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Making Sense of the Budget Battle: The Implications for HIV/AIDS

February 23, 2011

Phill Wilson

With the release of the President's 2012 budget last week, the battle is on. Both Democrats and Republicans are talking about how to protect our nation's future by reducing the federal debt and deficit. To be completely honest, it is not so clear to me if anyone, including the American public, is serious about taking the steps necessary to accomplish either goal. In addition, while reducing the deficit and the debt are clearly important, it is also clear they are not the only barriers threatening the future of our country.

The polls suggest that the top three priorities for the American people are creating jobs, cutting the deficit, and reducing the federal debt. No one seems to be asking if all three can be done at the same time.The Republican strategy is clear: cut the federal budget! Last week Republicans in the House of Representatives passed a stopgap measure, called H.R. 1, that would cut $61 billion from the 2011 budget. The bill would:

  • strip federal money from health care reform and roll back provisions that prevent big insurance companies from denying care based on pre-existing conditions and that allow adult children to remain on their parent's health insurance until age 26;
  • cut $1.7 billion from the President's request for the Social Security's administration; and bar the EPA from issuing global warming regulations; and
  • defund Planned Parenthood and the Corporation for Public Broadcasting (CPB), also known as PBS.

Compared to last year's funding levels, this bill would cut the Substance Abuse and Mental Health Services Administration (SAMHSA) budget by $229.5 million, Centers for Disease Control and Prevention (CDC) budget by $1.3 billion and the National Institute of Health's (NIH) budget by $1.6 billion.

SAMHSA provides critical HIV-prevention services to people with addiction. Treating addiction saves billions of dollars in other drug-related health expenditures as well as in productivity. A 21 percent cut to the CDC budget would obviously have dire consequences to efforts to end the HIV/AIDS epidemic. The CDC funds critical HIV screening and prevention programs. Research at NIH is also a critical tool in the fight against HIV/AIDS. A 5.2 percent cut to the NIH's budget will slow down attempts to further investigate and scale up critically important HIV biomedical breakthroughs discovered in 2010. Critics also warned that such cuts could mean shuttered Social Security offices and furloughed Social Security employees, delaying benefits to recipients who desperately need them.

The House leadership seem to come from the "Alice in Wonderland" school of public policy where "what is, isn't and what isn't, is". While H.R. 1 drastically cuts these favorite Republican targets (independent economists point out that the new health care law actually reduces both the deficit and the federal debt), it increases the Pentagon budget, doesn't cut Medicare, and of course the Republicans are dead set against allowing the Bush tax cuts for the wealthiest of Americans to expire.

But probably most importantly, there has yet to be an explanation on how these budget cuts will create jobs. With national unemployment rates holding steady at 9 percent (15.7 percent for Blacks), eliminating programs that provide jobs will only exacerbate the unemployment problem and possibly undermine the nascent economic recovering the country is starting to experience.

Basic accounting requires that you balance a budget by either raising revenues or decreasing expenses. The first place to look to try to reduce expenses should be the areas that represent the largest part of the budget. In this case that would be tax breaks for the rich, military spending and entitlement programs -- Medicaid, Medicare and Social Security. No conversation about reducing the deficit or debt can be taken seriously if it doesn't increase revenue, reduce expenditures on military and entitlement programs, and include a real plan for putting the middle class back to work.

Absent our willingness to seriously tackle the real issues, poor people become an easy target to demonize. The Republicans attack or want to eviscerate programs that support the most vulnerable among us but that in real numbers get us nowhere. For example, currently, the CPB only receives $1.40 cents per capita from the federal government. This is not where a serious attempt to solve our countries financial woes begins. And while cutting these programs might pander to the conservative base, in the real world and in real numbers it does virtually nothing toward reducing expenses. If you cut the budget for health services for the poor or HIV prevention, for instance, you create far higher costs down the line. So we delude ourselves if we think that poor or vulnerable people are the problem and that we're going to get out from under the budget deficit on their backs. Poor people did not create the economic crisis and punishing poor people will not solve the problem.

On the revenue side, popular opinion seems to be that you can't increase taxes on the richest Americans. There also doesn't appear to be an appetite for closing tax loopholes for corporations that make billions of dollars and pay relatively no taxes because they've figured out how to avoid that responsibility.

Many of our politicians are merely jerking our chain. Many of the cuts that they are talking about are short-sighted and counterproductive. It seems to me that if we really want to address our economic challenges, we would do the following:

1) Put every item on the table and evaluate its effectiveness. This means that there would be no sacred cows, including the enormous tax breaks that we give to the wealthiest Americans.

2) Invest in programs that will grow our economy and put Americans back to work, such as health, education, infrastructure, and technology.

We need to educate our children better so that they are better positioned to compete in a global economy. We need to make sure our populations are healthier so we are not spending as much money on health care. And healthy people higher levels of productivity in the workplace. If we have a strong infrastructure, our highways and our bridges and our ports become revenue generators. If we have cutting edge technologies, high speed trains and green energy, we have the potential of launching and/or expanding entire new industries.

But right now on every level we're still playing politics. Unfortunately politics has become a blood sport, where the rule of the game is an eye for an eye. But to paraphrase Mohandas Gandhi, "an eye for an eye only ends up making the whole world blind."

Yours in the struggle,


Phill Wilson is the President and CEO of the Black AIDS Institute, the only National HIV/AIDS think tank in the United States focused exclusively on Black people. He can be reached at or follow him on Twitter @iamphillwilson.

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This article was provided by The Black AIDS Institute. Visit Black AIDS Institute's website to find out more about their activities and publications.
See Also
More on U.S. HIV/AIDS Policy

Reader Comments:

Comment by: Mike D. (Cleveland OH) Thu., Mar. 3, 2011 at 4:48 pm UTC
The rich people of this country are PIGS. Wake up America we are being f*cked by the rich
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