State officials should do whatever is necessary to preserve and strengthen the Medically Needy program.
That was the consensus of dozens of officials, citizens and advocates who attended a health workshop as part of Utah Issues' 1990 conference, "Investing in the Common Good."The Medically Needy program is offered through Medicaid as an optional program and serves impoverished people who are not categorically eligible for Medicaid or the Utah Medical Assistance Program. If lawmakers decide not to fund the program or to reduce funding, 7,600 very-low-income Utahns who have no medical insurance and don't qualify for those programs would be unable to obtain any medical assistance.
There are four barriers to medical care for the impoverished, according to Pamela J. Atkinson, Intermountain Health Care's director of the Medically Needy Program. Even when these barriers - availability, accessibility, affordability, and knowledge and information about the assistance - are broken down, inadequate funding handicaps the program.
"Quality health care should be available to everyone," Atkinson said."
The poor also lack the means to pay for x-rays, pharmaceuticals and lab work. And the elderly - particularly the poor elderly - face gaps in health care.
About 13 percent of Utahns have no insurance because they can't afford the premium. Several thousand others are classed as uninsurable because they have had heart trouble, cancer, diabetes or Down's syndrome.
"Gaps" vary in urban and rural communities. In rural areas, transportation has been listed as a major problem because there isn't any if the patient has no car. But even in urban areas, a single mother with no income and three small children probably has trouble just maneuvering on public transportation systems.
During the special legislative session in September, lawmakers were asked to provide extra money to the Medically Needy program to bring it into compliance with federal rules. Instead, lawmakers came up with a "good faith" allocation.
Now, "we have to try to come up with a political compromise between the federal and Utah systems," said Bill Walsh, director of Utah Issues. Without a compromise, lawmakers could choose to dismantle the program.
"If they are pressed," said J. Winslow, legislative fiscal analyst, "it's not inconceivable that the Legislature may withdraw the program."
Dr. John C. Nelson, president of the Utah Medical Association, said that "instead of milking the taxpayers, we need to come up with some alternatives," to provide health care to the poor. One possibility, he said, would be a tax credit tied to the value of services provided.