Sean Philpott: Fight or Flight

May 2, 2013

I travel a lot for work. It’s the rare week when I’m not on the road or in the air to attend a conference, give a talk at some symposium, or serve on some panel or commission. In fact, if you’re listening to this commentary as it airs on the radio, I am likely on a plane cruising at 32,000 feet somewhere between Albany and Washington, DC. Given this grueling travel schedule, I was less than thrilled to hear that the federal budget sequester would affect air travel across the US.

Part of the Budget Control Act passed in 2011, the sequester mandates $1.2 trillion in across-the-board cuts over the next decade if Congress could not reach agreement on a budget before March 1st. Needless to say, our leaders weren’t up to the task. Despite vocal opposition from Republicans and Democrats alike, what was intended to be a measure of "last resort" to cut federal spending became the law of the land.

The sequester includes $85 billion in spending cuts before the federal fiscal year ends in September, or approximately 5% of the budget of federal agencies like the National Institutes of Health, the Internal Revenue Service, and the Social Security Administration.  The Federal Aviation Administration (FAA), the agency that manages and controls the flow of traffic in the nation’s skies, is slated for over $600 million in sequester-related cuts.

Given that nearly three-quarters of that agency’s budget is spent on salaries for air traffic controllers, air safety inspectors and technicians, FAA officials concluded that the only way to achieve $600 million in cuts was to furlough some air traffic controllers and to close some control towers.

Furloughing controllers and closing some towers, however, also requires that the number of flights also be reduced to a level that could be safely managed by the remaining staff. Flight delays of two or three hours in most major cities were predicted, slowing the flow of commerce and inconveniencing large numbers of travelers.

Apparently, the thought of irate businessmen being inconvenienced by flight delays was enough to get Congress to act. Late last week, both the Senate and House voted to end sequester-imposed furloughs of air traffic controllers. But while we jet setters are cheering, this vote illustrates exactly what is wrong with Washington. Cuts to programs that annoy but don’t really harm affluent Americans spur our leaders to action, but cuts that adversely affect the health and wellbeing of poorer Americans are largely ignored.

For example, the sequester requires Head Start – a federally funded educational, health and nutritional program for disadvantaged children – to slash its operating budget. Studies have shown that children enrolled in Head Start are less likely to need special education services, less likely to repeat grades and more likely to graduate from high school. But this year alone, sequester-related budget cuts have forced Head Start programs around the country to ratchet back on day care and transportation services, reduce the number of meals provided to needy preschoolers, and even cut eligible families from its rolls. An estimated 70,000 fewer children will receive services this year as compared with 2012, further swelling the ranks of America’s underclass.

Meals on Wheels – a network of volunteer programs that provides over one million meals daily to elderly or disabled individuals – faces similar cuts. Over a third of all funding for these programs comes from the federal government via money provided under the Older Americans Act. As a result of sequester-related cuts, some Meals on Wheels programs have been forced to cut the number of meals provided and to start waiting lists for seniors who qualify for assistance.

There are dozens of similar examples of how the sequester affects the lives of the less fortunate: cut in benefits for the long-term unemployed, fewer housing vouchers for low-income families or people with disabilities, reduced access to life saving medications for those living with HIV/AIDS. The list goes on and on.

To put it bluntly, the sequester is bad policy. A game of political chicken gone awry, it has had a negative impact on a variety of largely successful federal programs. So why hasn't Congress acted until now? Why hasn't Congress ended the sequester, other than addressing the minor inconvenience of airport delays?

The reason is that Washington, DC, is no longer an example of "Government of the people, by the people, for the people." The poor and disadvantaged don't vote, they don't call their Congressional representatives to complain, and they don't donate to political campaigns. Wealthy businessmen do. Until that changes, the costs of the federal budget battle will be borne primarily by those who can afford them least.

A public health researcher and ethicist by training, Dr. Sean Philpott is Director of Research Ethics for the Bioethics program at Union Graduate College-Icahn School of Medicine at Mount Sinai in Schenectady, New York.  He is also Acting Director of Union Graduate College's Center for Bioethics and Clinical Leadership, and Project Director of its Advanced Certificate Program for Research Ethics in Central and Eastern Europe.

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