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While Looking at a Tree
Recently, I was having a discussion with other advocates about a legislative agenda for the upcoming year. The advocates were proceeding with an agenda seeking to restore cuts in certain line items in human services. With the election of a fiscally conservative Governor and the projected $2 Billion deficit in Massachusetts, fighting for the same tired advocacy agenda is a recipe for failure. While advocates are focusing on a single tree (line-items), the forest (state budget) is about to be burned down and replanted around them. While to restore budget cuts is a laudable goal, I was alarmed by their actions of protecting the status quo.
Governor Romney has already called for a sweeping restructuring of human services. In addition we are already seeing cuts that would have been unthinkable a few years ago (elimination of dental, eye care and prosthetics from Medicaid). Now the Pioneer Institute has released a white paper written by Charles D. Baker Jr., entitled “Rationalizing Health and Human Services”. For those of you who are not familiar with Mr. Baker, he is the President and CEO of Harvard Pilgrim Health Care, Inc (HCHP). He served as the Secretary of Administration and Finance and the Secretary of Health and Human Services under Governor William Weld.
Advocates cannot afford to dismiss the White Paper written by Mr. Baker out of hand. Mr. Baker admirably turned around of HPHC. In addition as an advocate who had an opportunity to interact with Mr. Baker during his tenure at EOHHS I can tell you that he is a deeply thoughtful man. Despite the fact that the paper was released by the Shamie Center at the Pioneer Institute, Mr. Baker cannot be dismissed as an ideologue or a reactionary.
As advocates, we must admit that EOHHS agencies are probably bloated. We must state publicly what we have told each other for years that the state does not always get the best bang for the buck when serving the needs of consumers. We must welcome ideas to streamline the effectiveness of EOHHS agencies.
Our job as advocates must be to demand that services be improved and that a larger percentage of human service dollars be spent on meeting the needs of the consumers it is intended to serve.
As advocates we must focus our efforts on the bigger picture. Serious cuts in Medicaid will have much more devastating effects on the day to day lives of people with disabilities than a cut in some of the smaller EOHHS agencies. Already, the co-pay for medications has been raised to $2. This seems like a small amount but for someone taking 15 to 20 medications (not unheard of) the extra $30 to $40 dollars could equal 5 to 8 percent of their monthly income.
To simply fight to maintain the current structure will ensure that we are dismissed as merely protecting the status quo. Remember, after a fire the vegetation and trees grow back healthier than they were before.
John Winske is a Partner in DRS Consulting, and is the former Executive Director of the Massachusetts Coalition of Citizens with Disabilities (MCCD). His editorials can be found at least twice a month at DisabilityRights.com.