There’s a lot of discussion in Charleston this week regarding the consequences of some proposed cuts in the state’s health care budget.

Some programs, like the CARDIAC Project, which aims to reduce heart disease and diabetes, would see budget cuts of 30 percent. Others, like the West Virginia Center for End-of-Life Care, would close their doors altogether under proposals made by Health and Human Resources Secretary Patsy Hardy.

Members of the House Finance Committee sparred with Hardy over the proposals, with some legislators reviving the idea of breaking down the DHHR into smaller parts.

We think it’s as good a time as any to revisit the idea proposed more than a year ago by Sen. Brooks McCabe, D-Kanawha.

Over time, the DHHR has become a giant octopus with tentacles spread in every direction, overseeing everything from foster care to public assistance for indigent families to end-of-life care.

Layers and layers of bureaucracy stand between proposals and policies and the administering of programs under one huge umbrella.

Maybe it’s time for health care to become a separate entity. After all, when you consider all the ramifications to changes in the Medicaid or Medicare programs alone, it staggers the imagination to consider the multiple strands of red tape required to oversee all the current DHHR agencies.

Proponents of budget cuts say there are duplication of services, and that probably is the case. Wouldn’t it make more sense, for example, to directly fund agencies such as the American Heart Association or the American Diabetes Association to administer programs targeted to specific health issues? Instead, when other agencies initiate similar programs, the amounts of money to be distributed are thinned out by overhead costs.

We have no doubt those programs are vital to reducing the risks of some of the most troublesome health concerns in this state, but maybe it’s time to take a good look about how much good we’re doing.

When it comes to end-of-life care, Hardy says the center dedicated for this purpose provides information on legal directives and hospice care to tens of thousand of West Virginians. However, the center may have served its purpose. End-of-life information is available through hospitals and hospice services throughout the state. Money funneled directly to the agencies providing those services might be better spent than continuing to fund a central agency.

There’s no question a tightening of the budgetary belt has to happen. This is a prime time to examine areas where more money is going into bureaucracy than into the services. This may be a case where lawmakers need to start at the top and work their way down.