Governor Kasich has released his proposed budget, and the vivisection has begun. It’s not pretty, and there is already much spilled blood. Although many unkind lacerations can and should be protested, I worry that focusing only on the details will lead to a kind of advocacy Darwinism: “don’t take money from my cause, take it from someone else.”
The specifics are important, but equally important are the broad themes. I see four main strategic pillars holding up the Governor’s house of numbers. One, clearly, is privatization of public assets. A second is expense shifting: cutting aid, for example, to local governments, which virtually ensures that those jurisdictions will have to figure out ways to account for more expenses locally. A third can be thought of as narrowly defining entitlements. If one labels what individuals receive as “entitlements,” but what corporations receive as “economic incentives,” (the term I'm using) then one can make a compelling argument to restrict one, and expand the other – though they both function, from an expense/revenue perspective, as entitlements. The fourth strategy might be termed unequal burden distribution. By failing to enact a tax structure that’s truly progressive, the state places heavier public burdens, as a percentage of an individual’s capacity to bear those burdens, on low- and middle-income Ohioans.
In the end, we are left with a kind of budget sleight of hand, which any good magician will tell you is never about rabbits manifesting inside hats, but always about distraction and evasion.
For example, one issue is public funding of medical and pharmaceutical services for low-income people with HIV/AIDS – an issue I'm familiar with, having worked in the HIV/AIDS field for more than two decades.
Three things have been generally true about HIV/AIDS care and treatment over the last 15 years. The first is that if people with HIV/AIDS can access quality medical services, and if they can access specific services needed to ensure access to and utilization of those medical services, it is possible to maintain good health for a considerably long time. The second (and this may surprise some) is that a broad political coalition, one that includes both Democrats and Republicans, has consistently supported the idea that government ought to play a meaningful role in subsidizing medical care for low-income people with HIV/AIDS. The third is that the benefits of doing so aren’t just for the individual patient, but for whole communities as well:Untreated persons with HIV have higher levels of infectivity, which contributes to elevated community risk.
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