The election-year romance between New York Gov. George Pataki and the state's healthcare industry has soured as the governor faces off with the same powerful lobbying forces that last year helped him win his third term.
Last month, the Healthcare Education Project-a joint effort between the Greater New York Hospital Association and Local 1199 of the Service Employees International Union-launched a multimillion-dollar statewide advertising campaign. The campaign squarely targets Pataki's proposed budget, which calls for nearly $2 billion in Medicaid cuts, provider taxes and other revenue reductions, according to the education project.
The campaign culminated last week with a rally that overflowed the 20,000-seat Pepsi Arena in Albany, N.Y.-the biggest demonstration in the city's history, organizers boasted. Approximately 900 buses filled with healthcare workers arrived from New York City, and organizers estimated that nearly 40,000 people attended. A long succession of hospital CEOs, state lawmakers and union leaders took to the platform as the crowd chanted, "Put your hands in the air for quality care" and "Job-killing cuts, they've got to be nuts" before marching on to the capital.
The tone is quite different from last year, when the annual healthcare budget promised to directly subsidize healthcare workers' salaries and help in recruitment and retention efforts in hospitals and nursing homes with $1.8 billion in new revenue over a three-year period (Jan. 21, 2002, p. 18). It also helped cinch Pataki's re-election last November.
But last year's state budget package also guaranteed there would be no new Medicaid reimbursement rate cuts for the next three years, and therein lies the problem-one that is reverberating in state legislatures nationwide. Short of saying Pataki's proposal for this year reneges on last year's promises, GNYHA President Kenneth Raske called it "retrenchment."
"That combined with the extraordinary anemic financial condition of most New York hospitals has led us to the conclusion that the proposed Medicaid cuts are not sustainable," Raske said. Pataki "certainly has gone back on (his promises.) There's no question about that," Raske said.
In response, Robert Kenny, a spokesman for the state health department, described Pataki's commitment to healthcare as "nothing short of historic. Only the blindly partisan would disagree with that," he said.
In the recent past, direct-to-the-public advertising campaigns of this sort have worked well for the Healthcare Education Project, which was created in 1999 with the purpose of taking healthcare issues directly to the public (April 1, 2002, p. 22).
"We think the New York voter is a powerful entity once they are educated, and elected officials can't ignore the electorate," Raske said.
This time the message is being carried home to voters with television commercials that depict a distraught mother frantically rushing her baby to an emergency room, only to find it closed, and a nursing home resident pleading for the job of her nurse, who is "all I have."
It's all meant to skewer Pataki's cost-reduction proposal. Healthcare leaders estimate that hospitals collectively will lose $596 million in the budget's first year and $682 million in the second. Hospitals on average would lose 9% of their Medicaid inpatient revenue, according to the GNYHA's calculations.
As a counterproposal, the GNYHA and the SEIU suggest the state raise revenue through a surcharge on the wealthiest New Yorkers and a closing of corporate tax loopholes.
The advocacy campaign also includes direct mail, door-to-door canvassing and a phone bank that offers to patch voters through to their state legislators.
The budget proposal on the table could be up for a vote as early as May, Raske said. The campaign will continue indefinitely, he said.