Albany reveals its ailment

YOU’VE FALLEN, AND MAYBE YOU’VE BROKEN something, so you go to the hospital. But uh oh, the hospital’s closed today. Sorry folks, the state cut the funds, and you’re out of luck.

Or maybe not, though the state did cut $775 million from healthcare spending this week.

The governor said it was the only way to keep the state afloat financially. The state budget is two months overdue, and every day without a spending plan the $9.2-billion deficit looms larger. In the absence of a budget, the governor must submit a weekly appropriations request to keep the state operating. The legislature could have rejected the governor’s request this week, but if lawmakers had taken that approach, it’s likely all but the most essential state services would have shut down.

This week’s game of political chicken between Governor Paterson and the leaders of the two houses of the legislature, all of them Democrats, got serious, because the governor’s request included healthcare funding for the whole year. In essence the governor gave lawmakers a choice: either adopt my annual plan for healthcare cuts or risk chaos. It looked like a major showdown except for one thing; the governor and the legislators had already agreed on the cuts before the vote.

The political drama may have been staged, but the emotion that greeted the healthcare budget was far more genuine. The head of the Hospital Association of New York State condemned the cuts, predicting that hospitals will close, patient care will suffer and more hospitals will become takeover targets of bigger competitors.

There’s only one hospital in Columbia County, Columbia Memorial in Hudson, and administrators there figure the hospital will see revenue drop by about $293,000 this fiscal year, much of it in funding for what’s called the “trend factor,” which affects the rate at which hospitals are reimbursed for certain types of care. There is also another place where funds will be slashed: care for poor people and those with disabilities. Those folks don’t have as many votes as middle class and wealthy people do.

The hospital’s financial chief, Vince Dingman, put the cuts in perspective this week, noting that Columbia Memorial has an annual budget of $130 million. Overall, the loss of funds from the state amounts to about 2/10 of a percent of spending by the hospital. So Columbia Memorial, which now operates with a slight surplus, won’t have to make major cuts that affect patients and services. But some nursing homes and other healthcare and public health programs will face painful choices.

Mr. Dingman says that the cut does threaten job creation and retention programs at the hospital. That’s not good news in a county where, though there are promising signs in the private sector, unemployment remains stuck at historically high levels. And the county has yet to feel the impact of all the teaching jobs that will disappear days from now as the school year ends.

And as if things aren’t tough enough, the federal government reportedly plans to renege on the promise in the original economic stimulus package to pick up more of the cost of Medicaid. As a result, states will be left holding the bag for higher than anticipated Medicaid costs.

Perhaps as early as next week, the governor will try to move the budget process ahead another step by bundling his school aid budget cuts into a weekly budget extension bill. And because legislative leaders appear to have no stomach for shutting down the government, they will dribble out another set of major spending reductions, hoping nobody will notice.

This cockeyed budget process wastes tax money by keeping lawmakers in Albany when they should have passed a budget long ago and gone home. And despite the charade meant to mask the deal on healthcare cuts, the principle of take-it-or-leave-it budget extensions opens a backdoor way for a governor to exercise a level of executive power that he would not have under normal circumstances. This sets a dangerous precedent that another governor might someday abuse.

How ironic that a lame duck, unelected governor has found a way to achieve the goals of fiscal austerity he has called for practically since taking office. But this approach amounts to governing by loophole and fluke, not through a functioning democratic system. The governor is the agent of the current misguided actions, but the fault truly lies with lawmakers. Their dysfunction is a symptom. Their problem is cowardice.

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