Why Pay Now When You Can Pay Later?

Alright, alright, Rhode Island State Legislature, I get it.

I used to treat my finances the same way you are treating the budget. I liken it to the way I used to use my credit card. I’d charge and spend without really recognizing that eventually, I’d have to pay it all of. And I’d have to pay it with interest.

I remember the attitude I carried around with that credit card. And I get the sneaking suspicion that our elected officials have adopted the same ideas – Why pay now when you can pay later?

See, the framing of the budget issue makes it seem like the legislature is doing us a favor, like they are being fiscally responsible, like they are “cutting back” on unnecessary programs. In truth, they are screwing over, like, everyone in Rhode Island. Farmers, college students, any student, state employees, immigrants, and children, etc., etc., etc.

Cutting programs for health care, education, and preservation of the environment might seem like a good idea for a state that is genuinely experiencing a financial crisis. But in the long run, these cuts will cost us more money. Because we aren’t just backing out of welfare programs, we are backing out of investments into the vitality of our state.

A function of our government is to invest in the well-being of its citizens, right? Isn’t that what that “social contract” thing is? We pay taxes and participate in the government and they provide the programs we need to be a thriving, educated, healthy, economically viable populace.

I thought that’s what I signed up for.

But I take a look at what’s happening on Smith Hill, and I get the feeling that the only people our state government is honoring that contract with is the rich folks.

To put it in a food writing metaphor, the legislature is treating the wealthiest Rhode Islanders to a nine-course tasting menu, with the food grown, harvested, cooked up, and served by the average hard-working Rhode Islanders, and then they are skipping out on the bill. That is so not classy.

They’ll pay eventually, of course. We’ll all pay. The budget will send our state in a direction that might take decades to recover from. And how will we pay? We’ll pay with a sicker population, a less educated workforce, a smaller middle class. We’ll pay because we’ll have more expensive, less attractive institutions of higher ed. We’ll pay with higher municipal taxes. We’ll pay with dirtier drinking water and a more polluted landscape.

And finally, what is most important in all of this, we’ll pay the highest price by cashing in on our integrity. And we’ve already done it.

I can’t think of anything more despicable than denying a child, any child, especially a sick child, the right to live a healthy life. I could go on and on about the immorality of the RIteCare cuts, but just read Felice Fryers’ article in the ProJo and you’ll get a sense of what I mean.

Let me just respond up front to those that will respond to this post with whines of how high Rhode Island’s taxes are, and that we have to cut back somewhere. The cuts to RIteCare are impractical and fiscally irresponsible. Any cuts to state-sponsored health insurance will end up being more expensive for you in the long run:

The state expects to save $667,000 in the current fiscal year and $4 million next year as a result of removing these [2,800] children from RIte Care.

But [Dr. Robert Burke] calls it a false economy, because children are going to get sick and come for care anyway. “What do we do with these children? Ignore them? Stand in the doorway and block them from coming in? It’s unrealistic and it’s immoral.” Cutting benefits doesn’t save money, he said, but just changes the route by which the money flows –– and often requires that more be spent.

For example, taxpayer dollars through RIte Care will no longer buy asthma medication for Brian Cordones. As a result, Brian may have an asthma attack and go a hospital emergency department, where he will receive free or discounted care. His emergency visits will cost more than keeping him healthy on medication. Taxpayer dollars and the premiums paid by insured people cover some of this “uncompensated care” at hospitals; the rest comes out of the hospitals’ bottom line, potentially straining nonprofit institutions that everyone depends on.

Okay, so let me break it down for you again. Much as you’d like to tell yourself that kids just *poof* disappear when we aren’t paying for their health care, these kids are still here. They get ear infections. They get strep throat. Some of them have chronic illnesses like diabetes or sickle cell anemia, diseases that, when treated with regular visits to a primary care physician, are actually cheaper to care for.

But when these kids are taken off the rolls and don’t have access to primary care, parents are forced to find other routes for health care. Sometimes they are able to use non-profit orgs for help, but these folks are already at capacity. Often the uninsured come to rely on the emergency room for care. And while everyone knows that emergency care is more expensive, it’s also important to recognize that emergency care isn’t preventative care. So people get sicker and sicker and the cost gets higher and higher, usually for ailments that can be avoided with access to cheaper primary care.

This is serious shit. When kids are sick, they either receive quality health care and get better, or they get sicker. Or maybe they die. (Though I have a rep for being a drama queen, I’m being totally real right now.) When we have a group of elected officials who send a message to our children that their lives just aren’t a priority, there will be consequences. And this is just one piece of the budget puzzle.

So, like I said, we’ll pay later. And we’ll pay with interest. More crime, less innovation. More disease, less progress. Wealth will be more concentrated, poverty will be more pervasive. It’s gonna be a mess.

A state legislature that sends a “Fuck You” to the general population will, eventually, get a “Fuck You” right back.