The Clinton administration has rewarded some of its most loyal healthcare allies with deep budget cuts.
Specifically, President Clinton's HHS budget would nearly eliminate nursing education funding. The Clinton budget decreases such funds by $55 million, to just $8 million in fiscal 1998 from $63 million in fiscal 1997.
The funding, provided through the Health Resources and Services Administration, is the single largest source of funding for nursing education programs awarding bachelor's or graduate degrees.
The administration says the cuts are justified, however, because health profession funding has, during the past 30 years, resulted in sufficient increases of primary-care practitioners and health professionals.
Nurses were among the most enthusiastic supporters of the Democratic Party in the 1996 election. The American Nurses Association's political action committee spent nearly 90% of its $816,073 campaign budget on Demo-cratic candidates.
Although they are not raising the question of their Democratic loyalty, nursing leaders are questioning the wisdom of the decision to cut back on advanced nursing education at the same time healthcare providers are looking for more cost-effective ways to deliver primary care.
"The education of future health professionals has always been a sound investment of federal funds," said Geri Marullo, executive director of the ANA. "The Clinton administration no longer believes the federal government has a role in preparing the caregivers of tomorrow."
"This is completely counter to what's going on in the marketplace," said Sharon Swan, federal relations and policy director for the American Organization of Nurse Executives.
Rose Gonzalez, the ANA's assistant director of federal government relations, characterized the nursing education program as "budget dust," saying the elimination of funding does not contribute significantly to balancing a $1.7 trillion federal budget.
Despite their strong alliance with the Democrats, nursing leaders hope they can get some of the money restored once spending bills begin working their way through the GOP-led Congress.
"We've always had bipartisan support for our programs," Gonzalez said. But she added that the Clinton budget is "going to make our job more difficult."
The reduction in nurse education support was part of a larger $160 million reduction in all health professions training funding through the HRSA in the budget plan.
The biggest loser in that area would be primary-care and public health training programs, which would see funding drop to $8 million from $82 million if the president's plan survives.
Also losing money would be area health education programs, which seek to balance supply and distribution of health professionals. Those programs would lose $31 million, dropping to $24 million.
The administration will preserve current funding for only one set of training programs, those that seek to increase the number of minority and economically disadvantaged people in the health professions. Funding for those programs in fiscal 1998 is $89 million in the Clinton budget, equal to 1997 funding.