th in state spending as a share of personal income for K-12 education and from 35th to 48th in spending for higher education. During that same time period, the state fell from 23rd to 48th in access to prenatal healthcare. Between 1991 and 2004, the proportion of low-income children without health insurance doubled in Colorado, a feat catapulting the state into last place nationally. Coloradans have been so impressed by these results that they voted in 2005 to suspend TABOR for five years. Link

We’re used to not reading the news accounts of unrest associated with the imposition of so-called “free market” policies in third world countries. Though we’re still narcotized by tax cuts and a corporate media loathe to encourage thinking—AC-T excepted—the third world is coming to our towns, and not just in the persons of Mexican workers. In terms of healthy life expectancy for its citizens, the United States ranked lower than Canada, Israel, and all of Western Europe except Cyprus and Turkey in the 2002 World Health Report. Infant mortality in our country is higher than in Cuba. Link

More of the same is on the way. When you read the heartrending reports of mentally disabled people shut out of services, dying, or committing heinous crimes in Western North Carolina, take a deep breath and turn the page. It’s only the sound of a social service drowning in Grover Norquist’s bathtub.

—Michael Hopping
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