Beware! Dangerous rhetoric ahead.

Subject: health care for the poor and near-poor.

Prospects: More and more over-heated rhetoric ahead, at least until a State budget is approved.

Possible side effects for innocent bystanders: drowsiness, dyspepsia, confusion. Sometimes ignorance.

This rhetoric will come from both sides of the political spectrum; from conservatives warning that the state budget must be trimmed, from liberals warning that the proposed trims will cause unacceptable human suffering.

Both sides could be right.

Or, just as (more?) likely, both sides could be wrong.

Let’s examine some of the rhetoric we’ve already heard. From Richard Davis, the executive director of the Vermont Citizens Campaign for Health, the cuts in health care services proposed by Gov. Jim Douglas would cause “more people to suffer and die.”

But perhaps the only alternative to these budget reductions is higher taxes, and Douglas’s Administration Secretary, Neale Lunderville said. ‘The governor does not believe Vermonters have a capacity to pay more in taxes.”

For now, Davis’s statement can be neither confirmed nor refuted. If the cuts are made, it should be possible to determine after a year or so whether they actually killed anyone. But it’s hard to see how and why they would. Suffering is quite a bit more subjective; one person’s suffering is another’s inconvenience.

Lunderville’s statement is no doubt true, but meaningless. Gov. Douglas has made his belief abundantly clear. But belief is not evidence. There are tens of thousands of affluent Vermonters and thousands of downright rich ones who no doubt have the capacity-though perhaps not the willingness-to pay higher taxes.

So far, then, we have learned nothing, except that people on both sides of this debate overstate their case.

Somewhat milder opposition to health care cuts came from Peter Sterling, executive director of the Vermont Campaign for Health Care Security, who worried that if  low-income Vermonters had to pay more for their own premiums and health care services, many of them would decide they couldn’t afford it, and drop health insurance altogether.

“No one drops their health insurance because they don’t like the benefits,”  Sterling said. “They drop their insurance because they can’t afford it anymore.”

True, but at the risk of seeming harsh, that’s their choice. People who “can’t afford” higher premiums or higher co-pays when they visit the doctor can’t afford it because they’ve chosen to live in a certain house, drive a certain car, and engage in other pursuits that leave them  without enough money for health care. They could find a cheaper apartment, drive a cheaper car, do less of whatever else they are doing so they could keep their health insurance.

It isn’t as though Douglas is proposing huge increases in premiums or copays. For children and the poorest adults, monthly payments would return to their 2007 levels. There are no records of Vermonters starving in the streets or dying for lack of health care two years ago. Some premiums would rise as little as four dollars a month; others as much as $40 a month.

That won’t be easy for some people. But to claim that they absolutely can’t handle it seems exaggerated. The same is true for the slightly better-paid people who are in the Catamount Health program

The fact is that there are two-bedroom apartments  available (from a quick Internet search, meaning cheaper ones are probably there for the more determined seeker) in the Burlington area for $750 a month. They’re probably not  very nice apartments, but nobody really needs a very nice apartment. With that apartment and an old car with a low(or no) loan, a $30,000-a-year family of three (that’s about the poorest not eligible for Medicaid) can pay several hundred dollars a month for health care and still have almost $1,000 a month for food and other necessities. Not much, but it’ll do. Those who choose to spend the money on something besides health insurance, have…well,  so chosen.

OK, the previous four paragraphs do not simply seem harsh. They are. And they do not apply to all those recently laid-off people who had insurance and a house and a car and their other pursuits ,and were going about life quite responsibly, only to find themselves out of work and uninsured at about the worst possible time to try to sell a house and move to a cheaper place.

The point here is not to endorse Douglas’s proposed cuts. It’s to caution against accepting any faction’s rhetoric at face value. These cuts may be a bad idea. They are not likely to kill anyone. Nor will they actually force anyone to drop his or her health insurance.

On the other hand, they may be very bad for the state’s economy. An analysis of 29 studies in 23 states (not including Vermont) by the Henry Kaiser Family Foundation found that cutting Medicaid spending “has an impact on the larger state economy” which leads to “declines in economic activity” in the state.

The analysis doesn’t claim to be conclusive proof. But the studies it cites are from prestigious universities, business schools and journals. Besides, it makes sense. Medicaid effectively gives money to poor people. And as the late comedian Pat Paulson noted, “if you give money to poor people, they’ll just use it to buy food and clothing and pay the rent.”

In other words, they’ll consume more, just what the economy needs right now. Cutting health care for low income people means giving them  less money. So they’ll consume less.

Of course the alternatives proposed by health care advocates-such as a one percent income tax surcharge on those earning more than $500,000 a year-would also take money out of the private economy where it could be used for consumption. But at that level, a lot of money is saved, not spent. At times, encouraging more saving is desirable. In a recession, consumption is key.

The proposed health care cuts might do less harm to the people directly affected than one side’s rhetoric claims, but more harm to the economy-and therefore to the taxpayers-than the other side’s rhetoric would lead one to believe.