Friday, November 21, 2003

By Ervin Dyer, Pittsburgh Post-Gazette

The budget stalemate in Harrisburg threatens to leave a popular health-care program underfunded and looms as a critical issue for 900,000 Pennsylvanians.

Officials with the Urban League of Pittsburgh, the Center for Minority Health and the Consumer Health Care Coalition warned yesterday morning of dire consequences if there is no increased funding to Healthchoices, a federally mandated state program that funds HMOs serving the poor.

"There will be less services, fewer doctors willing to see patients and higher costs associated with caring for sicker people," said Esther Bush, Urban League president.

The speculation is that, when funding is inadequate, providers will pull out of the program, taking crucial services with them. The severity of the cuts on managed care providers remains a mystery because they do not have to report their finances.

"They could have a profit to buffer some of the reduction or they could be scraping by," said Geoffrey Webster, of the Consumer Health Care Coalition. "That information just goes into a black box."

Last year, Healthchoices received an estimated $68 million in state and federal funding.

Since then, health-care costs have gone up at least 10 percent, said Webster. At the same time, however, the state wants the budget for Healthchoices to remain unchanged. Of the 900,000 Pennsylvanians affected, at least 100,000 live in Allegheny County.

Most affected are residents who are poor and black, a population already suffering the greatest health disparities. Black Americans' rates of diabetes, heart disease and firearms injuries are double -- and in some cases triple -- the rates of their white counterparts.

Reducing choices seems to contradict state goals outlined to improve health disparities, said Stephen Thomas, head of the Center for Minority Health at the University of Pittsburgh.

Flat funding for Healthchoices "cuts a hole in the safety net," he said, a problem that will be exacerbated by severe cuts in mental health and drug and alcohol funding.

The social consequences will grow as well, since drug and alcohol addiction are linked to crime and chronic and serious health issues.

"You save a dime now," Thomas said, "but you pay a dollar later."

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