By LILLIAN ROBERTS
Executive Director
District Council 37, AFSCME

Budget proposals are windows into the political souls of our elected leaders. More than any speech, spending plans give us a clear view of their character and priorities. Every politician says they believe in better health care — but if you want the truth, you have to check their budgets to see where they are putting our money.

In his new federal financial plan, President George W. Bush again funds warfare and starves health care to pay for his macho adventures abroad. He is generous to the generals and stingy with education and health services for the poor and middle class. Bush’s budget even underfunds the federal veterans’ hospitals that care for the brave women and men who fight his war and come home with shattered bodies, damaged brains and combat-stressed minds.

Here in New York City, the Bush plan would slash a devastating $570 million per year from our public hospitals — about one-eighth of the budget of the Health and Hospitals Corp., where about 17,000 of our members work.

The Bush administration is trying to impose new Medicaid payment rules that would take $350 million from HHC’s public hospitals, where every year our members help handle 5 million clinic visits, 1 million emergency room visits and 21,000 births.

Another Bush cut would cancel $200 million that trains interns and residents — the doctors of the future — who provide medical services to patients. With New York City medical schools and hospitals supplying one-half of the nation’s doctors, cutting these funds shows utter disdain for the future quality of medical care in our country.

And rather than helping state children’s insurance plans, such as New York’s Child Health Plus, so they could cover more uninsured children, the budget provides too little for currently enrolled kids and lowers the income eligibility standard, which will dump thousands of children into the ranks of the uninsured.

On the other hand, New York State Governor Eliot Spitzer is a leader whose health care budget tells us that he truly shares our strong belief in ‘Patients First.’

Every year for many years, we have had to build fight-back coalitions to protect the services HHC provides against state budget proposals that would have cut huge chunks out of public health care. This year, for the first time in recent memory, we have a governor who is not trying to devastate the services we provide.

Big improvement with Spitzer
This year we have a state budget that does not propose cutting services to Medicaid patients or to children in CHP, does not try to raise patients’ co-pays, and does not downsize, consolidate or close a single HHC facility.

Instead, Gov. Spitzer plans to redirect Medicaid funds to where they are most needed — to our public hospitals, where 85 percent of the patients are Medicaid patients. His proposed public hospital pool alone will yield another $43 million for HHC.

In sharp contrast to Bush, Spitzer plans to raise income limits so CHP can cover another 400,000 uninsured kids, expand Medicaid outreach programs to inform 1.3 million uninsured people that they are eligible, and streamline Medicaid enrollment and recertification by eliminating harsh, excessive documentation requirements so more patients can have continuous coverage.

In this budget, as in any budget, there are pluses and minuses, including a $32.5 million cut — tiny compared with previous years — which I expect we can work out with the Spitzer administration. But overall, the governor’s health spending plan is a positive break with the past, a major step toward health care reform.

Spitzer’s health budget is patient-centered. It focuses on primary care and follows the concept of Medicaid dollars following Medicaid patients, a sound and principled public policy. This is a plan we are proud to endorse.

Bush’s budget would overpay private Medicare plans but underfund the more cost-efficient traditional Medicare program. That telling discrimination in funding plus the president’s continual health cuts remind us of what’s wrong with our nation’s insurance-centered health care system.

Spitzer’s plan to make better use of the public’s funds for public health care at public facilities and to help uninsured people obtain Medicaid, would bring us a small but significant step closer to a universal government-funded system.

Bush’s budget, which we are fighting in Congress, would damage HHC and threaten our jobs, while Spitzer’s would help HHC. Bush’s plan emphasizes the worst of the current system. Spitzer’s looks toward a better world, where health care is a right, not a commodity that only the well-to-do can afford.