More Than a Flesh Wound: How the Budget Cuts Go Deep and Wide


By Dr. Nicole Dubus

The Black Knight in Monty Python and the Holy Grail is known for his perseverance
It’s never just a flesh wound.

On Friday March 1, 2013, Congress let pass $85 billion in Federal cuts. According to the Office of Management and Budget, the following are some of the ways these cuts will affect healthcare: $20 million cut from the Maternal, Infant, and Early Childhood Home Visiting Programs; $10 million cut from Substance Abuse and Mental Health Services Administration; $75 million cut from Aging and Disability Services Programs; $51 Million from Prevention and Public Health Fund; $44 Million from Affordable Insurance Exchange Grants. I include the following cuts as well because although they are not directly related to health care, they do impact our health: $184 million cut from Rehabilitation Services and Disability Research; $928 million from FEMA’s disaster relief; $6 million from Emergency Food and Shelter; $61 Million cut from the Hazardous Substance Superfund; $53 million cut from the Food Safety and Inspection Service. The lack of safe housing is a primary need for health. $199 million will be cut from public housing, $96 million from Homeless Assistance Grants, $17 million cut from Housing Opportunities for Persons with AIDS, $19 Million cut from Housing for the Elderly, and $175 million cut from Low Income Home Energy Assistance.

What do all these large dollar numbers mean?

It means that for years to come there will be fewer services for those who are in greatest need: women and newborns, those with substance abuse issues, people in need of mental health services, and services for our grandmothers, grandfathers, elderly parents, and disabled family members and friends. It means that there will be less help when disaster hits, less ability to clean up after hazardous accidents, and less oversight of our food safety. It also means that there will be less help for those who are homeless or soon to be homeless. It means that some of our grandparents, elderly parents will be without housing. If they do have housing, more will go without heat in the winter or air conditioning in the hot summer.

Whose responsibility is it to take care of the disabled, mentally ill, elderly, poor, and vulnerable? Whose responsibility is it to take care of others during a disaster? Whose responsibility is it to clean up hazardous accidents or to keep beef free of E. coli? If you approve of these cuts then you believe the government is not responsible, and in turn we as members (and tax payers) of our society are not responsible. Government is merely the collective will of the people’s desire to care for each other. We must ask ourselves: what do we believe? Do we believe we live in a country that cares for all of us as an extended family, or do we believe we are a collection of individuals who must protect our individual interests over the collective good? Then we must ask: is it in our individual interest to let our grandparents, our disabled, our poor look out for themselves?

Dr. Nicole Dubus is Assistant Professor of Social Work at Wheelock College. Nicole Dubus has been active in the field since the mid-1980s, working in northern California and Massachusetts in public and private settings. Her research interests are in community-based research, home-visitation programs, early parenthood, culturally-sensitive clinical skills, and the experiences of refugees throughout the life course.


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  1. Staggering losses. It is difficult not to feel hopeless and impotent by the magnitude of the suffering that is being caused. But now is not the time to give up or give in. Now is the time to make pests of ourselves with every elected official, every bureaucrat, petty fogger, or moron who created this mess. Thanks Nicole for putting a face on it.

  2. Of course there will be fewer services and serious decisions will have to be made. The cold reality is, each individual is responsibility to care of themselves, their children, and their elderly parents. America is not a “nanny state” (at least not yet). Of course communities, States, and the Federal Government should respond to natural disasters and assist those unable to care for themselves. However, Dr. Dubus’ emotional plea to continue funding programs to care for the “disabled, mentally ill, elderly, poor, and vulnerable…care of others during a disaster…clean up hazardous accidents or to keep beef free of ecoli” is not rational. Her argument is emotional hogwash. These “staggering losses” are less than .023% of the $85 billion cut. Can she not understand that the debt we leave our children will be far worse than the poorly run social programs she promulgates? Let the Federal Government run as we run our households–on a balanced budget. Yes, be responsible, but if we cannot pay for it, we are being doubly irresponsible. The National Debt is nearing $17 Trillion…Dr. Dubus, how are we going to pay off that debt?

  3. Let’s take the first step to decrease the debt by abolishing tax breaks and royalty relief for oil companies. I, as a tax payer, do not want to provide subsidies to profitable industries. They clearly don’t need the help while they continue to report record profits. I would rather have my tax dollars support programs that help the elderly, the mentally ill, the disabled, and children. Not only do these programs improve their quality of life, but in the long run such programs decrease the cost of health care through prevention. That’s the kind of country I want to leave to my children.

  4. If the amount of money in question is so small, then why not leave it in the budget and look for more productive cuts like keeping enough troops on Europe to defend our allies from an attack ordered by Josef Stalin. Perhaps we could find some extra dollars in the subsidies we pay to oil companies. Why not save money by allowing Medicare to negotiate prices for medications covered by Part D or start taxing wealth made from investment interest at that same rate as that earned from wages. Is there not a lot of room for debate on whose arguments are “emotional hogwash”?

  5. What happens when there is no family to care for a poor homeless, and/or mentally ill person. I am not being a “Nanny” by making sure this human being gets the basic care she needs. I am being a responsible citizen. And yes, prior governments ran up an awful mess of a debt in a few short years. Must the most vulnerable pay for the poor decisions if elected officials? I know there are better ways to balance the budget. Underwriting the wealth of the oil companies is one place that comes off the top of my head. Why should any person go homeless and hungry in the wealthiest nation on earth, when we make sure that folks who already have more money than they will ever need in a hundred lifetimes stay on the dole. Cuts of a small percentage hurt those who have the least the most.

  6. It’s interesting when someone calls this a Nanny state and says they won’t don’t want to leave that to our children. What about all the children living in the street right now; do we not care about those children?
    Most people will work for a decent living. Many people, though, do not get that opportunity. Those dollars that Dr. Dubus notes represents large numbers of other peoples’ children left without care by our society, some who have growin up and still have nothing. We need a different system that allows people to earn enough to pay for their children’s college, their own retirement, housing, medical needs, clothing and food. If we can’t do that and we can’t seem to do that right now, we need to support people in need. We rescue corporations, why can’t we rescue people?

  7. Ms. Miller articulates the conservative position well, sadly it is cynical, misguided and atavistic . It has become known as the 47 percent position. Helping those in need does not weaken those helped, it empowers. The financial drain on families having the sole financial responsibility for their elderly or handicapped family members is more likely to negatively effect a growing economy than the money it takes to ease their suffering. The National Debt that she would like Dr. Dubus to attend to has more to do with 2 wars paid for by credit card and a cockeyed debt/GNP ratio. It is not a measure of intergenerational equity. Her position is ultimately wrong and was disavowed by voters in the last election and I suspect will be rejected in the next.

  8. There is a complete lack of honesty and transparency in the way government is financed. If the government were forced to use accounting methods they require of public companies, the total debt is closer to $200 Trillion if the government is going to keep the promises made to the public. For example, we all expect to receive substantial benefits from Social Security and Medicare when we retire. That money is not there and whatever surplus there was was spent. The politicians cook up some fancy terms like “trust fund” or “lock box” but they do not change the fact is that there is no money.

    At the rate that health care cost are climbing it will be only two years until all government revenues will go to entitlements and we will have to borrow more money to finance the rest of government. That is an unsustainable situation. THe government can print the money if it wants but that will only make the costs go even higher and the money worthless.

    The current debt is $17 trillion. What did the 2 wars cost? Maybe $3 trillion at most? The more that so-called experts exaggerate and make emotional statements like that the longer it will be for this problem to reach a solution.

    The truth is that the youth of today are saddled with the debt from over-priced college educations. When they get a job they are facing an economy where incomes are DECLINING, they have the benefits paid to current social security and medicare beneficiaries taken directly from their paychecks. (That is how Ponzi Schemes work. The schemer takes the money and pretneds to put it in trust but actually spends it. Then they take money from new investors to pay the older ones. Sound familiar?) And they will end up paying back the national debt in some manner, either through much higher levels of taxation, cuts in services and benefits or inflation. There is no getting around it. The facts are there, it is truly intergenerational theft.