Kaiser Daily Health Policy Report Rounds Up Coverage of Reactions to Bush Budget Proposal
[Feb 06, 2003]

      Newspapers and advocacy groups nationwide in recent days have addressed provisions in President Bush's fiscal year 2004 budget proposal. Bush on Feb. 3 sent Congress a $2.23 trillion budget proposal for fiscal year 2004 that would create a $307 billion deficit in the next budget year and a deficit of more than $1 trillion over the next five years. Bush's FY 2004 proposal calls for a $6 billion "downpayment" on a 10-year, $400 billion Medicare reform plan that the president mentioned in his State of the Union address and in a speech in Michigan last week. The plan also includes a proposal that would reform Medicaid to allow states more flexibility in administering the program and would give states fixed allotments of federal funds. In addition, Bush's budget proposal includes $15 billion over five years to combat HIV/AIDS in African and Caribbean nations and $600 million over three years for a new substance abuse treatment program, which would provide vouchers that could be used at "faith-based" or secular drug treatment centers. The plan would raise NIH funding by 2% after several years of larger increases (Kaiser Daily Health Policy Report, 2/4). The following are summaries of several reactions:

Editorials

• Baltimore Sun: President Bush's budget proposal "shamelessly provid[es] ... many tax breaks for the wealthy," making it "more likely younger Americans will later bear much greater tax burdens" to continue to provide Medicare to "aging baby boomers," a Sun editorial states. The editorial concludes that Bush's proposals "mainly serve the economic interests of those with the very highest incomes -- for which the vast majority of us could be paying for generations" (Baltimore Sun, 2/5).
  
• Bangor Daily News: Bush "took several important steps" toward reforming Medicare last week: he made it part of his agenda, he recognized the need for a drug benefit and he conceded that such a benefit would require a large amount of money, according to a Daily News editorial. President Bush is "right" to recognize that Medicare is "growing unaffordable" and needs a prescription drug benefit, but his plan to offer a drug benefit to seniors who switch to HMOs is flawed because "there are good reasons" why many Medicare beneficiaries have not already switched to managed care plans, a Daily News editorial states. The editorial concludes, "The risks that [Bush's plan] will add a layer of corporate bureaucracy and allow the government to define its contributions instead of Medicare's benefits are too great" (Bangor Daily News, 2/4).
  
• Los Angeles Times: President's Bush's decision to discuss Medicare reform in a speech last week in Grand Rapids, Mich., was the "right choice" politically because "[s]eniors vote," but the true "national crisis" is that 41 million people "lack any kind of health coverage," a Times editorial states. The editorial concludes, "With his party controlling both houses of Congress, Bush cannot afford a continuously growing tide of working people with no health care coverage at all in what is still the wealthiest of industrial democracies" (Los Angeles Times, 2/4).
  
• Macon Telegraph: Although President Bush "seemed to propose" a Medicare reform plan that would offer a drug benefit in return for joining an HMO, even the lawmakers who support Bush "don't have a clue" on the details in the president's actual plan, a Telegraph editorial states. According to the editorial, House Majority Leader Tom DeLay (R-Texas) said critics of Bush's apparent plan "were wrong to suggest" that Medicare beneficiaries would be required to join an HMO to receive drug coverage. However, the editorial concludes, "If DeLay is right and [Bush's plan] is not an either or proposition, what is the plan? Privatizing Medicare -- or parts of it -- is not the answer" (Macon Telegraph, 2/5).
  
• Memphis Commercial Appeal: Although President Bush's budget proposal has "appealing elements," such as his proposal to provide $15 billion to fight HIV/AIDS worldwide, the plan would "mortgage the nation's future fiscal stability" and "distort the tax system today," a Commercial Appeal editorial states. The editorial concludes, "Congress needs to address -- and revise -- the White House budget accordingly" (Memphis Commercial Appeal, 2/5).
  
• Philadelphia Daily News: The Bush administration's plans for Medicare reform that discuss "choice" are "code for the ultimate privatization: the dismantling of Medicare," a Daily News editorial states. The editorial continues that it is "unfair" to attempt to "entice" seniors to join managed care programs by providing prescription drug benefits in return because more than 80% have elected to remain in the traditional fee-for-service program. According to the Daily News, in the short term, the Bush plan would result in a "two-tiered" system; in the long run, it would "end ... Medicare as we know it." The editorial concludes, "Medicare has worked well over four decades. ... Like anything else, it can be improved. But the best way to provide the prescription drugs that seniors need is to provide them as a benefit in Medicare" (Philadelphia Daily News, 2/4).
  
• Springfield Union-News: It is a "step forward" for the Bush administration to "acknowledg[e] the importance" of drug treatment by providing funding for treatment programs, but it "can't be lauded," because the funds could be used for treatment programs run by religious groups, a Union-News editorial states. The editorial asserts that "virtually everyone in the medical community" views religious groups' methods of drug treatment, including prayer, as "without merit." While a person's faith could mean "the difference between success and failure" in treatment programs, the use of faith in drug treatment is a decision for the person undergoing treatment, their counselor and a member of the clergy, "if desired." According to the Union-News, it is "most decidedly not a matter for the government to support, ... especially not with taxpayer money." The editorial concludes, "Having made that all important leap" to provide funds for drug treatment, the Bush administration "should stand firmly on that ground, seeing the afflicted and the addicted as fellow citizens who need help, who need treatment -- not as the enemy in some metaphorically dubious war, and not as people who need nothing more than a good dose of someone else's religion" (Springfield Union-News, 2/4).
  

Opinion Pieces

• Steven Findlay, USA Today: While a drug benefit for Medicare is "unquestionably needed," the expense of such a benefit "threatens to sideline" efforts to expand health insurance coverage to the uninsured, which is "unacceptable," Findlay, a health policy analyst, writes in a USA Today opinion article. According to Findlay, there are "significant ... obstacles" to enacting a Medicare prescription drug benefit and expanding coverage to the uninsured, because both are "expensive and complex reforms." However, Findlay recommends undertaking reform efforts for both issues this year -- "before the 2004 elections bog things down." Findlay proposes that Congress and the Bush administration commit to cutting the number of uninsured people in half by 2010 through a "phased-in expansion" of public health programs and tax credits to help families and small business purchase insurance. Further, Congress should enact a phased-in requirement for all Americans to have health insurance. Meanwhile, Findlay proposes Congress enact a Medicare drug benefit targeted at low- and middle-income seniors and seniors with high drug expenses that will eventually expand to all Medicare beneficiaries over time. Findlay concludes, "Bush and Congress should get started this year on creating such a future -- and not just for the country's seniors" (Findlay, USA Today, 2/6).
  
• D.J. Tice, St. Paul Pioneer Press: By announcing a "vague" plan to reform Medicare and add a prescription drug benefit, the Bush administration perhaps is being "coy" and attempting to foster debate on the subject, Tice, a Pioneer Press editorial writer, states in opinion piece. Tice notes that the subject of changing Medicare is "politically explosive," but that Medicare drug coverage is the "only train leaving the station." Tice concludes that a "frank debate over how to best control Medicare spending is necessary. Bush is wise to use the political appeal of prescription drug coverage to lure the country into one" (Tice, St. Paul Pioneer Press, 2/5).
  

Advocacy Groups

• American Cancer Society: Daniel Smith, national vice president for federal and state government relations with the ACS, said, "The budget ... is a grave disappointment to millions of people whose lives have been touched by cancer. After several years of strong and consistent growth in cancer and other medical research funding, the administration's proposed 2% increase for the NIH is effectively slamming the brakes on future progress" (ACS release, 2/3).
  
• American Heart Association: Bush's budget proposal "comes up short" in the fight against cardiovascular diseases, according to the AHA. "The President's 2% recommendation for NIH next year is essentially a no-growth budget, especially when you consider inflation and other demands on the agency's budget that can pull funding from much-needed chronic disease research, such as heart disease and stroke," AHA Chair Craig Beam said (AHA release, 2/5).
  
• American Legislative Exchange Council: The ALEC "welcomes" Bush's proposal to reform Medicaid. "Governors, state legislatures, taxpayers -- but most importantly patients -- are winners under the Administration's Medicaid proposal. States that choose this option will be afforded the opportunity to design patient-friendly programs," Duane Parde, executive director of ALEC, said (ALEC release, 2/5).
  
• American Public Health Association: Dr. Georges Benjamin, executive director of the American Public Health Association, said, "We fully support several initiatives the president outlined in his budget that will improve the health of people," adding, "Sustained support for public health preparedness, increases to reduce chronic diseases, expanded funding for community health centers and a new U.S. commitment to fight global AIDS represent some of the good news." Benjamin concludes, "But the budget also includes missed opportunities, and the good news should not come at the expense of other vital health programs" (APHA release, 2/3).
  
• FamiliesUSA: Ron Pollack, executive director of FamiliesUSA, said that Bush's budget "does not add up to the health care promises he made to the American people in his State of the Union address." He adds, "Unfortunately, $400 billion only covers a very meager share of seniors' prescription drug costs, which are projected to total $2 trillion over the same 10-year period." Pollack concludes, "The President's new proposal ... pressures seniors into choosing between the drug coverage they so desperately need and the doctors they have come to depend on" (FamiliesUSA release, 2/3).
  
• National Mental Health Association: Michael Faenza, NMHA president and CEO, said, "The NMHA is deeply concerned that the administration's budget for FY 2004 encourages states to cut benefits provided by Medicaid, while proposing virtually no increase in overall funding for community mental health programs under the Substance Abuse Mental Health Services Administration" (NMHA release, 2/4).

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