New York’s Heated Health-Care Battle

In the increasingly heated battle over health-care funding in Albany, health interests are using plays from their traditional playbook, while Gov. Eliot Spitzer is employing some new and unusual tactics.

Hospital lobby groups brought some 3,000 workers to the Capitol to protest more than $1 billion in spending reductions proposed by Spitzer in the state budget due April 1. The hospital groups and powerful health-care unions have also paid for television ads criticizing Spitzer’s plan, saying it’s all about cuts and not true reform of the health-care system, as Spitzer has argued.

These tactics have proved successful in the past. Similar ads and shows of force persuaded the Legislature in years past to reject health cuts suggested by former Gov. George Pataki.

But Spitzer, now infamous for reportedly referring to himself as a “steamroller,” shows no sign of weakening his health-care position. Instead, he’s tried to bolster his case by holding news conferences with patient groups that support his plan and running his own ads poking fun at the health-care lobby by insinuating they are crybabies (the ad features crying babies).

Spitzer even made a direct appeal to hospital board members, writing to trustees across the state urging them to support him over the interests of the health-care lobby. And he’s been “in your face” about hospital and union budgets, suggesting that high executive salaries and the millions that health-care interests spend on campaign contributions and lobbying undermine health care’s cries of poverty.

But health industry and union leaders are good friends of the Legislature, and leaders of both houses have spoken critically about Spitzer’s cuts. Senate Majority Leader Joseph Bruno, speaking to workers at their Capitol rally, said he will probably block Spitzer’s plan to freeze reimbursement rates to hospitals and nursing homes under the Medicaid subsidized health insurance program.

Legislative leaders and the governor have agreed the state will have $575 million more to spend next year than the $120.6 billion included in Spitzer’s proposed budget. It’s likely that Bruno and his ally in the Assembly, Speaker Sheldon Silver, will want to put at least some of that money toward restoring the health-care cuts.

But Spitzer has other ideas. He’s talked about putting the additional money into reserves and using some of it for health care but for “prevention, detection, research and smart public policy that focuses on patients, not institutions.”

The rhetoric in this fight has escalated. The health-care folks started out with ads that were relatively mild, compared to some of the spots they ran against Pataki. But when Spitzer retaliated, they returned fire with more pointed ads.

Let’s hope that the tit-for-tat doesn’t deteriorate to the point where a rational discussion of the facts and policy options isn’t possible. History has shown us that an effective ad campaign can all but end rational discourse (remember how quickly the “Harry and Louise” ads killed any discussion of Hillary Clinton’s health-care ideas?).

Spitzer makes a compelling argument when he points out that the state’s most-expensive-in-the-nation Medicaid program hasn’t yielded a healthier population. Yet hospitals and unions can point to real cost pressures, including looming budget cuts at the federal level. New Yorkers would be better served by a cool but spirited discussion that helps them sort through the competing points of view than they are by expensive ad campaigns appealing to emotion.