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News :: Political-Economy |
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Mississippi’s disaster preceded Katrina, promises to outlive it |
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by Ricky Baldwin
Email: baldwinricky (nospam) yahoo.com (verified) |
28 Sep 2005
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Mississippi's poor are particularly vulnerable to disasters like Katrina, not by accident but by "intelligent design." Medicaid cuts and other welfare "reforms" are a big part of that design. |
Much has been made of the poverty exposed in Mississippi and Louisiana since Hurricane Katrina dragged a thirty-foot wall of water over Coastal communities there, killing thousands, displacing half a million and severely impacting 2-3 million people. National media have also touched on some of the vulnerability to natural and other disasters implied by such poverty. But eerily absent has been any public discussion of the causes of that poverty, much less the ripple effect that will now spread through poor households as a result of ignoring those causes.
The causes of poverty are not difficult to discern in an economic system predicated on the difference between rich and poor. The effects are particularly pronounced of course in the richest country in the world with the most extreme income disparity in the industrialized world, where the fastest growing sector of the economy is the one that pays least and good-paying jobs have been systematically exported for at least a generation. Unionization in the US is also one of the lowest in the industrialized world (even lower in Mississippi and other "Right to Work" states), incarceration the highest. And social services, including poverty relief, is the most miserly of any industrialized country.
Prof. David Brody of Duke and other social scientists also claim that poverty statistics are artificially low in the US. The real poverty rate could be as much as 50 percent higher than the official rate, says Brody. And relative US poverty may be twice as high as in Canada or Britain and three times that of some European countries with intact social safety nets and limits on some of harshest effects of capitalism.
This also means poor communities in the US are more vulnerable to disaster, not by accident but by design.
Politics of poverty
Mississippi, for example, is the poorest state in the nation. It also has a very wide income gap between its rich and poor, relies heavily on regressive taxes that disproportionately impact the poor (e.g. sales tax) over more progressive taxes (e.g. graduated income tax), and is a constant battleground for restrictive welfare “reform” proposals.
Last year over one-quarter of Mississippi’s population received Medicaid, the joint state-federal healthcare program for the poor. That’s 768,000 people who not only have no health insurance but also subsist on incomes low enough that they must rely on public assistance for healthcare. The program is jointly funded by the state and federal government, and with a per capita income of under $16,000 it is hard to meet the state obligations to the program if lawmakers insist on low taxes on upper income earners.
In the spring of 2004 the State Legislature of Mississippi voted to save $65 million without raising taxes. They simply eliminated the Poverty Level Aged and Disabled (PLAD) category in Medicaid, which included 68,000 patients. Fifty thousand of those were expected to fall into Medicare, the federal healthcare program for the elderly, and therefore lose prescription coverage. Prescriptions are the biggest expense generally in an increasingly expensive healthcare system. And for people poor enough to qualify for Medicaid, losing drug coverage is a particularly hard blow.
Republicans in Mississippi including Governor Haley Barbour promised that the federal government would pick up the tab, referring to the shaky debate going on in Washington over a possible eventual Medicare prescription partial benefit that may be even less likely according to some lawmakers in the wake of Katrina.
Another 17,000 “PLADs” who would not be old enough for Medicare were promised they could continue Medicaid coverage for life-threatening illnesses and a few other conditions. The details were of course unclear, and many Medicaid patients received no notification at all but were forced to rely on vague and contradictory press reports. State employees and their union officials often professed little understanding of what was about to happen. Agencies representatives told patients who called to “watch the news, because that’s where we’re getting our information.”
Protests from Mississippi’s poor and their advocates resulted in a federal restraining order in October against the changes. By the end of that month, the state had settled a lawsuit with a group of patients receiving legal assistance from the Mississippi Center for Justice, and PLAD was temporarily saved. The battle raged on, however, and soon healthcare providers as far away as Ohio began to turn down Mississippi Medicaid patients for care -- such as life-saving organ transplants -- due to the uncertainty of their ability to pay.
Other cuts went into effect on the first of July 2005, limiting Medicaid patients to five prescriptions down from seven and increasing the financial burden on patients in some cases tenfold. Only two brand-name drugs are now covered, leaving AIDS patients and others who rely on multiple drugs for which there is no generic equivalent in the cold. “A triple cocktail [like the kind used to treat HIV], you know, is not two drugs, but three,” notes Rims Barber of the Mississippi Human Services Coalition.
“If you can't afford to live, then we'll let you die,” commented Shannon Reaze of Jackson, MS, a member of newly formed AIDS Action in Mississippi.
A statement from the advocacy coalition Lambda Legal in Mississippi predicted: “People will die as a result of this law.”
Mississippi Medicaid patient Dorothy Bishop, who is bedridden, asked state officials, “If you were in our shoes, our shoes, could you take the pain that you are causing us?”
When the music stops…
Rims Barber says the prescription cuts as well as the elimination of PLAD and other changes are not just about saving money. “It’s also a starve the beast kind of thing,” he says. “Those people didn’t vote for [Republicans in office] in the first place.”
He notes that the elimination of PLAD will come up again in January. Mississippi’s legislature is in special session a the moment, and the agenda is dominated by Katrina. At least three federal hurricane relief bills that could help Medicaid patients await Congressional action, Barber says, but the Bush Administration opposes all three.
And even if the state does receive aid in a form that could help Medicaid, says Barber, it is not at all certain what impact the money will have. The state government has a history of “frittering away” money instead of using it to help the poor, he says.
In the early 1990s Mississippi decided to allow several casinos to be built over moving water, including those on the Gulf Coast destroyed by Hurricane Katrina. Casino proponents in government promised that the millions of tax dollars raised by casino gambling could bail out the state’s ailing education system and other dire needs. Once the casinos were in place and the money started rolling in, Republican Governor Fordice reneged on the promise, saying he would save the money for “rainy day” (as if it were not always a rainy day for most Mississippians).
Mississippi also earned substantial millions in one of the tobacco lawsuit settlements that swept the nation in during the last decade. Somehow that money never made it near the poor, either, unless of course we count the expensive state program that took cops off the streets to “educate” school kids in Mississippi about police work.
In April of this year Mississippi also made the Bush Administration’s list of 15 states allegedly “recycling” federal money instead of contributing appropriate amounts to the program, according to the New York Times. In a typical arrangement, goes the allegation, states overpay cities and counties for Medicaid expenditures. The local governments are then required to pay back the excess to the state. This, say federal officials, makes it appear the state is contributing more than it is and allows it to take a bigger bite out of federal money than the rules allow. State officials deny the allegations, noting that in other ways the federal government defers costs to the states.
Meanwhile in this political-economic game of musical chairs, it is the poor who keep winding up out on their asses.
Now, according to Barber, Mississippi officials are talking about taking federal relief for Medicaid, then diverting money the state would have spent on that program to rebuilding the Gulf Coast -- most likely in a similar way to recent New Orleans dealings: with no-bid contracts to well-connected firms such as Halliburton and Stevedoring Services of America, illegal exceptions to Davis-Bacon wage requirements, union avoidance and a focus on high-end construction that leaves little room for affordable housing for returning victims of Katrina. |
This work is in the public domain |
