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Budget desperation: Save a dollar today, spend six tomorrow

The budget cut has evolved under the tenure of our action-hero governor. First Gov. Arnold Schwarzenegger whacked through the budget with a machete. Then there was machine gun spray.

Friday’s budget suggests he's moving to the armored tank, as some programs face total elimination.

Only six months ago, the Los Angeles Times ran a story that is perhaps even more relevant today. It explains the notion that deep budget cuts could lead to higher costs in the future.

Michael Rothfield and Evan Halper led the article with a peek into the life of 85-year-old Irene Steinlege: “[She] has trouble walking, getting dressed, making her bed, taking a bath. She has stayed in her Folsom home with the help of a health aide, one that Gov. Arnold Schwarzenegger says the state can no longer afford."

The program that benefits Steinlege was on the carving table then, possibly leaving Steinlege without the in-home aide who, for about $10 an hour, helped her with basic tasks. Under the budget plan released Friday, the In-Home Supportive Services program may end completely.

But cutting this program could lead to far greater costs down the line. (And that’s not to mention the human cost of those who fall between the cracks.)

In-home care cases tended to cost the state about $892 per month in 2008, scholars from the San Diego State University School of Social Work found.

The likely alternative for many of the 460,000 people who rely on care workers for feeding, bathing and transportation to medical appointments is assumed to be the nursing home. It’s a setting that carries a far higher bill – more than six times that of in-home services.

The total monthly cost for a patient in a nursing home comes to $5,850, based on the average daily rate of $195, reported by the Office of Statewide Healthcare Planning and Development.

The federal government foots half of the state’s annual $3.8 billion nursing home bill. That’s a truckload of money that state budget-balancers don't have to worry about. Yet it’s also far more that all U.S. residents may have pay via federal taxes if any significant portion of those 460,000 people enter nursing homes.

Other variables in the equation are whether those left without in-home aids would qualify for Medi-Cal nursing home funding, or whether the state’s roughly 1,000 nursing homes could absorb them.

News reports make it pretty clear that legislators and the governor realize that the cuts being made now will do little to help posterity. The bottom line seems to be that basic arithmetic goes out the window in favor of legislation by desperation.

Gov. Arnold Schwarzenegger acknowledged as much last summer, as reported by the Times: "As much as we believe those cuts will result in greater expense down the line – especially in healthcare – we have to do it because I can't promise the people something we don't have."


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I fear it will get more desperate as tax receipts fall and home prices resume their downward trend. They will have to face the reality of the problem sooner or later.

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