Monday, February 07, 2005

The eve of (self) destruction

The New York Times (byline Robert Pear) reported on Saturday that the Bush budget will cut a wide range of public health programs, including those in biodefense. This is the irony of the Bush national security image: he will make us inherently less safe with policies that may last decades and endanger the next generation, physically. As Aunt Deb notes in the comments to a previous post, there is still a lot of back-and-forth before there is a final budget, but given the weakness of the public health lobby these days I am not optimistic much of this will get restored.

Some of the public health budget is internally contradictory, which is not a surprise. Thus there is a request to expand the Strategic National Stockpile of vaccines and pharmaceuticals to be used in the event of a terrorist event but the budget for centers to help state and local agencies prepare for a bioterrorist attack is cut 12.6%.

The program for disease prevention would be cut 6.5%. This includes the obesity program. Block grants which provide $131 million in preventive health services to "address urgent health problems" would be eliminated. The NIH budget would increase by 0.7%, but research costs are rising at 3.5%/yr, so this amounts to a 2.8% net cut for NIH. Here is some more of The Times info:
  • The budget for training nurses, dentists and other health professionals would be cut 64 percent, to $160.5 million in 2006. The president would cut $100 million, or 33 percent, from a $301 million program that trains doctors at children's hospitals.
  • Mr. Bush seeks a $38 million increase in programs promoting sexual abstinence, which would bring the total to $192.5 million in 2006, an increase of more than 50 percent since 2004.
  • The Low-Income Home Energy Assistance program, which helps people pay their heating bills, would be cut 8.4 percent, to $2 billion. High prices for home heating oil make this a particularly contentious proposal.
  • The Centers for Disease Control would receive $306 million, a 4.2 percent increase, for global health activities, including work on AIDS.
  • Mr. Bush requests $120 million to deal with the threat of a global flu epidemic. That represents an increase of 21 percent.
Also gone is a program for treatment of traumatic brain injury, and interestingly, a small ($9.9 million) program to collect umbilical cord blood stem cells at childbirth. So even stem cells that don't have the ethical problems that concern some bioethicists are being stricken. Once a stem cell, always a stem cell, it seems.

The increase to deal with a global flu epidemic is welcome, but pitifully small ($120 million, total). To put it in perspective, the increase in the IRS budget to police compliance with tax laws (which no longer involve the rich, remember) is $500 million, i.e., the IRS increase just for this one aspect of its program is more than four times larger than the entire global flu budget item. The only word for this kind of behavior is self-destructive.

Well, maybe not the only word.