The ethics of care

Oregon is currently the model for effective home- and community-based health services for the elderly and disabled. David Fuks, CEO of Cedar Sinai Park and adjunct professor at Portland State’s Graduate School of Social Work, says that when he goes to national conferences, all eyes are on Oregon for learning the ins-and-outs of the assisted-living model.

Fuks notes that assisted living was practically invented in Oregon. In a time when some states are making huge Medicaid cuts, such as Arizona, which has cut their Medicaid funding more than $1 billion this year, now more than ever we need to be a good example of fair treatment for our most disadvantaged citizens.

Why then is Governor John Kitzhaber proposing to cut Medicaid rates 19 percent for nursing homes, 16 percent for community-based care and 25 percent for at-home care?

Fuks’ recent article in the Oregonian, “Calling for a moral system of care for elders and people with special needs,” addresses why, if these cuts pass, it will be detrimental to those in need.

If the cuts are passed, Oregon will see the closure of multiple long-term care facilities, driving more patients into hospitals, where costs are greater. The reductions will create harsher consequences in rural communities because of the lack of access to primary care providers.

Fuks likened the cuts “to an attempt to return to social Darwinistic times before the Social Security Act,” and addressed that our current economy might be behind the cuts, but that it is disturbing to take resources from those who need them and “can’t tough it out.”

However the economy argument is tough to rationalize since Fuks also adds that for every Medicaid dollar the state puts in, $1.7 is matched at the federal level. This money circulates approximately seven times in the local economy, making spending on Medicaid seems like a pretty safe gamble and a good investment, both ethically and economically. 

At the federal level, proposed funding cuts to the state’s Medicaid would leave 44 million more Americans without health insurance, according to Colorado NPR writer Erin O’Toole. One has to wonder what is wrong with the ethics of this country when the elected officials steal funds from those in need, while a continuation of Bush’s $1.3 trillion federal tax cut for “high earners” is approved.

This is why there needs to be a moral system used when society addresses resource problems. As the adage goes, “A civilization should be judged by how it treats its most underprivileged members.”

Just because the economy goes through ebbs and flows is no reason to adopt a sink or swim ideology toward our social relationships, allowing the elderly and disabled to be undercut.

Concerned Oregonians should email the Joint Ways and Means Committee of Oregon as well as the Joint Ways and Means Human Service Subcommittee and demand that we don’t take funds away from home- and community-based services for the elderly, disabled and underprivileged.

Any and all creative efforts to prevent this funding reduction will help our state and city continue to provide a working model that teaches others that we need a system that, as Fuks eloquently states, “responds to people’s needs instead of the people responding to the needs of the institution.” ?