My dear friends Manny Cruz and Valerie Revering are featured in a compelling New Times article by Amy Silverman. It’s about their 5 year old daughter Jessica, known to everyone as Rocky, and their ordeal trying to get her the extensive and comprehensive care she needs.

And so when Rocky’s mom, Valerie Revering, told Sue Johnson she was applying for ALTCS (Arizona’s Long Term Care System, the state’s version of Medicaid services — including everything from access to speech and other therapies to state health insurance and even babysitting assistance), it never occurred to Johnson that Rocky wouldn’t qualify. By law, a child must have one of four conditions severe enough to require institutionalization: cognitive disabilities (until recently, referred to in the law as mental retardation), cerebral palsy, autism, or epilepsy.

Rocky didn’t qualify. Twice. As of press time, Revering was awaiting the ruling of an administrative judge who heard the family’s appeal in early May. Even if the judge agrees with the family — which is unlikely — the final decision is in the hands of state bureaucrats.

This is the direct result of state budget cuts, which were the inevitable outgrowth of decades of lawmakers in the thrall of Republican trickle down fantasy economics. This season they’re all doubling down on the market fundamentalist hooha. It is imperative, we are told by one after another glib business-suited talking head these days, that government is best when run by Business Leaders^TM with Private Sector Experience^TM. David Sirota took that canard apart in a recent Salon piece:

Among the most insulting memes in the national debate about government are those about leadership — in particular, the three-pronged notion that assumes that 1) running a public institution requires no public-sector experience at all, 2) public sector experience is something inherently bad, and 3) a public institution will actually benefit from an infiltration of business executives, because those bare-knuckled suits will “run government like a business.”

Bizarre as it sounds in the post-financial-meltdown era — how can anyone want a Wall Street executive running anything? — the idea persists, and with few real challenges to its fundamental premises. Indeed, the leading candidate for the Republican nomination, Mitt Romney, is a guy with just four years of experience in government (far less than even President Barack Obama had when he ran for president) — a guy whose entire candidacy is predicated on the notion that only the ruthlessness and know-how of a private equity barbarian can get the government to start doing what needs to be done.

The unasked question, of course, is whether there is any truth to those assumptions. That question raises other uncomfortable ones, such as: What actually happens when corporate executives with zero relevant experience run public institutions? And what do those institutions do when said executives run them “like private businesses”?

Sirota draws from examples in his home state of Colorado of “government run like a business” going predictably awry to argue that:

…public administration is a professional expertise unto itself — one whose nonprofit mission, obligation to taxpayers, and responsibilities to the common good are fundamentally different from the private sector’s objectives.

But this isn’t only about the people who get elected and the beliefs that guide them – in the case of Business Leaders^TM the belief that government exists to enrich them. It’s also about who has influence at the state capitols and Congress. It’s true that there are brave and wonderful people advocating passionately at those institutions on behalf of our most vulnerable citizens, like Rocky Cruz. But they don’t hold a candle, influence-wise, to the vast assortment of corporate lobbyists, anti-tax cultists, rich egotists, and other ruthless barbarians pushing their wish lists on captive legislators. The limitless needs of these Masters Of The Universe^TM are crowding out those of the 99%. And to a large extent it is intentional.

You can see how awful this all is in this comprehensive 2011 report, After the Dust Settles, by St. Luke’s Health Initiatives.

The cuts that have occurred to date are beginning to take their toll on people – especially our state’s most vulnerable children and adults, such as people with behavioral health conditions and children with special health needs. Oftentimes, these people depend on publicly administered care. In part, this is because health coverage for people with chronic health conditions is often inaccessible or inadequate, and healthcare costs associated with their care are often out of the range of affordability for even middle-income families. It is also because people with complex conditions require coordinated systems of care – systems that the state has historically played an active role in creating.

If they can’t cut it in this glorious new government-run-as-a-business, they can go ahead and quit! Oh wait, they can’t.