PRIVATE HELP FOR POOR BEING SET ASIDE

Who should care for the poor?

Before the government welfare and taxpayer-funded insurance, the answer was simple: Churches, organizations and private citizens reached out to help neighbors in need.

But the government's deep pockets has managed to push aside many of these do-gooders.

Such is the case with the Caring Program for Children, a private, not-for-profit health-care foundation that has served more than 25,000 Missouri children since 1987.

But now the need it gone thanks to the "generosity" of Gov. Mel Carnahan and Missouri taxpayers. Recent legislation expanded Medicaid coverage to some 90,000 children in families that meet liberal guidelines.

A family of four with an income of $49,350 would qualify for Medicaid coverage under the expanded income guidelines. That's 300 percent of the federal poverty level. For a family of six, the income tops $66,000. As a result, more middle-income families may look at the option of going without insurance for several months so they can qualify for the state program.

This additional coverage doesn't come cheap. It taps a new source of $51 million in federal funding combined with $20 million in state revenue.

Of course, this expansion is a two-edged sword. Missouri will gallantly push wide the doors for inclusion, but it will give no assurance that doctors will take the onslaught of new Medicaid patients.

Already there is a scarcity of physicians who will take new Medicaid patients in this region. And those health professionals who do accept Medicaid are often frustrated by the lack of referral options, inadequate payback, slow reimbursement from the state and mounds of paperwork.

The new state budget includes more dollars for increased reimbursement for medical services. But it only increases physician fees on procedures that have typically been underpaid as opposed to a blanket percentage increase. This change may do little to open the doors for Medicaid patients lacking quick and easy access to a local family doctor or specialist.

It is a shame that the Caring Program for Children will close its doors. Perhaps Blue Cross Blue Shield will find another way to help impoverished Missourians. But what would be the incentive?

The government must stop taking away the incentive for private enterprise to help the poor. This government-funded largess is certainly not free. It takes a heavy toll on taxpayers and business, and it feeds the vicious cycle of dependence on government handouts.

The answer to breaking government dependence is more private assistance, not less.