At the very end of 2011, a study was published in a British medical journal, in essence advising medical practitioners to “brush up (on their) Shakespeare” as the Broadway musical put it. According to the published study, the Bard was way ahead of his time in identifying the deep connection between the emotions roiling his characters and the physical ailments of which they complained. The study included myriad examples in the plays, both comedies and tragedies: vertigo, breathlessness, chills, palsy–all connected to deep emotional conflict.
The question animating this essay: Might the opposite also be true? Might a lack of health in the body also disrupt the healthy workings of the mind?
In Act Two, Scene Four, of his masterpiece, King Lear, Shakespeare answers in the affirmative, giving the King the line, “When nature, being oppressed, commands the mind/To suffer with the body….
The Same Is True of a State and Her People
In considering statements of California’s public policy, none speak as loudly as those reflected in her budgets, as adopted over the last several years. In the Governor’s proposed January budget, one can see a clear expression of belief in the lack of connection between education and healthcare — the mind and the body. Though both suffered deep cuts when revenue plunged (because the vast bulk of all California budgets are taken up with the costs of education, K-14 and higher, and the costs of health and welfare), the proposed budget reflected the Governor’s decision that only funding for education should be meaningfully restored.
First, The Body: Health Care Reform and the ACA
Although the budget contains a number of new investments tied to the roll-out of California’s compliance with the Affordable Care Act, the money is there, primarily, to pull down significant federal funding for Medi-Cal. The Governor’s January budget, as presented to the Legislature, contained only sketchy possibilities on what might be done. It included $350 million (a very low figure) for six months of 2013 and projects $700 million annually thereafter as a kind of placeholder for the costs that will be incurred by having to provide coverage to individuals who are currently eligible for Medi-Cal and not presently enrolled. Many will enroll, the theory goes, because of the insurance mandate, subsidies and greater outreach.
In addition, the budget presents two options for covering people newly eligible for Medi-Cal because the cap on income has been raised a teeny bit. Under the ACA, if you earn up to 138% of the Federal Poverty Level (138% would be about $33,000 a year for a family of four), you are now eligible for Medi-Cal. However, the state is allowed to choose one of two ways to cover these enrollees: it could expand the existing Medi-Cal state-based program, or it could build on the county-based Low Income Health Program. Counties pay for care for adults who are not eligible for Medi-Cal through their local indigent health care service programs, with the state providing only a portion of the money. The January budget foreshadowed a struggle concerning just how much the state will pay and how much local governments will pay.
Second, the CalWORKs Program Is Left to Drift
CalWORKs is California’s welfare-to-work program. It was cut to ribbons over the past several years, including a decrease from 60 to 48 months of lifetime eligibility, and further restrictions so that some enrollees lose eligibility for a lifetime after only 24 months. The monthly amounts paid to each recipient have also been slashed, year after year. The January budget proposed no help, except to earmark $142 million to help people look for jobs that, mostly, weren’t there in the recession. For child care, the Gov. proposed to convene a “stakeholder group” to figure out how to save more money. Child care is more at risk than ever since the last budget took funding for school-based child care out of the Prop 98 guarantee. In home support services, which provides care for frail seniors, was proposed to be cut by an additional $113 million.
And How Did The Mind Fare in the January Budget?
The January budget proposed $56.2 billion for K-14 (meaning grades all the way through Community College, which gets a share of Prop 98 funding), an increase of $2.7 billion above the revised 2012-13 budget. This includes a $520 million increase in the Prop 98 minimum guarantee.
Funds were also added to reduce long-standing budgetary deferrals–monies owed to the schools for all those years that Prop 98 was “suspended” and not fully funded. This payback, as proposed in January, was to amount to about $1.8 billion for K-12 and 179 million for community colleges. Per pupil expenditures were proposed to be increased from $7,967 to $8,304 for the new budget year. $1.6 billion more was added to implement a new Local Control Funding Formula for school districts and county boards of education to replace formulas by which certain categories of programs were specifically funded. (More about this in the education sections of the budget as adopted, in essays to come).
So, have you ever gone to school hungry? I once attended a hearing where one student testified that he purposefully got in trouble at school because, when he was sent to the principal’s office, he got to eat a piece of candy, which was his only food all day until dinner.
No doubt it is good to feed the mind, but if the body is starving, what can it learn?
Sunday, 21 July 2013