Blair Horner: Sequestration Comes to Albany

Feb 25, 2013

The nation faces its latest budget crisis resulting from gridlock in Washington.  On March 1, budgetary “sequestration” kicks in.  Barring an unlikely last-minute deal, about $85 billion is set to be cut from military, domestic and certain health care programs beginning this Friday.

Much of the federal government’s spending will not be immediately affected, which only magnifies the impact of the cuts on the rest.  Unless these cuts are reversed, federal spending that is controlled by the Congress will eventually fall to a new five-decade low.  Cuts of even larger size are scheduled to take effect every year over the next 10 years, signaling – as one pundit put it – an era of government austerity.

Throughout the government, the cuts would hit certain programs particularly hard without hurting others.  The National Institutes of Health, for instance, would need to cut about 5 percent of its annual budget in just seven months, meaning hundreds fewer research grants.

If sequestration goes into effect, it would also cut funding for the Centers for Disease Control and Prevention’s colorectal, breast and cervical cancer screening programs.  The Colorectal Cancer Program currently provides funding to 25 states – including New York State – for implementation of colorectal cancer education, awareness and screening programs for low-income and uninsured men and women.

The National Breast and Cervical Cancer Early Detection Program provides breast and cervical cancer screenings, information, and follow up services to women at highest risk – especially poor, low-income, and racial/ethnic minority women.  The program is offered in all 50 states.

In New York State, those services are administered by the Department of Health.  The Health Department offers screening and early detection of breast, cervical and colorectal cancer to women and men who are under- and uninsured for more than twenty years.  Those services are offered through the Cancer Services Program (CSP).  The CSP’s budget is supplemented by state funds.

For those who qualify, the CSP provides clinical breast exams, mammograms, pap tests, pelvic examinations, colorectal cancer screening, surgical consultation and diagnostic testing to people without health coverage in every county of New York State.  And while the program has screened tens of thousands of people, even at current funding levels the New York State Cancer Services Program is able to help fewer than 20% of the women who don't have insurance and can't afford a mammogram.

Despite that fact that federal support for these programs may be cut significantly, Governor Cuomo’s budget proposal further jeopardizes funding for the state’s Cancer Services Program.  The governor proposes the elimination of the current specific line item appropriation for CSP, and instead consolidates its funding with 14 other public health programs and then cuts the aggregate funding by 10 percent. 

That cut’s impact is deepened by the federal cuts resulting from sequestration.

Detecting cancer early increases the chances of successful treatment, improves survival rates, and saves New York in overall medical costs.  For example, research shows that the earlier breast cancer is detected and treated, the better the survival rate. When breast cancer is diagnosed when the tumor is localized and has not spread the 5-year survival rate is 99%.  Yet, uninsured patients are less likely to get recommended cancer screenings and are more likely to be diagnosed with cancer at later stages.  For example, uninsured women diagnosed with breast cancer are 2.5 times more likely to have a late stage diagnosis than women enrolled in private health insurance.

Now is not the time to cut state spending on cancer services.  Hopefully, state lawmakers will decide that investing in cancer screening programs not only saves lives, but helps reduce state medical costs as well.  Here is hoping that the state’s final budget sees a boost for cancer screening, not a cut.

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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