Bush’s 2003 Federal Budget - Another Giant Sucking Sound

By: Dr. Erik Steele

Q: What weighs four pounds and is going to hurt about 100 million people?

A: President George W. Bush's proposed 2003 federal budget.

The 2003 federal budget proposed by President George Bush should look like different things to different people, none of them good for the health of most of us.

For those Americans wealthy enough to have benefited most from the tax cut and not need Social Security or Medicare, the proposed 2003 budget looks like hot wax on the Cadillac. The budget will cut social programs, cut Medicare, cut job programs, lock in the rest of the Bush tax cut plan of 2001, and spend an additional $48 billion on "homeland defense". If nothing else this country will be safer for nights out at the club. Yah, baby!

For the poor, the chronically ill, the working class and the non-wealthy elderly, the proposed federal budget should look like a laser-guided smart bomb dropped on them from about 30,000 feet. For the baby boomers it should look like a giant vacuum cleaner; combined with full implementation of the 2001 tax cut, the proposed budget is going to suck cash out of the Medicare and Social Security trust funds they will start needing in six years, when the first baby boomers retire. Up the hose will be Medicare and Social Security money necessary to take care of retiring baby boomers, any real chance of a Medicare prescription drug benefit and big chunks of the safety net that stands between many elderly Americans and disaster.

In developing the budget, President Bush had a few problems; the 2001 tax cut, the economic downturn and the new costs of protecting this country against terrorist threats. The result of those events has been a big increase in federal costs, a whopping decrease in federal revenues and a president with few options.

Option One is to scale back the tax cut, which the President is loath to do despite the fact that it is now unaffordable and even a drunken sailor would not spend like that in the face of the new financial realities. He is loath to do it despite the fact that those getting taxes cut the most need cuts like the Enron Corp. needs another shell subsidiary. He is loath to do it because a president whose No. 1 campaign contributor in the last presidential campaign was Enron knows that rollback of a tax cut which primarily benefits his wealthy corporate and public constituency is spelled:

Option Two is to cut back dollars for defense, which he wants to do less than a chicken wants to become acquainted with KFC. This is true despite the fact that the $48 billion increase for the defense budget, while described as necessary for homeland defense, is larded with high-priced weapons systems that have more to do with pork than safety. A budget not balanced on the backs of those who can least afford it will require some combination of Options One and Two.

Option Three is what Senate Majority Leader Tom Daschle described as the Enron budget maneuver, in which big cuts are hidden in budgetary shell games and constituencies with no clout. The cuts are passed on to the future in the form of raided Social Security and Medicare trust funds, and to the poor and the working class in the form of social program cuts. They are passed on to the middle class, which will see its health care costs after retirement covered less and less by a Medicare system that has inadequate funds.

The cuts will be borne by those whose voices cannot be heard above the powerful, voices like that of Enron, which paid no corporate income tax in four of the last five years and had a $220 million tax break written into the proposed Republican economic stimulus package. The 2003 proposed federal budget is Option Three, the Enron budget.

The biggest impact of the President's budgetary and tax-cut approach may be felt in American health care. The budget-busting combination will require cuts in the public health and social programs that are so crucial to the health of the poor. It will require huge cuts in Medicare and Medi-caid, including cuts in patient benefits or increases in co-payments, payment cuts to hospitals and doctors (self-interest alert — I am a doctor who works for a hospital).

It will mean further shifting of the unreimbursed costs of caring for Medicaid and Medicare patients to private insurance, and no legitimate prescription drug benefit for Medicare patients.

President Bush needs to defend not simply those threatened by terrorists, but all of those threatened by the terror of poverty and unaffordable health care. He can only do that in the new budget by standing up for someone other than the Enrons of the world, rolling back the tax cut and cutting defense budget pork. We should tell our U.S. senators and congressmen to help him do that.