A WORD TO THE WISE: DON'T GET SICK
On April 15, Leona Helmsley will report to prison. One of those desperate dowagers who wipes on the cosmetics with a catcher's mitt, the hotel hostess was convicted of being a tax weasel. On the very same day that Helmsley begins serving her sentence, the rest of us will have our own moment of reckoning with the Internal Revenue Service.
As we make out our checks of tribute to the government this month, it is impossible not to recall how our governor tried to make all of us a little richer by creating an across-the-board tax refund.
Governor J. Fife Symington III said in his State of the State speech in January that everyone in Arizona should get a tax break. In order to finance this campaign pledge, Symington proposed that a large bloc of the poor should no longer get state-insured healthcare.
This is the kind of public policy that fills the streets of Calcutta with beggars. But it is the kind of public policy Arizonans regard as sound economics when touted by no-nonsense Republican businessmen who are self-made entrepreneurs like Fife.
Of course, Fife isn't entirely the self-made entrepreneur his campaign sold us.
Fife is a fox-hunting blue blood descended from the Frick robber baron fortune who married a graduate of Miss Porter's finishing school, a woman who possessed even more trust funds than he did. Together they raised a family that matriculated at the Phoenix Country Day School.
With the kids out of the house, the Symingtons grew restless and sought the governor's office. Pouring more than a million and a half dollars in family money into the campaign, the Symingtons bought a seat on the ninth floor of the statehouse. More recently the federal government sued the couple, claiming Fife's sleazy business practices while on the board of Southwest Savings and Loan helped bankrupt the financial institution.
Symington is a man of the people-people like Michael Milken, Charles Keating and Donald Trump.
Symington's scam to fund a tax refund by screwing the poor was immediately applauded on the editorial pages of the Arizona Republic and the Phoenix Gazette.
Actually, to be more precise, Symington did not want to merely screw the poor; he wanted to screw the poor when they were struck down by a catastrophic illness such as cancer, or crippled by the expense of a debilitating heart attack, or chronically bedridden by a long-term disease requiring hospitalization.
Nor were the targets of this tax-refund proposal those figments of your Arizona imagination: The welfare queens who spit out babies for AFDC payments and sell their food stamps to buy drugs; federal laws protect these citizens. No, Symington's targets were the working poor, people who hold down the state's worst jobs and are not covered by health insurance.
By abandoning 30,000 people statewide, Symington intended to save $80 million and give the rest of us a tax break.
A middle-income person could expect a tax refund from $30-enough for a case of beer and a couple of lottery ticketsÏall the way up to $60.
Sixty bucks is nothing to sneeze at; three or four years of those kinds of refunds and you could buy your kid a pair of Air Jordan sneakers.
Dr. Leonard Tamsky wears sensible shoes. He is the chief medical officer of the Maricopa County Hospital. In his office, there are as many sheets of unfiled paper as there are poor people in the clinics right outside his door.
Dr. Tamsky was direct when asked about Governor Symington's proposal: The immediate effect would be catastrophic."
Pulling charts and graphs and documents out of the paperwork that passes for office decor, Dr. Tamsky explained Maricopa County has 23,342 patients in the group the governor has targeted. In hospital jargon, they are called the ÔMedically Needy and the Medically Indigent." These are patients who, in a family of four, earn less than $5,300. For a couple with no kids, the magic number is $4,300.
County hospital treats more than 6,000 of these people, with the remaining 17,000 scattered throughout the Valley's hospitals. All of the medical institutions now treat the poor people because the state picks up the tab. Under Symington's proposal, Arizona would not pay a cent for anyone between the ages of 21 and 64. ²Overnight, 17,000 patients, the ones now going to private hospitals, would suddenly be dumped back on county hospital.
Of course the county can't afford to treat these people. Near Tamsky's office, construction of a new hospital wing is under way. While the steel goes up three floors, the county has only enough money to pay for the first floor. Voters rejected a bond proposal that would have financed floors two and three.
If the counties actually had the money to treat the working poor, then Symington's proposal would be no more than a cynical hoax on taxpayers. Instead of paying state taxes to treat the indigent, citizens would pay county taxes. Caesar would still get his.
But the counties are broke. Symington's proposal would, in reality, mean that the working poor would be denied medical coverage the way they are in such backwater outposts as Mississippi.
Symington knew who the victims would be prior to choosing this plan for financing the tax refund. A week before his State of the State address, budget analyst Michael Kearns sent a detailed report on the proposal to Peter J. Burns, director of the Governor's Office of Strategic Planning and Budgeting. In the middle of the memorandum Kearns confesses, It is not clear at this time how and where persons not covered under this plan will seek services. It is certain, however, that they will present themselves for care somewhere and will most likely not be able to pay, thereby increasing uncompensated and charity care."
For many years, Arizona was the only state in the union without Medicaid. Locally, people believed Medicaid was akin to socialism, which was akin to communism, which was akin to...well, you get the picture.
Rather than participate in the federal program, Arizona's counties assumed responsibility for the healthcare of indigents. Treating the poor pushed all of the counties to the brink of bankruptcy. Faced with insolvency, the state, in 1982, created the Arizona Health Care Cost Containment System (AHCCCS), which allowed the state's medical establishment to tap into federal healthcare dollars.
By refusing to call our plan Medicaid," we were able to join Medicaid, take federal tax dollars for healthcare and still claim that Medicaid was a communist plot.
If you are on welfare or permanently disabled, federal tax dollars now cover your medical problems.
²But the ÔMedically Needy and the Medically Indigent" are not covered. These people fall between the cracks and the state of Arizona has paid for their healthcare.
²Who are these people?
²According to Dr. Tamsky, the 23,000- plus people in Maricopa County in this group are the homeless, the working poor and people who are chronically ill and cannot work. More recently, they are people who've been laid off in the recession.
²If you work, but are not covered by health insurance, it is very easy to have an illness that strips you of everything.
²Let's say you make $20,000 a year and an uninsured motorist smacks into you, leaving you with a $17,000 hospital bill. You fit into the Medically Needy and Medically Indigent" category.
If you are someone like George Duncan, you are on Governor Symington's hit list.
I met Duncan the morning after St. Patrick's Day, when he arrived in his yellow cab to take me to the office. Wary of my own driving, I'd abandoned my car during the holiday celebration the night before. After working his entire life on the railroad, Duncan was laid off and replaced by a computer. By driving a cab from five in the morning until five in the evening, he is able to keep a roof over his head and feed his wife and three children. The 62-year-old Duncan is not able to afford health insurance for his family.
Recently one of his daughters dislocated a finger. Less than an hour of medical attention cost him $300, which he paid out of his own pocket.
But Duncan doesn't know what he'd do if his family actually had a medical emergency. He says he already works 12 hours a day, six days a week. He doesn't know if he can work any harder.
The problem with the George Duncans of this world is that they didn't learn any lessons from the go-go Eighties. They didn't study the successes of people like J. Fife Symington III.
While sitting on the board of Southwest Savings and Loan, Symington convinced the bank to grant him the single-largest loan in the institution's history for construction of the EsplanadeÏwhich promptly defaulted on the note, plunging the S&L into bankruptcy.
With a total investment of $400 in the Esplanade project, Symington paid himself $5 million in fees out of the S&L loan. It goes without saying that the Symingtons can afford health insurance while George Duncan, who drives a cab 72 hours a week, cannot.
Last week the Arizona State Legislature passed a budget that balanced the state's ledgers. It did not include Symington's $80 million tax-refund program.
Senate president Pete Rios told the governor last week that he would not undo healthcare for the working poor.
Who will blink?
You will have to wait to see if Fife's plan to savage the Medically Needy and the Medically Indigent" is resurrected; you will have to wait to see if anyone suggests that the way to hit these numbers is to screw the George Duncans of Arizona.
You will have to wait to see if you get your case of beer and a handful of lottery tickets.
THE WINDMILLS OF JACK LEVINE THIS LAWYER... v4-01-92
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