Austerity Forever

Health care took the most visible hits at the Legislature this year, and the future only looks bleaker: Linda Berglin, the only DFLer who stood and fought Pawlenty's cuts.

Berglin:Yes, and so the incentives are for hospitalization. It is going to be a real perverse incentive for things like mental illness, because the major way of stabilizing people is medications. But then when you discharge them, they can't afford their medications because outpatient services aren't covered. It is not uncommon for mental health medications to run anywhere from $500 to $1,000 a month. We are talking about people who earn $8,000 a year. I mean, the cost of their meds is more than the income they have. So an unfortunate part of it is, not only will this lead to more hospitalizations but more incarcerations. Today, about 40 percent of our workhouse population suffer from serious mental illness. Thirty percent of our prison population do also. Prisons and jails are expensive ways for us to take care of people's mental illness. It is another way we are going to be driving up the cost of the system.

CP:We've talked about the outpatient caps on MnCare. Are there any other cuts in that program?

Berglin: The original intention of MnCare was to treat people as they went along, so you could stay in the program [earning] up to 275 of the poverty level, paying a higher and higher percentage of your premium but still eligible. Now these people will fall out at 175 percent of poverty and I had to fight like crazy so they wouldn't cap it at 150. The real tragedy of that is, 175 percent of poverty for a single individual is a wage of about seven dollars an hour. So if somebody at that level is going to get a dime-an-hour raise, they are going to lose all their health care! People should not get penalized for working, but under this policy they will. Some of these people, who know they have a health condition, they are going to have to cut their hours that they work, in order to make sure they can stay in an affordable health care program.

CP:What do you think was the biggest concession you made during the negotiations?

Berglin: MFIP. We are going to rename it the More People In Poverty program instead of the Minnesota Family Investment Program. There will be tens of millions of dollars in grant cuts to the neediest families. There are changes in the diversionary program for work-first. We had said if you have a high school diploma and have been employed four of the last twelve months, then you might have a chance, even in this economy, of finding a job. So go out and try and find a job for four months. But now [work-first is also for] people who don't speak English, who don't even have a GED, have health problems, alcohol problems, mental health problems--those people are not going to succeed in this diversionary program. And it creates a lot of administrative costs to put them through it. People that professionals have already decided are not employable have to be in work search.

CP:Another cut in the welfare program was $16 million out of emergency assistance.

Berglin: It will create homelessness. Most of that money now goes to help pay the difference in a rent increase so someone has a home while they look for another place that is more affordable. Or it goes for utility problems, a rise in utility rates. Those things help prevent people from being evicted. The more people who are homeless in this program, the longer it is going to take them to get into a state of self-sufficiency, and the more the program costs us. The homeless shelters and the housing advocates all say that if you make emergency assistance more available we will have less homelessness. And it is a big cut. There are so many things that were done.

CP:Is there a political cost for doing all these things? Most of the people affected don't vote very often.

Berglin: MFIP, I think, is going to be difficult, which is why I have to confess that it is one of my biggest disappointments. I have been interviewed by a number of press people. I have mentioned MFIP in every one of them and none of them have printed anything about it. It is not even on the radar screen. They want to talk about MinnesotaCare or people with disabilities. Those are deserving subjects. But MFIP is an equally deserving subject. This was a bipartisan program when it was adopted and there were Republicans like Randy Johnson at the county board that worked with Governor Perpich in putting this together. It has been supported by Governor Carlson and Governor Ventura, and now all of a sudden it is not a good program anymore. It's not about whether it is a good program or not, it is about taking money out of the program so they can put it in the general fund.

CP:Do you think what has just happened is a profound change in the way we approach government? If so, how big a change is it?

Berglin: Pretty big. Some things that were very controversial back in the Quie Administration in terms of budget cuts were not even on the radar screen this year because there were other things so much worse. One of the controversies during the time Quie was governor happened when he eliminated payments for leave days at nursing homes. That's when a patient goes to the hospital for something but is coming back, and the state helps subsidize the bed space while the patient is gone. In Quie's time there were rallies in the Capitol rotunda over eliminating leave days. Well, we just eliminated leave days and nobody's talked about it because there are so many other things that are so much worse.

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