by Phyllis Vine
Bush administration proposals would sharply reduce programs for people with mental illness or substance abuse disorders. “Unrealistic,” is how Sen. Max Backus (D-Mont) chair of the Finance Committee described the overall budget recommendations. “We cannot solve the problem of growing health care cost on the backs of seniors, people with disabilities, and the poor.”

The Bush budget, which proposes to trim $2.8 billion from a $3.1 trillion budget, is described in sanitized formulations. With language evoking a sleek business plan, it is remarkably devoid of the impact on people. The administration calls it “a true marketplace for health care.” Phrases such as “improved efficiency,” “competition,” or the “stewardship of [America’s] tax dollars” pepper the document.

Whatever language it employs, the proposal shreds programs underwriting real recovery for people.

For the 84 millions suffering from mental illness and substance abuse disorders, $79 million is cut from prevention and $126 million from mental health services. Bush cites “manicures” --reminiscent of Ronald Reagan’s provocative ploy describing Cadillac-driving welfare mothers -- as a reason to de-fund Recovery Community Services Program.

Some spending stays flat, such as the $29 billion allocated for the National Institutes of Health, the premier government engine for research. Flat funding actually retards promising bench research and numerous clinical studies leading to evidence-based findings on which successful treatments and programs depend.

A few areas are slated for increase, such as the 5.7 percent hike for the FDA. Given revelations of an agency on the brink of dysfunction, incapable of adequate inspection of foreign and domestic factories, obsolete information systems, and almost no post-marketing surveillance (including for generic drugs which are now replacing branded medications used in psychiatric treatment), some doubt this is a sufficient increase. Programs teaching sexual abstinence are slated for a $28 million, or 17 percent, increase to $191 million. And faith-based programs for community services are slated to receive an additional $98 million.

Swift responses have come from many quarters. Rep. John D. Dingell (D-MI), Chairman of the Committee on Energy and Commerce, issued a scorching remark, saying the budget is a “plan that will result in more State budget short-falls, more uninsured Americans, and an even more severe national health care crisis.”

David Shern, CEO of Mental Health America, noted the inconsistency between the president’s retreat and the bold recommendations in the President’s New Freedom Commission on Mental Health. Medicaid cuts “abandon many low-income Americans who need the critical support Medicaid provides,” Shern said.

The Alliance for Retired Americans pointed out that cuts to Medicare accompany boosts to private insurance companies. In a press release issued Feb. 4, it noted that

At the same time as these proposed cuts, the Bush administration continues to stand by its subsidies to large insurance companies “estimated to be $150 billion over the next ten years” to operate privatized Medicare Advantage plans at a cost between 12 and 19 percent higher than allowing Medicare to directly serve these same people. This siphons away badly-needed money from the Medicare Trust Fund.

In addition to cuts for mental health, the budget slashes funding for the Centers for Disease Control and the Administration for Children and Families, and eliminates funding for training doctors for work in children’s hospitals.

Controversy is likely to continue as congressional hearings pick up and 2008 candidates weigh in on health care. But insofar as this document symbolizes the administration’s ideas about what's need to help vulnerable people, it explains why the public is keenly looking for health care reform.