Weill Cornell Medical College Dean Antonio Gotto testified in Albany Feb. 13 before the New York State Assembly's Ways and Means Committee and the Senate's Finance Committee on behalf of the Associated Medical Schools of New York. Gotto lobbied before a joint committee of both groups to stem proposed cuts in New York Gov. Eliot Spitzer's 2007-08 health and Medicaid budget.

To control spending and prevent a projected $1.6 billion shortfall without raising taxes, Spitzer has proposed cuts in several areas, but has specifically targeted health care and Medicaid as examples of "runaway spending." According to the governor's office, New York state has the highest rate of Medicaid spending per capita in the country.

The 2007-08 proposed budget would cut $24 million from graduate school medical education programs, which help provide training for roughly 15,000 residents at state teaching hospitals. The funds would be reallocated to hospitals based on the number of Medicaid patients served and would limit payments for Medicaid services performed by residents; that would save the state $36 million but would mean hospitals would be reimbursed for services at a lower rate.

"These cuts will have a devastating impact on teaching hospitals and medical training," said Gotto. Several health-care advocacy groups predict physician shortages by 2020 as a result of baby-boom generation retirement. Cuts to medical student training would hamper efforts to increase the number of physicians, the organizations argue.

A report on the proposed cuts by the State Senate's Finance Committee predicts that the cuts would have the greatest impact for hospitals on Long Island and in upstate New York, where there are fewer Medicaid patients. The report also argues that hospitals cannot make such operational decisions as how many staff to hire, including medical residents, based on the number of Medicaid patients in their area.

Separately, Gotto also argued for an increase in funding for post-baccalaureate science and math training for economically disadvantaged students who hope to become physicians in New York state. Spitzer's budget calls for $264,000 for the program; Associated Medical Schools of New York asked the Legislature to increase the budget to $750,000.

Gotto also praised the governor's Stem Cell and Innovation Fund, which will support $2.1 billion over 11 years to support research and investments in stem cells, life sciences and other emerging industries. Thus far, New York state medical schools and biomedical research institutions have been forced to turn to private foundations and donors for stem cell research funding. New York is a leader in biomedical research -- only California and Massachusetts receive more research funding from the National Institutes of Health. However, at least six other states have or are in the process of allocating public funds for stem cell research, and New York state has been lagging behind in support of this research. This has caused New York researchers to move to states where they can receive more funding for their stem cell work.

"The effects of this brain drain will reach into all corners of New York unless the state acts quickly to make up the ground that has already been lost," Gotto said.