Budget cuts will hurt many in need.

Byline: GUEST VIEWPOINT By Steve Skipton and Dan Reece For The Register-Guard

A yes vote on Ballot Measure 30 will preserve what remains of our safety net for frail elderly and disabled Oregonians. A yes vote supports cost-effective programs that help our most vulnerable citizens stay as independent as they can. These programs save lives and money.

Health programs serving seniors and people with disabilities already have been cut. Even if Measure 30 passes, many programs will not be fully restored. A no vote will cause further cuts and will put thousands of seniors and people with disabilities at risk of losing their independence, health and safety.

The impact would not be limited to patients. In most cases, patients' struggling families will have to assume greater responsibility for providing their care and financial support. Social service agencies will do what they can, but it won't be enough.

Measure 30 asks voters whether we want our state to continue to operate humane and effective health and long-term care programs. More than 20 years ago, Oregon made the wise choice to use federal and state Medicaid dollars to serve people who need long-term health care and related services in their own homes, instead of in nursing homes. This allows people who need help managing their medications, bathing, eating, or getting around to live more independently. It is cost effective, because the state can use Medicaid funding in this way only if it costs less than providing care in nursing homes.

But Oregon's long-term care program is on the chopping block again. If Measure 30 is defeated, 1,200 more low-income seniors and people with disabilities will be denied long-term care services. Even with help from family and friends, their health and their ability to care for themselves will decline. Once their health and living situations deteriorate to the crisis point, they may become eligible for care again - but by then their independence will be lost and more expensive care will be needed.

Another innovative health program, the Oregon Health Plan, provides basic health and prescription drug services to people, including seniors and those with disabilities, who otherwise would not have health coverage. If Measure 30 is defeated, 50,000 people will lose all coverage, and another 125,000 people will have their Oregon Health Plan services, including prescription drug coverage, severely reduced. To make matters worse, a special prescription drug program designed to help 6,700 people who are not eligible for the health plan will not be restored if voters reject Measure 30.

These innovative programs were, and still are, a win-win choice. Because of these programs, Oregon has one of the lowest Medicaid costs per client anywhere in the country. This helps keep health care costs for all Oregonians lower. Cutting access will cost all Oregonians. When the ranks of the uninsured grow, health care costs shift to the insured.

Here is what happened to one local woman who lost coverage under the Oregon Health Plan - let's call her Mrs. Green. She's an 85-year-old widow with congestive heart failure and osteoarthritis. She was fiercely independent and had refused to accept public help for years. She finally applied for the health plan, and in January 2003 she was living in an apartment in a senior complex with relatively stable health. She lost her health and prescription coverage last February due to budget cuts resulting from the defeat of Measure 28.

In May, Mrs. Green was found on the floor of her apartment and taken to the emergency room. She had not been taking her heart medicine because she couldn't afford it. She was then found to be eligible for assistance, and her health has stabilized somewhat. But she is now living in a nursing home and will stay there for the rest of her life. The state now pays $2,600 per month for her nursing home care, in addition to paying for her health and prescription coverage.

Mrs. Green's story is one of many. Her story shows that if Measure 30 fails, real Oregonians will suffer real harm. And taxpayers will end up paying more for less.

Voters don't often get the chance to vote their pocketbooks and consciences at the same time. A yes vote on Measure 30 is a wise vote, because it supports cost-effective health programs that ultimately save money. More importantly, a yes vote is a vote from the heart, because it says we as a society value the independence, health and safety of frail elderly and disabled Oregonians.

Steve Skipton is an attorney with the Lane County Law and Advocacy Center. Dan Reece is the director of the PeaceHealth Center for Senior Health.