Governor Cuomo last week unveiled his proposed $140-plus billion budget for New York State. The goals of the governor’s budget were to close a $1 to $2 billion deficit without raising taxes, as well as to offer his blueprint for spending federal dollars expected to flow to New York to rebuild after Superstorm Sandy.
On the health front, there was some good news: the governor proposed full implementation of the federal health care reform law – aka Obamacare – and to expand Medicaid coverage to tens of thousands of uninsured New Yorkers.
Yet the governor’s budget masked a dark secret: his plan to secretly slash the state’s investments in public health programs, even those programs battling cancer.
Here is what we know: it is estimated that nearly 110,000 New Yorkers will be diagnosed with cancer in 2013 and that over 34,000 will die. We know that four cancers – lung, breast, colorectal and prostate – account for roughly half of all cancer diagnoses and half of all cancer deaths. Lung cancer is the number one killer, accounting for a quarter of all cancer deaths.
We know that pockets of New York State have higher-than-the-national average lung cancer deaths – areas in upstate New York and areas which consist of the urban poor.
And we know that New York’s primary mechanisms for dealing with cancer are woefully underfunded. The state’s program to keep kids from using tobacco and help smokers to quit has lost 50 percent of its funding over the past few years despite the state raising over $2 billion annually in tobacco revenues.
The New York State Tobacco Control Program has been proven effective in reducing the number of women and men who smoke and the number of children taking up this deadly addiction. The rates of adult and teen smoking in New York have fallen at a faster rate than the United States as a whole. The program is independently reviewed and those reviews have concluded that the program is responsible for significant public health improvements. In addition, the review has most recently identified the program’s single biggest weakness – dwindling state support.
Another underfunded program that battles cancer is the state’s Cancer Services Program (CSP). The CSP is the program to offer free breast, cervical and colorectal cancer screenings for the uninsured New Yorkers. Yet, at current funding levels, the CSP only reaches 20 percent of the eligible population.
So, what does the governor propose to strengthen these programs? Instead of openly itemizing the spending for these cancer programs, the governor instead proposes to lump these two programs together with other public health programs into one appropriation of state money. Sort of a block grant for public health spending.
Thus, it is nearly impossible to know how much money will be made available for any one of these public programs. The governor’s argument for this move is to make the programs more efficient by allowing him to coordinate public health efforts. For example, we know that poor nutrition can cause both cancer and diabetes. Why not ensure better coordination of these programs? Of course, such an argument seems – on its face – to be reasonable. Who could argue against more efficiency and better coordination?
But the governor then takes one additional step that shows his true motives – he proposes a deep cut in the aggregate spending for all of these programs. The impact is clear: advocates for public health programs cannot get answers as to whether their programs are taking a budget hit since the cut is being proposed in the aggregate, not in a specific program. Which program gets cut and how deep those cuts will be is left to the discretion of the Administration. The move is quite clever, without public details, concerns over the impact of the governor’s plan are muted and any opposition is hard to mobilize.
But the impact on real people is a bad one.
New Yorkers should be very concerned that this budget will cut lifesaving programs. If that’s the goal, then the governor’s budget plan will mean one thing – more people will suffer from the consequences of getting cancer and other terrible diseases.
Anyone who cares about the public’s health should urge the legislature to ensure that these important programs are bolstered, not slashed.
Blair Horner is the Vice President for Advocacy for the American Cancer Society, Eastern Division. His commentary does not necessarily reflect the views of the American Cancer Society.
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