[NYAPRS Enews] TU, AP: Early Budget Word Spells Some Health Cuts, Less in Education

[Harvey Rosenthal]

Trim Budget For Lean Times 

Governor Plans Cost-Cutting Measures From Health Care To Education
Sectors  

by JAMES M. ODATO, Albany Times Union   January 20, 2008 

 

ALBANY -- Gov. Eliot Spitzer on Tuesday will release a budget plan that
shaves about $1 billion from health care costs, diminishes scheduled aid
for education and adds several new taxes and fees, people briefed on
some of the details said Saturday.

 

Spitzer's second budget will come with several belt-tightening measures
necessary to deal with a $1 billion upstate revitalization program to be
paid for with borrowed funds, these people said.

 

The governor will put almost every spending sector on a diet except for
criminal justice and homeland security, according to an informed person.

 

....Here's what people briefed on details said can be expected:

*	Funds to meet previous commitments, such as property tax
rebates, will be included but not necessarily at the levels planned.
*	The health care spending strategy is aimed at encouraging
primary and preventive care by boosting outpatient Medicaid
reimbursement rates and cutting inpatient rates, while substantially
slashing prescription drug costs paid to drug companies.
*	The plan calls for greater taxation of health care insurance,
tightens costs on pharmaceuticals for Medicaid patients, and reduces
Medicaid rates paid to hospitals, nursing homes and home care providers.
*	Most of the roughly $1 billion in savings, new revenues and cuts
in health care would be borne by drug companies and health plans, and
would make medical insurance premiums more costly for individuals and
employers.
*	In education spending, a planned $1.25 billion in aid under
Spitzer's program to send extra money to distressed school districts
will be cut potentially by as much as a few hundred million dollars,
according to those familiar with the public education budget.

 

....Laura Anglin, Spitzer's budget director, said this year's revenues
will be $500 million lower than projected in October, which forced
agencies to cut back, and next year's revenues will be $700 million
lower. A budget gap of $4.4 billion will have to be closed.

 

The budget adopted last April was about $121 billion.

 

....People familiar with the education budget say Spitzer will discuss
the importance of leasing the state Lottery to achieve higher-education
priorities, such as hiring 2,000 more faculty members over five years.

 

The Lottery deal, which would take at least a year to deliver, would
help set up a $4 billion endowment for higher education spending while
also providing a trust for k-12 education funding.

 

....Spitzer, who said he would not raise taxes, will plan for $200
million from sales taxes from American Indian stores, although
implementation of the tax law on the Indian retailers is uncertain.
Other "corporate loopholes" would be closed, such as requiring payments
of a corporate franchise tax and taxation on investments in out-of-state
real estate investment trusts, sources said.

 

The budget, those briefed said, will include a premium tax on health
maintenance organizations. HMOs tend to pass such costs onto companies,
including many small businesses. An increased tax on health insurance
policies, which raises premium costs, is also budgeted, a source said.
Fees on banks and insurers would climb to help support the budgets of
the state banking and insurance departments.

 

The governor's budget is expected to expand the preferred drug list.

 

Spitzer's methods of cutting costs will be across the board so various
sectors of the health care industry take some of the brunt, people with
knowledge of the process said. The state would also book savings from
cutting excess health care beds. 

------------

 

Spitzer Health-Care Plan Could Ease Overcrowding

By ANGELICA A. MORRISON   Utica Observer-Dispatch   January 19, 2008

 

UTICA - The governor's plan to revamp the state's health-care payout
system could send more low-income residents to family doctors for minor
illnesses instead of to local emergency rooms, state and local leaders
say. 

 

When Gov. Eliot Spitzer unveils his 2008-09 budget on Tuesday in Albany,
it should contain details on how he proposes changing the way New York
reimburses hospitals and doctors for services. 

 

..."If it means that there will be more people who will have access to a
primary physician, then that's wonderful," said Lucille A. Soldato,
commissioner of social services in Oneida County. "Increase the number
of providers, and increase the number of specialists - that would be
wonderful as well." 

 

The governor's plan could mean: 

* Shorter waits for low-income families, since it can take hours to be
seen in an emergency room. In addition, if fewer people go to the ER for
minor illnesses, overall waiting times might decrease. 

* Treatment and prevention by neighborhood doctors of chronic
health-care problems, including asthma, diabetes, HIV/AIDS, hypertension
and stroke. 

* Lower government health-care costs, since treatment at a doctor's
office generally is less expensive than at a hospital emergency
room..... 

 

The current system for reimbursing doctors in the pay-per-visit Medicaid
and Family Health Plus programs hasn't been updated since 1981, said Dr.
Richard Daines, the state health commissioner. When primary care doctors
are paid a fee that reflects the service they deliver, patients will
have more options, he said. 

 

While managed-care programs tend to pay doctors about the same amount
that private insurers pay, a doctor treating a Medicaid patient under
the pay-per-visit system receives $67.50 per visit, whether it's an
expensive, complex treatment process or a simple booster shot, Daines
said. 

 

"If we are able to pay higher rates to primary care doctors, it will be
easier to find a family doctor," Daines said. 

 

Contributing: Valerie Bauman, The Associated Press.

--------------

 

Spitzer health-care plan: Reactions

Utica Observer-Dispatch   January 19, 2008

 

Gov. Eliot Spitzer proposes revamping health-care payouts to help drive
low-income families to primary-care physicians instead of to the
emergency room. 

 

Supporters 

Patient advocates like the proposal. "The most serious and most
expensive health care problems that New Yorkers face - asthma, diabetes,
HIV/AIDS, hypertension, stroke - these are things that can be treated
and sometimes prevented if you've got strong, community-based primary
and preventive care," said Michael Kink, legislative council for Housing
Works, an organization serving low-income people and people with
HIV/AIDS. "We shouldn't be waiting until people get really sick and
incur really kind of high-cost, high-complexity illnesses. 

"If you've got a Medicaid card in your pocket, you're going to see more
primary care doctors in your neighborhood," Kink said. "You may see
doctors sooner." 

 

Expressing concerns 

Hospitals support providing preventive and outpatient care but are
apprehensive about the transition. Hospitals and health-care providers
tend to have very small profit margins, and changes in reimbursements
raise concerns that if primary care physicians are paid more, other
specialties could be paid less, said William Van Slyke, spokesman for
the Healthcare Association of New York State. "Any reduction, period, in
health-care reimbursement increases the challenge of providing community
care," Van Slyke said. 

 

State's view 

Officials at the state Health Department said data suggests some
providers might not be thrilled with the changes, but most would find a
balance between procedures paying more and those paying less. "A year
ago, I was one of those hospital executives waiting to hear what the
budget would do, so I've been on that end of it," said Dr. Richard
Daines, the state health commissioner. "So it's a perspective that I've
brought that there are rates of change that can be tolerated and there
are bottom-line issues. We're sensitive to those."

 

http://www.uticaod.com/homepage/x469079790 

 

------------

 

Spitzer's Budget: State School Aid Rises, But A Fight Expected

By MICHAEL GORMLEY   Associated Press   January 20, 2008

 

Gov. Eliot Spitzer's state budget proposal on Tuesday that must will
deal with a deficit and declining revenues is expected to ignite a fight
with the Legislature because it includes less of an increase for New
York City and suburban schools than local officials had expected. 

 

School districts statewide will see an average increase of about 7.5
percent in state aid for daily operations and construction under the
budget Spitzer will present on Tuesday. 

 

New York City schools will get $8.1 billion in state school aid under
Spitzer's 2008-09 budget proposal, compared with about $7.5 billion this
year, according to a Spitzer administration briefing. That includes $490
million more in operating aid, the money used to run the schools day to
day, or about a 7-percent increase over current operating aid. 

 

....The Democratic governor's plan appears to give Long Island about 8
percent of the state's increase in school aid, compared with the 12.9
percent of the increase in aid they typically have gotten. That would
likely set off another battle between Spitzer and Senate Republican
leader Joseph Bruno, who are still trying to decide if they can work
together and avoid the sort of conflict that has gridlocked much of
Albany since June. 

 

...The biggest hit from state aid will be in what is considered the
low-needs or wealthier suburban districts, many of which are in
Westchester and on Long Island...

 

www.newsday.com/news/local/wire/newyork/ny-bc-ny--statebudget0120jan20,0
,1983585.story 

 

 

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