The very first program Gov. James Douglas proposed cutting to close the budget gap was V-Pharm, which helps lower-income Medicare patients pay for their prescription drugs.

It was also the first cut the Legislature rejected, though the rejection, like almost everything else about the budget, is subject to revision or reversal in the end-of-days (fiscally speaking) negotiations now under way in Montpelier.

It’s easy to see why Douglas said V-Pharm should be eliminated. Getting rid of it saves a lot of money, roughly $8.6 million.

It’s also easy to see why the lawmakers wanted to save it. The program serves a lot of people, 12, 548 of them according to the official document of the Office of Vermont Health Access. More precisely, 12, 548 people who are at least 65 years old. Legislators are quite sensitive to the wishes of people who are over 65 years old, at least in part because they vote

Douglas called his proposal to eliminate V-Pharm, during his January 22 budget address to the Legislature, “particularly difficult.” He’d been in favor of the program when it was created in 2005. But, he noted, getting rid of it is not going to leave elderly patients dying in the streets.

“Seniors eligible for assistance will still receive a prescriptiondrug benefit through Medicare.,” he said. Meanwhile, the money that has been going to Medicare-covered seniors under V-Pharm should be used “to ensure continued health care coverage for Vermonters with no other options.”

Wherever one stands on the issue of this or the other proposed budget cuts, the Governor’s case deserves to be taken seriously. When money is tight, priorities have to be set. Channeling the money to the very poorest makes some sense.

V-Pharm beneficiaries are not poor. Some of them make as much as two-and-a-half times the poverty rate, meaning an elderly couple with a $35,000 a year income can still get the benefits. That’s not a lot of money, but it should be enough to pay for life’s necessities, including most of the “wrap-around” costs (co-payments) of prescription drugs.

The same holds true for Douglas’s other proposed cuts in social service programs. If the Legislature agrees to all of them (and that’s not likely) Vermont’s social safety net will be weaker, but it will not be in tatters. In fact, the level of services would still be more generous in this state than in than most of the others.

No one has lately starved to death in Vermont, and no one is likely to in the coming year, even if there is a cut in state aid to food banks and homeless shelters. (One Vermonter did die of starvation in another state in 2007, the Health Department said). State and local governments, churches, synagogues, and other private agencies will provide enough food to keep everyone alive.

Of course it’s always possible for someone to slip through the cracks, for a drunk to fall asleep where no one will find him or an old person to be left alone in her home and succumb to hunger and neglect. Such mishaps, though, can happen at any funding level.

But accounts of low-income people eating pet food, notably short of detail, are probably more urban legend than fact. They sound rather like the abortions actually performed with a coat hanger, which almost surely never happened, or, from the other side of the political spectrum, the grown children of the recently deceased small businessman who had to sell the family firm because they couldn’t pay the estate tax. Find them.

It would be absurd to claim that the cuts called for by the Governor would not degrade the quality of some people’s lives. They would. In a few cases, those cuts would probably even cause people to suffer. But not all degradation is suffering, and there is nothing inherently evil about taking into account the limits of the community’s (meaning the taxpayers’) obligation to care for people. If (as noted here yesterday) some business leaders and conservative commentators exaggerate the horrors of even the tiniest tax hike, perhaps some liberal activists equally overstate the consequences of modest budget cuts

Then there is the question of personal responsibility. Considering that 87 percent of all Vermont households have cable or satellite television service (so estimates the National Association of Broadcasters) It is almost certain that a substantial majority of the V-Pharm beneficiaries are hooked up, and a pretty good bet that so are many, if not most, of the people going to food bank (though of course the homeless are not).

Maybe before they get the free food or the drug benefits they should cancel the cable and spend the $40 or so a month on necessities. Nobody needs a hundred television channels (or a television set at all?) to live a decent life.

People do need health care to live a decent life, and because of the proposed cuts, some might go without it. This even includes some of the not-so-poor V-Pharm recipients. Patients whose drugs are so expensive that they hit the “donut hole” of the Medicare program, where they have to pay thousands of dollars out of pocket before their benefits kick in again might simply decide to do without their medications. Patients suffering chronic diseases – diabetes, some heart ailments and cancers – often do not have pain or other immediate symptoms for quite a while even if they stop taking their prescriptions.

Again, personal responsibility comes into play here. Many, perhaps most, or these people could dip into savings or get help from their grown (and often affluent) children and pay the bills. Perhaps some of them (as well as other recipients of public aid) should consider moving to a cheaper home or buying a less expensive car. These suggestions might be unkind. But so is ignoring the burden placed on middle-income taxpayers who might not have very much more money than the folks getting helped.

Others who might actually suffer from the Douglas budget cuts are the mentally ill, both children and adults. These patients don’t need money as much as they need caretakers, who have to be paid. If the public agencies and publically funded private non-profits who serve the mentally ill have to lay off workers, the decline in the quality of life of their patients could decline to a level many would find intolerable.

One unusual (and largely un-noted) aspect of the current debate is that, in their determination to protect spending programs for the poor and low-income,  the liberal activists oppose all spending cuts, even those that benefit the rich. There has been, for instance, no suggestion to cut the $3.6 million budget for Department of Tourism and Marketing, some of which subsidizes the promotion efforts of profit-making ski and golf resorts.

Or what about Senate Appropriations Committee Chairwoman Susan Bartlett’s recent threat to close all the Interstate Highway rest areas and temporarily shut down the fish hatcheries? That’s money that could  be saved to help the poor and the sick, though in the case of the hatcheries several laws would first have to be changed; they are financed by hunting and fishing license fees and excise taxes on hunting and fishing equipment.

It’s good political tactics for the liberals not to endorse those cuts. Both the rest areas and the hatcheries are popular with middle-class constituencies. Setting them against the poor would be a risky move.

Barbara Postman, the policy coordinator for the “One Vermont” coalition fighting the budget cuts said her group didn’t want to play the “Don’t cut you, don’t cut me, cut the fellow behind the tree,” game, playing one interest against another

“We don’t have a spending problem,” she said, “we have a revenue problem. Before this economic downturn, the Governor signed off on this spending level. Now have a big drop in revenue. We (the “One Vermont” coalition) don’t have the capacity to analyze the budget at that intricate level” to say what else should be cut.

Perhaps nobody does. Try to find the Vermont State Budget, or the budget of any state agency on the Internet. It doesn’t seem to be available. It isn’t that the appropriations are secret. Through the Legislative web site anyone can find last year’s budget bills as passed, and see the appropriation for each agency.

But not a detailed, accounting of the item-by-item, function-by-function spending from year to year. On Thursday, the liberal Public Assets Institute and the conservative Ethan Allen Institute will unveil a new web site designed to make the Vermont budget process more transparent.

But their efforts will be limited by the information actually available from state government, which seems not to be much.

You don’t suppose some folks prefer it that way?