Archive for February 2020
Posted by NYPIRG on February 24, 2020 at 8:59 am
State lawmakers return from their Presidents’ Week “mini-break” and begin to seriously debate the next state budget. New York’s fiscal year starts on April first, thus giving Albany 5 weeks to negotiate the proposed $178 billion state budget.
Contained in that budget are many important policies – from
Medicaid spending to higher education to the environment to education
financing. Most of the budget’s “top
line” items are publicly debated; sometime equally important items are
not. One under-debated issue is the
rising threat from infections that are increasingly resistant to antibiotics,
also known as “superbugs.”
According to the U.S. Centers for Disease
Control and Prevention (CDC), antibiotic-resistant
bacteria are most prevalent in environments associated with high antibiotic
use: healthcare settings, the general community, and in livestock production. Antibiotic resistance can spread from person
to person, from animal to person, via the natural environment or contaminated
food and from bacteria to bacteria. Some
bacteria have developed resistance to multiple antibiotics, making them
especially difficult to treat, and thus very dangerous and sometimes deadly. Common infectious diseases such as
tuberculosis, pneumonia, blood poisoning, food poisoning, and gonorrhea have
already become harder and sometimes impossible to treat due to
multidrug-resistant bacteria.
The problem of antibiotics-resistance is not just one found in the
United States, it is a worldwide problem.
And worldwide problems demand global responses.
Antibiotic resistance happens when bacteria develop the ability to
defeat the drugs designed to kill them. Each
year in the United States, more than 2.8 million infections from bacteria that
are resistant to antibiotics occur and more than 35,000 people die as a direct
result. Many more die from complications
from antibiotic-resistant infections.
A study commissioned by
the U.K. government predicts that if action is not taken now to combat
antibiotic resistance,by 2050 the annual death toll will have risen
to 10 million globally.
The situation is getting
worse with the emergence of new bacterial strains resistant to several
antibiotics at the same time (known as multidrug-resistant bacteria). Such
bacteria may eventually become resistant to all existing antibiotics.
Without antibiotics, the world could return to the “pre-antibiotic era”, when
organ transplants, cancer chemotherapy, intensive care and other medical
procedures would no longer be possible. Bacterial
diseases would spread and could no longer be treated, causing death.
There is hope. Data from European agencies show that
interventions can work. Medical data
shows that Scandinavian countries and the Netherlands have low rates of
superbugs, but that there are higher rates in Southern Europe. Countries with lower resistance rates have
generally lower use of antibiotics, while countries with higher antibiotic
resistance rates use more antibiotics.
Buried in the governor’s
proposed health budget is an item to begin to address the rise of antibiotics
resistant superbugs. In his budget, the
governor proposed that every general hospital and nursing home must establish
an antibiotic stewardship program that meets or exceeds federal conditions of
participation for antimicrobial stewardship programs in health care facilities.
Additionally, such program shall incorporate an ongoing process to measure the
impact of the program. While vague, the
governor’s program leaves the details up to the state’s Health Commissioner.
Yet, the governor’s plan
leaves out an important area of antibiotics overuse and misuse: use on farms. Nearly two-thirds of antibiotics that
are important for human medicine are currently sold for use in livestock,
not people. These drugs are routinely given as poor compensation for inappropriate
diets and the stressful, crowded and unsanitary conditions on industrial
feedlots. This practice hastens the spread of antibiotic resistance in bacteria
and increases the risk of drug-resistant infections in people.
When antibiotics are
given to food-producing animals, they kill most of the bacteria in them. The
resistant bacteria, however, survive and can contaminate animal products during
slaughtering and processing. They can also contaminate fruits and vegetables via
contaminated soil or water, especially when animal manure is used as
fertilizer. Antibiotic-resistant bacteria can contaminate food prepared on
germ-filled surfaces and the environment via animal feces. According to the
CDC, approximately 1 in 5 antibiotic-resistant infections are caused by germs
from food and animals.
Thus, the governor’s plan
ignores 20 percent of the problem – and in dealing with the growing menace of
superbugs, comprehensive approaches are the only ones that will work.
It is clear from the
Scandinavian experiences that policies can significantly reduce the rise of
“superbugs”: policies that focus on cleanliness in health care settings, a
reliance on antibiotic use in humans only when medically necessary, and a
drastic reduction in use on farm animals.
The most obvious way to reduce use among farm animals is for veterinarians
to stop the use of antibiotics on healthy livestock.
This is a worldwide
problem, unless the rise of “superbugs” can be stopped, the next generation
will be faced with a world without effective antibiotics, one in which
illnesses like urinary tract infections will be untreatable, leaving people to
suffer and perhaps die, from infections easily treatable today.
Posted by NYPIRG on February 17, 2020 at 6:29 am
Last week, Governor Cuomo made a push for environmental initiatives contained in his budget plan. The governor advanced what he described as an “historic $33 billion, five-year commitment to fight climate change.”
The governor urged support for measures: to ban single-use
styrofoam food containers and packing materials; to earmark $300 million for
the state’s Environmental Protection Fund; to add $500 million to improve drinking
water infrastructure; and to permanently ban hydrofracking.
But the centerpiece of his environmental package was his
plan to create a $3 billion environmental bond act that “will fund critical
environmental restoration projects in every corner of the state to ensure New
York is able to withstand the threat of more intense and frequent storms fueled
by climate change.” He dubbed this part
of the plan, the “Restore Mother Earth” bond act.
On the need for billions to address the costs of climate
change, the governor’s right. New York –
like the rest of the planet – will have to spend billions to mitigate the
enormous damage caused by climate change.
A “Restore Mother Earth” bond act offers a down payment for the costs
that New York will undoubtedly have to pay.
The question is, who
should pay back the costs of the bond act borrowing?
The governor’s plan proposes that the general public pay the
back the costs of borrowing the bond monies; for most bond acts, the public
usually pays.
A bond act is a way for the state to borrow a large amount
of money to meet pressing needs. The
borrowed money should be used for projects that are expected to last at least
the lifetime of the borrowing – usually 30 years. Thus, spending makes sense for state projects
that would protect drinking and fresh water supplies.
Usually, bond acts are paid back through general revenues –
we all pay them back. But not
always. In the Environmental Bond Act of
1986, for example, which was designed to finance the clean-up of hazardous
waste sites, the bond monies raised were to be offset by the state charging
polluters responsible for the messes.
That formulation was so successful that the 1986 Bond Act was
overwhelmingly approved by voters.
It’s a formulation that makes sense now.
Governor Andrew Cuomo’s proposed bond act is – as he has
stated – to finance projects to help the state “withstand the threat of more
intense and frequent storms fueled by climate change.” But who’s responsible for climate change?
The responsible parties for the climate crisis are the oil,
gas and coal industries. It is those
industries that should pay the borrowing back.
It was those industries that knew for decades the dangers of
global warming from the burning of fossil fuels. It was those industries that spent money – on
lobbyists, public relations and campaign contributions – on a disinformation
campaign to combat measures to curb greenhouses gas emissions that form the
“blanket” contributing to the heating up of the earth.
The oil, coal and gas industries should pay for the costs
resulting from their actions, not the general public. If your neighbor dumped poison on your lawn
and it had to be cleaned up, should you pay or the neighbor? The neighbor
should.
While that is a hypothetical scenario, effectively that’s
what happened with climate change. The
fossil fuel industries used their political know-how to undermine the science—including
their science—that warned the public
about climate change and used their deep-pockets to block policy reforms
designed to protect the public and the environment.
But like that fictional neighbor, it is their fault. They
made the mess, they should clean it
up. A responsibility lesson that every
child learns, they’ve been able to dodge through political muscle and their fat
checkbooks.
Governor Cuomo and state lawmakers should ensure that the
oil, gas, and coal industries are on the financial hook, not taxpayers, for the
looming climate catastrophe. The
“Restore Mother Nature” bond act is needed, but those responsible should pay.
Posted by NYPIRG on February 10, 2020 at 8:05 am
Last week, as the state budget hearings continued, lawmakers heard pleas from academics, faculty and students that higher educational institutions are struggling, and that New York’s public policies make things worse.
One consistent refrain was
the need for the Legislature to change the governor’s proposed budget by
closing the so-called “TAP gap.” What’s
a TAP gap? First, some background.
When Governor Cuomo came into
office in 2011, one of the initiatives he advanced was a plan to annually
increase tuition at public colleges and universities. The appeal of predictable increases,
according to the governor, is that students and their families would know the
annual cost of tuition. Under his plan,
tuition would go up annually, but be capped at a certain amount. In the early years, that cap was set at $300
annual increase.
But what was not fully discussed
was the impact it would have on the state’s biggest college financial program –
the Tuition Assistance Program, or TAP.
TAP is an almost fifty year old program that awards state financial aid
to college students – both at public and independent colleges – based on
income. The poorer the student, the
larger the award.
Until Governor Cuomo, the
maximum TAP award matched the cost of tuition at public colleges.
When the governor first advanced
his plan, that relationship was severed.
Instead the maximum TAP award was frozen at $5,000 annually (it was
bumped up a few years later to $5,165) while tuition costs annually went
up. Tuition at the State University of
New York today hovers around $7,000.
Under the new system, the local college must make up the $2,000 difference
per needy student out of their own local budget.
The difference between
public college tuition and the maximum TAP award is known as the “TAP
gap.” That “gap” is increasingly putting
strains on the community colleges and four-year public colleges, since they now
must pony up a million dollars or so to help needy students – assistance that
used to be provided by the state.
Independent (private)
colleges are facing the financial pressure too, since TAP offers less and less
assistance for low-income students that often needs to be made up by those
institutions.
In addition, there are
substantial demographic changes in New York.
The upstate population is shrinking, particularly among the college-aged. SUNY community colleges have taken a dramatic
hit, with tens of thousands of fewer students than a decade ago.
As a result of these
pressures, SUNY 4-year colleges have had to raise tuition and administrative
fees to cover costs. Many SUNY community
colleges are teetering on the brink as they grapple with cratering student enrollments
and tight state assistance. Community
college tuition – already among the highest in the nation – has had to
jump. With fewer students, but the same
costs, tuition hikes have to cover the difference. Higher tuition results in fewer students and things
keep getting worse.
Independent colleges and
universities are taking a hit too and their share of the TAP awards has dropped
substantially.
What is to be done?
In the short-term, the
state needs to cover the difference of the “TAP gap.” Doing so will immediately bring relief to
struggling campuses. The help to
community colleges will need to be even more robust, as some of them are in
dire financial straits. Also, the state
must boost aid to independent colleges to help them make ends meet.
A longer-term solution is
to modernize the state’s TAP program.
Peg the maximum award to the cost of public college tuition – which
helps all colleges – and modernize it.
Ten years ago, the state stopped awarding TAP to graduate students. In the modern age that doesn’t make
sense. Part-timers – students typically
juggling job and family responsibilities – should get aid, too.
The state’s Excelsior
Scholarship – which offers some help – benefits only a very small portion of
students. Last year, of the total 452,000
full-time undergraduate public college students (287,000 at SUNY and 165,000 at
CUNY), only 25,000 received an Excelsior award.
One hundred years ago,
reformers pushed to make public school free.
They argued that a better educated populace benefited the nation’s
economy and strengthened democracy.
In the 21st
Century, education beyond high school is as critical now as universal education
was at the turn of the 20th Century.
Public policies today should seek to make it more affordable and
accessible, not less. One place to start
is by closing the “Tap gap.”