Sometimes public acts have very private consequences. One case in point is the Balanced Budget Act of 1997, which has effectively eviscerated West Virginia's health care system.

When lawmakers on Capitol Hill passed $206 billion in Medicare cuts, more than 5,000 people in West Virginia instantly became ineligible for home health care. Hundreds more were denied home health services for a variety of reasons, including the high cost of care, and 1,200 people who sought help from the state for in-home keeping and hygiene visits were placed on waiting lists.

The Associated Press, which reviewed the consequences of the Balanced Budget Act, found a system under strain that routinely denied people services or released them early from hospitals. In addition, layoffs are forcing hospitals to close rural clinics, home health agencies, and skilled nursing facilities in an attempt to keep their fiscal house in order.

"All the easy cost shifts and management tricks you can make -- they're all gone,' says Robert Hammer, chief executive officer of Davis Memorial Hospital in Elkins. "A reduction here, a change there -- it's all used up. We're to the point now where we don't have anywhere left to cut. So the next thing is, we start cutting services."

Hammer added that it's a dilemma for hospital administrators. "The business decision there is real easy. The moral decision is real hard."

Demographics point to why West Virginia is particularly hard hit by Medicare reductions. It has the oldest median age population in the nation and ranks second in the percentage of its population covered by Medicare.

The West Virginia Hospital Association says that Medicare cuts will cost state hospitals $525 million by 2002 and claims the state's 71 home health agencies are each losing about $180,000 a year.

Access to home health care is crucial in a rural state where patients often face the possibility of having to travel hundreds of miles for basic medical services. But home health agencies can no longer serve as a safety net for a public that direly need their services.

The results are often catastrophic for the patients themselves. Many are staying home and receiving no service whatsoever. Many are lying in back rooms or sitting in homes that are far removed from modern health care.

Since Congress is to blame for putting the health care system in critical condition, only it has the means to resuscitate it. Lawmakers should restore all Medicare funding before more lives are negatively impacted by a business decision that fails to look after the needs of its most helpless citizens.

If government wants to reduce the budget deficit, it surely can find other programs to pare that aren't nearly as critical to the basic needs of the populace.

Governments should be remembered for how they treat the disenfranchised, not the power elites.

Today's editorial reflects the opinion of the Exponent editorial board, which is comprised of John G. Miller, James G. Logue, Kevin S. Courtney, Patrick M. Martin and J. Cecil Jarvis.