As a Final Fuck you to the country Bush Attempts to cut health care to nation's poorest

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Budget documents show that Mr. Bush will propose legislative changes in Medicare to save $6 billion in the next year and $91 billion from 2009 to 2013. In his last budget, by contrast, his legislative proposals would have saved $4 billion in the first year and $65.6 billion over five years.

The president’s budget also takes aim at Medicaid, the insurance program for low-income people. He would pare $1.2 billion from it next year and nearly $14 billion over five years.

Those figures do not include tens of billions of dollars that Mr. Bush wants to save through new regulations. Such rules are not subject to approval by Congress, but could be revised by a future administration.

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Kenneth E. Raske, president of the Greater New York Hospital Association, said the president’s proposals showed “great insensitivity to teaching hospitals” across the country. The proposals “would undermine our ability to train young doctors at a time when the nation is facing a shortage of doctors,” Mr. Raske said.

Under the president’s budget, Medicare payment rates for nursing homes would be frozen in 2009, and payment rates for home health agencies would be frozen at current levels through 2013.

William A. Dombi, vice president of the National Association for Home Care and Hospice, a trade group, said the proposal could affect many of the three million Medicare beneficiaries who receive home health services each year.

“Under the proposal,” Mr. Dombi said, “75 percent to 80 percent of home health agencies would be doomed. They would not be able to meet payroll. They would not be able to operate.”

Within 15 days of sending his budget to Congress, Mr. Bush is supposed to submit legislation to strengthen the financial condition of Medicare and to reduce its reliance on general revenues, which include income taxes. The 2003 Medicare law established special procedures to ensure that Congress would consider such legislation.

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