Budgets and Appointments Reveal Presidential Priorities

 

U.S. presidents make their philosophies and priorities known through their budgets and appointments. However, both require Congressional approval, so Congress has a choice to follow the president or fight for a competing philosophy.

Presidents craft budgets which reflect their priorities, with top concerns getting top dollar, and less-valued programs getting cut.

Similarly, presidents make appointments based on not just expertise, but also on shared philosophy, and a willingness to manage a huge bureaucracy accordingly. Like presidents, however, agency heads must weigh competing goals. In the case of the Food & Drug Administration (FDA) or Health and Human Services (HHS), agency secretaries must figure out how to be pro-health without being anti-industry.  

President Bush’s fiscal 2009 budget request reveals his philosophy on health programs, an essential theme in the 2008 campaigns. The Bush administration’s budget serves as a case study of how philosophy has the potential to become policy – and how presidential priorities can affect specific programs.

Budget cuts in health

The Bush administration’s budget request would reduce discretionary spending at HHS by about 2.5 percent overall and cut spending on most HHS programs.

The proposal would cut spending for programs including for the Centers for Disease Control and Prevention, public health programs and social services, and block grants for state and local anti-poverty and child-welfare programs.

In addition, the budget for the National Institutes of Health, the country’s main source of medical research funding, would stay the same as 2008. In the face of rising prices, some consider this a cut.

The budget for the Food and Drug Administration would increase by $130 million, or about 5.7 percent, but critics say it’s not enough because of problems with food and drug safety that could be expensive to solve. House Democrats have asked the FDA’s science advisory board, which has criticized the agency’s funding, to recommend an alternative budget.

Medicare and Medicaid

The president has also proposed cuts for Medicare and Medicaid.

In particular, the administration would like to reduce the growth of Medicare, the larger of the two programs. Without cuts, Medicare’s coffers will be emptied in 11 years, according to HHS Secretary Michael O. Leavitt.

To do so, Bush would reduce the expected increase in Medicare spending by $12.4 billion in fiscal 2009 and by $178.2 billion over five years.

The projected rise in Medicaid spending would also be reduced, by $1.8 billion and $17.4 billion over the same periods.

While these cuts aren’t likely to happen under a Democratic Congress in an election year, Bush can still use the power of the veto to make his philosophy real.

Keep in mind how philosophy is applied when voting in the November Presidential Elections. 

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