State of the State: Arizona

Well, the news is not good.

Arizona faces a $3 billion dollar budget shortfall, which is 30% of the budget.

Our governor, Jan Brewer, thinks we should cut services to the poorest and most vulnerable in the state — AHCCCS (medicaid) and mental health services recipients.  The total of people who would be affected by this is nearly 450,000.  Nearly 400,000 adults, some 36,000 children, and some 36,000 mental health patients.  Now, where are these people going to go when they need care?  To the emergency rooms, of course, where they are not required to pay any money up front (and won’t pay at all ever).  Where there is already a hemorrhage of funds in every hospital.  It is going to mean more hospitals frankly shutting down their emergency departments out of self preservation and only accepting patients with private health insurance for direct admits from doctors and prescheduled surgery services.  It will mean more layoffs in the health care sector as hospitals cut staff.  It will mean more lawsuits filed against hospitals for nosocomial infections which are directly linked to staffing levels, further undermining funds available to actually provide care.

The coming cuts in Medicare and Medicaid payments to doctors by 22% after already reducing them by about 15% is going to mean a crisis of health care for the poor in this country; my own area of Prescott made the news recently because retirees can’t find a doctor who will accept Medicare.  Some of these people travel over 130 miles one way to Phoenix and stay overnight just to see their doctors, because there are no local doctors willing to see them unless they pay cash.  The doctors interviewed said that they still see the patients they’ve had in their client list who are on medicare but aren’t accepting any new patients due to the hassle with reimbursement thanks to the confusing rules from our esteemed government, the length of time it takes to get reimbursed versus private insurance, and the lesser amounts paid for the same services.  These people as well end up in the emergency rooms because they can’t get seen for things that should be taken care of by a primary care doctor, further overloading an already breaking system.

These cuts will have even farther reaching consequences than many realize; more than a few doctors — our experienced and competent ones — are nearing retirement age.  These doctors will simply retire rather than deal with the increased hassle.  At my emergency room, there are four doctors I can think of right now who will simply retire when the cuts take place.  They can afford to.  This means we will lose nearly half of our present physician staff; the ones who are left are for the most part brand new and relatively inexperienced.  It also means they will either be working many, many more hours or we will be seriously understaffed, leading to increased waiting times for patients to be seen and an increase in critical incidents in those patients due to wait times.

Our fire services are facing serious budget problems; tax revenues are in the toilet as they are everywhere but here it is a particular problem.  Many fire services have operated in a deficit thinking that next year’s revenues would cover this year’s expenses and have done this for years.  The last two fire departments I worked for were in this trap and had been told for years by the county comptroller that one day they simply might not be allowed to do that any more — that their budgets would not be approved by the county board of supervisors — which would mean they would simply be shut down.  The City of Phoenix, which five years ago had the biggest hiring spree in their history is now facing laying off as many as 500 employees according to the rumors I hear swirling around.  This means that anyone hired since then is up for layoff.

The police are just as bad off; the speed cameras which were to go away soon I think will be staying and even possibly expanded.  The City of Phoenix has instituted taking reports only for many types of property crimes that were formerly investigated by an officer due to lack of staff.

Taxes are going up in all categories; there will be both a state and a local food tax instituted in the near future, at least in the larger metropolitan areas.  Property taxes are going up while tax valuations are going down; our own taxes went up by nearly $100 while our assessed valuation dropped by over $4000 dollars.

There are abandoned properties everywhere I look; two of my coworkers moved into a new subdivision on the outskirts of metropolitan Phoenix; their houses are the only ones actually completed.  None of the others have been touched in nearly a year.  I would guess that they won’t be either.  On my own street there are homes that haven’t been lived in since 2004.  If anyone is paying taxes I don’t know.  Out by my farmer friends I counted 12 vacant properties just directly on the roads leading to their house; if that’s any indication than fully 40% of the properties out there are abandoned, foreclosed on, or simply vacant.

My farmer friends are in a monetary crisis; they were able to get their long standing mortgage re worked, but they still haven’t been able to make payments in months.  They literally have no income.  His business hasn’t had a new account since before Christmas and his father’s business has also been extremely slow.  He has tried to find work but there simply isn’t any to be had, and being away from the farm means chores will fall on her directly and solely.  She has also tried to find work but, having been a stay at home wife and mother since the late 80’s no one is apparently willing to take a chance on her even as a night shift clerk at a grocery store.  They are feeding their animals through donations from the local food banks of produce that is too old to give to people, and by taking in even more animals for boarding on the condition that the boarders provide extra food for their own animals.

Reading Craig’s list for my local area is a litany of sorrow.  The listing of free animals, the sales of entire households of belongings, it goes on and on.

I don’t think it will get better.  I don’t think we can go on this way for much longer either.  I am crossing over into fantasy land here, but I really wish Obama would have simply given each home owner the cash to pay off their mortgage rather than giving it to the banks.  It would have gone to the banks, same as it did, but it would have actually benefited a large portion of our citizens as well as the banks.  Ah, but there’s the rub.  We’re not citizens, we’re consumers…and no body cares about consumers unless they have money to spend.

One response

  1. -“our own taxes went up by nearly $100 while our assessed valuation dropped by over $4000 dollars”

    Same thing here in the broke state of Indiana. I am so pessimistic about home ownership anymore. What a *terrible* investment this has turned out to be. I am ready to sell (ha ha) and move to a rental.’

    So, sad AZ is chosing to remove funding to the population who probably truly need it to not overwhelm the system in other areas (as you brilliantly outlined)…

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