Friday, March 23, 2007
New York's governor You ain't seen nothing yet
ECONOMIST.COM
If you don't think the world is watching what Spitzer is doing..think again....here is a snappy little piece from England........andy
HE IS not known for being timid. As New York's attorney-general, he was called “The sheriff of Wall Street”. Last year he campaigned for governor with the promise to shake up state government. He won with 70% of the vote, and now he is trying to live up to expectations. In his first three months in office he has reformed an outdated workers'-compensation law, issued executive orders to make Albany's politics more transparent and got involved in a fight about the choice of comptroller—though, embarrassingly, he lost that one.
Now Eliot Spitzer is in the biggest fight of his term so far: an all-out brawl over health care. With the state's budget due on April 1st, the battle is the first real test of whether his forceful style will be effective in his new job. Charles Rangel, a Democratic congressman from New York City, called the melée a “food fight”. The governor seems to be enjoying himself.
If Mr Spitzer wanted to pick a fight, he has chosen the right one. Not only has health care become a prominent issue among governors, inspired by plans for universal coverage in Massachusetts and California, but New York's health system is in dire need of fixing. The state's Medicaid programme, at more than $45 billion, is America's most expensive, with spending per person more than twice the national average. New York saw a hint of progress last year, when a state commission recommended closing underused hospitals and nursing homes. But Mr Spitzer still has his work cut out.
To inch towards universal coverage, Mr Spitzer wants to extend health care to all New York's 400,000 uninsured children. His plans to curb spending are more controversial. In a testament to Albany's perversion, Mr Spitzer, a Democrat, wants to rein in costs; the Republican-led Senate, backed by the health-care lobby, does not. For years New York has subsidised inefficient hospitals and nursing homes through high Medicaid reimbursement rates, providing an incentive to provide unnecessary services. Mr Spitzer wants to begin changing this by freezing such rates. Other measures to contain costs include spending less to train interns, tightening the list of drugs covered by Medicaid and ramping up efforts to fight Medicaid fraud. In all, the governor's budget would cut health-care spending by about $1.2 billion.
Such changes are unheard of in Albany. The previous governor, George Pataki, had similar ideas, but he pursued them with the audacity of a dormouse. Mr Spitzer, by contrast, is relishing his role as a crusader against “special interests”. Enraged, the hospitals' association and the health-care workers' union have spent more than $4.5m to condemn his cuts through television advertising, rallies and mailings. They recruited Al Sharpton, an omnipresent black activist, to denounce Mr Spitzer, and on March 15th thousands of health-care workers protested outside the governor's office in Manhattan. (One hand-written sign read: “Eliot is an Idiot”.) Mr Spitzer is fighting back with characteristic zeal. He called the Senate's plan to restore his cuts “ruinous” and has spent $2m of campaign money on television ads of his own.
This tussle may extend past the budget deadline, but it will eventually end in compromise; the question is how far Mr Spitzer will retreat. If he concedes too much, he will encourage future opponents. But the governor is in a unique position to be firm. Unlike Mr Pataki, he enjoys high approval ratings—61% in February, according to a poll by Quinnipiac University. And the state Assembly, led by Democrats, seems amenable to many of his proposals.
Still, Mr Spitzer's budget only begins to address New York's health-care mess. Among the questions that remain are how to care for the elderly more efficiently and how to reform Medicaid reimbursement rates, which are now based on data that is over 14 years old, so that the programme subsidises patients, not hospitals.
The governor must also do much more to be a true reformer. His $120.6 billion budget may cut health-care costs, but it is far from fiscally conservative, says E.J. McMahon of the Manhattan Institute, a think-tank. Mr Spitzer wants to raise state spending by 7.8%, up to three times the projected rate of inflation. This increase is driven in part by the governor's proposed new infusion of money into the schools: $1.4 billion this year, part of a 40% rise over the next four years. In exchange for this munificence, schools must comply with a “contract for excellence” that requires them to show how they are spending the cash and face sanctions if they fail to improve. This is all well and good, but the plan may not be sustainable. New York already spends more on education than it does on Medicaid; the state's comptroller has warned of future budget gaps.
And though Mr Spitzer has declared himself an enemy of special interests, there are many groups he has yet to challenge. He has been reluctant, for example, to take on New York's unionised public employees, who account for one in eight of the state's workers (the national average is one in 19). The cost of their pensions is rising by the minute. Mr Spitzer, asked recently about his guns-blazing style, replied with a smirk, “That wasn't guns going.” The biggest fights are yet to come
If you don't think the world is watching what Spitzer is doing..think again....here is a snappy little piece from England........andy
HE IS not known for being timid. As New York's attorney-general, he was called “The sheriff of Wall Street”. Last year he campaigned for governor with the promise to shake up state government. He won with 70% of the vote, and now he is trying to live up to expectations. In his first three months in office he has reformed an outdated workers'-compensation law, issued executive orders to make Albany's politics more transparent and got involved in a fight about the choice of comptroller—though, embarrassingly, he lost that one.
Now Eliot Spitzer is in the biggest fight of his term so far: an all-out brawl over health care. With the state's budget due on April 1st, the battle is the first real test of whether his forceful style will be effective in his new job. Charles Rangel, a Democratic congressman from New York City, called the melée a “food fight”. The governor seems to be enjoying himself.
If Mr Spitzer wanted to pick a fight, he has chosen the right one. Not only has health care become a prominent issue among governors, inspired by plans for universal coverage in Massachusetts and California, but New York's health system is in dire need of fixing. The state's Medicaid programme, at more than $45 billion, is America's most expensive, with spending per person more than twice the national average. New York saw a hint of progress last year, when a state commission recommended closing underused hospitals and nursing homes. But Mr Spitzer still has his work cut out.
To inch towards universal coverage, Mr Spitzer wants to extend health care to all New York's 400,000 uninsured children. His plans to curb spending are more controversial. In a testament to Albany's perversion, Mr Spitzer, a Democrat, wants to rein in costs; the Republican-led Senate, backed by the health-care lobby, does not. For years New York has subsidised inefficient hospitals and nursing homes through high Medicaid reimbursement rates, providing an incentive to provide unnecessary services. Mr Spitzer wants to begin changing this by freezing such rates. Other measures to contain costs include spending less to train interns, tightening the list of drugs covered by Medicaid and ramping up efforts to fight Medicaid fraud. In all, the governor's budget would cut health-care spending by about $1.2 billion.
Such changes are unheard of in Albany. The previous governor, George Pataki, had similar ideas, but he pursued them with the audacity of a dormouse. Mr Spitzer, by contrast, is relishing his role as a crusader against “special interests”. Enraged, the hospitals' association and the health-care workers' union have spent more than $4.5m to condemn his cuts through television advertising, rallies and mailings. They recruited Al Sharpton, an omnipresent black activist, to denounce Mr Spitzer, and on March 15th thousands of health-care workers protested outside the governor's office in Manhattan. (One hand-written sign read: “Eliot is an Idiot”.) Mr Spitzer is fighting back with characteristic zeal. He called the Senate's plan to restore his cuts “ruinous” and has spent $2m of campaign money on television ads of his own.
This tussle may extend past the budget deadline, but it will eventually end in compromise; the question is how far Mr Spitzer will retreat. If he concedes too much, he will encourage future opponents. But the governor is in a unique position to be firm. Unlike Mr Pataki, he enjoys high approval ratings—61% in February, according to a poll by Quinnipiac University. And the state Assembly, led by Democrats, seems amenable to many of his proposals.
Still, Mr Spitzer's budget only begins to address New York's health-care mess. Among the questions that remain are how to care for the elderly more efficiently and how to reform Medicaid reimbursement rates, which are now based on data that is over 14 years old, so that the programme subsidises patients, not hospitals.
The governor must also do much more to be a true reformer. His $120.6 billion budget may cut health-care costs, but it is far from fiscally conservative, says E.J. McMahon of the Manhattan Institute, a think-tank. Mr Spitzer wants to raise state spending by 7.8%, up to three times the projected rate of inflation. This increase is driven in part by the governor's proposed new infusion of money into the schools: $1.4 billion this year, part of a 40% rise over the next four years. In exchange for this munificence, schools must comply with a “contract for excellence” that requires them to show how they are spending the cash and face sanctions if they fail to improve. This is all well and good, but the plan may not be sustainable. New York already spends more on education than it does on Medicaid; the state's comptroller has warned of future budget gaps.
And though Mr Spitzer has declared himself an enemy of special interests, there are many groups he has yet to challenge. He has been reluctant, for example, to take on New York's unionised public employees, who account for one in eight of the state's workers (the national average is one in 19). The cost of their pensions is rising by the minute. Mr Spitzer, asked recently about his guns-blazing style, replied with a smirk, “That wasn't guns going.” The biggest fights are yet to come
