Our state’s health commissioner, John McDonald, earlier this month asked a group of health-care professionals gathered in Albany to consider the word “contrast.”

He went on to contrast the federal direction in health policies with the state policies.

The federal government is making cuts to the National Institute of Health, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration among others, he noted. 

“You see 17 million people becoming uninsured during 2026, 2027. You see the attack on fluoride … You see attacks on vaccines so people like me, who haven’t seen these preventable diseases, now have to brush up on those things,” said McDonald, who is a doctor.

He contrasted this with the state health department initiatives.

“We implemented the New York State Health Equity Reform Waiver … improving individual social determinants of health, right? We just released the master plan for aging … so people can age in place in New York. We just released the prevention agenda — a catalog of all these evidence-based health benefits that we know work in populations. We support community water fluoridation. We support vaccines.

“By the way, we also support health centers and we’re supporting health-care workers … We know what we’re doing at the state health department. I’m worried the federal government doesn’t know what they’re doing or, worse, they do.”

The health-care professionals met at Whitney Young, Albany’s Community Health Center, to discuss changes to Medicaid under President Donald Trump’s reconciliation bill that will eliminate insurance coverage for millions of New Yorkers.

Statewide, Community Health Centers serve 2.4 million low-income and uninsured patients each year — or one in eight New Yorkers. Nationwide, although they account for just 1 percent of total health-care spending, Community Health Centers serve 10 percent of the population.

The health centers, McDonald said, provide “the highest quality care” and are “accessible to everyone.”

He went on, “But, quite frankly, they do things that other places don’t …. Health centers get population health. Health centers get why it’s important to make sure everybody’s got the proper immunization.”

Rose Duhan, the president and chief executive officer of the Community Health Care Association of New York State, described the centers as the “safety valve” for the entire health system.

“If people cannot get access to preventative care,” she said, “then those chronic conditions are going to become exacerbated.”

A conservative estimate is that, because of the federal bill, health centers will lose $200 million in revenue in the coming year, she said.

Elizabeth Whalen, who served as Albany County’s health commissioner during the pandemic and is now the medical director of the Office of Public Health for the state’s health department, said, from both a local and state perspective, “The work that the health centers do is the cornerstone of preventive care … a cornerstone of health.”

Addressing the nation’s “epidemic of chronic disease,” in “a reactive manner is not cost effective and it is not patient effective …,” said Whalen. “There are no winners when we have cuts like this.”

The core of the work, addressing holistic care, social determinants of health, and behavioral health, said Whalen, is provided by Community Health Centers.

“If you are looking at this from a dollars-and-cent perspective,” Whalen concluded, “it is more cost effective.”

The health-care professionals made it clear that we all will suffer with these federal cuts. Fewer people will be vaccinated, spreading disease to everyone. More people will go to emergency rooms for conditions that could have been prevented thereby increasing premiums and hospital fees for everyone.

The reconciliation bill is adding trillions to the national debt while making life worse for a broad swath of Americans, favoring only the wealthiest among us.

As we listened to McDonald, we thought back to earlier roundtable discussions we’ve covered hosted locally by Democratic Congressman Paul Tonko and began to see those talks in terms of contrast.

In April, leaders of local food pantries gathered at the Regional Food Bank headquarters in Latham to share the harmful effects they were already experiencing because of federal cuts.

Sister Betsy Van Deusen, chief executive officer of Catholic Charities, which covers the Albany Diocese’s 14 counties, including a food pantry in the Hilltowns, said her 11 pantries and three soup kitchens were seeing significant impact.

Van Deusen also said, of cuts to food stamps, “If they have less coming in the door, they’re going to  need and demand and require more from us … We also do domestic violence programming,” Van Duesen said of Catholic Charities, “and there’s much conversation about violence.”

When opportunities for farmers are gone because of cuts to the United States Department of Agriculture, local food sources will disappear, she said.

“Once a dairy herd has been dispersed, there’s no ability for a family to get that herd back,” said Van Duesen. “And that’s the end of a family farm.”

With USDA programs that kept farmers afloat being cut, she asked, “Who’s going to feed us? …. What those farmers do for us every day is make it possible for our grocery stores to be open.”

Van Deusen also stressed how malnourishment in children affects them throughout their lives and said she couldn’t imagine what it would be like to be a mother who was unable to feed her child.

“Crime is going to increase,” Van Deusen predicted, “because desperate people do desperate things. And what we’re doing in this nation right now is we’re making people desperate. We’re making them afraid. We’re creating chaos.”

We can contrast this with what New York state is doing to ease hunger. Sean Mulkerrin’s front-page story this week looks at the state’s new program to provide free lunches and breakfasts to all students.

One in five children in our state lives in poverty. Now those children, with no stigma, will be able to eat meals as healthy as their wealthier peers.

Two years ago, we advocated on this page for the Universal School Meal program, citing reams of research supporting the fact that students who are well fed are not just healthier in general but, importantly, better at learning.

A state law, we wrote, would be a wise investment in our future. That is even more true now as federal cuts loom for the Supplemental Nutritional Assistance Program.

All families will be helped as the savings per child has been calculated at nearly $2,000 annually. 

Also, the stigma will be lifted. Bonnie Kane, superintendent of the rural Berne-Knox-Westerlo school district, where close to 40 percent of the students are considered economically disadvantaged, bravely revealed that she herself “was that student who received free and reduced lunch growing up … I remember that stigma as well.”

Kane wisely concluded, “So these types of programs really do a great job of removing that. And just making sure that every student is fed.”

In July, a group of leaders of local historical sites met with Tonko on Peebles Island. Similar to the library leaders who met at the Bethlehem Public Library in April, they lamented the dissolution, by Trump’s executive order, of the Institute of Museum and Library Services.

They also spoke with anguish of the erasure of history by the Trump administration, particularly the history of minorities and their contributions to our nation.

In contrast, New York state responded through its education department earlier this year when Trump issued an executive order, “Ending Radical Indoctrination in K-12 Schooling,” that, as we wrote earlier on this page, chilled our soul.

“Parents trust America’s schools to provide their children with a rigorous education and to instill a patriotic admiration for our incredible Nation and the values for which we stand,” the order states.  

“In many cases,” the order goes on, “innocent children are compelled to adopt identities as either victims or oppressors solely based on their skin color and other immutable characteristics. In other instances, young men and women are made to question whether they were born in the wrong body and whether to view their parents and their reality as enemies to be blamed. These practices not only erode critical thinking but also sow division, confusion, and distrust, which undermine the very foundations of personal identity and family unity.”

Even as the Trump administration guts the United States Department of Education, our State Education Department has stood firm against the onslaught. The department noted that, since 1954, when the Supreme Court held that separate schools for African-American children were inherently unequal, New York has taken seriously its constitutional requirement to have public schools educate all the children of the state.

Since the pivotal 1954 Supreme Court decision, the State Education Department notes, Congress has protected and prioritized historically neglected students through legislation such as the Elementary and Secondary Education Act, the Individuals with Disabilities Education Act, and the McKinney-Vento Homeless Assistance Act.

“These laws recognize and celebrate personal, social, and economic differences,” our State Education Department says. “They are models of strength through diversity.”

The department states that Trump’s orders are not only antithetical to this tradition but also ineffective since he has a constitutional duty to see that laws are faithfully executed.

The State Education Department concludes, “The Board and the Department remain committed to the inherent dignity and worth of every child. As such, we denounce the intolerant rhetoric of these orders. Our children cannot thrive in an environment of chaos; they need steady and stable leadership that we will endeavor to provide.”

The leaders of historical sites who gathered on Peebles Island also noted the economic harm the federal cuts would cause. Bob Radliff, director of the Erie Canalway National Heritage Corridor, said the recent cutbacks make no economic sense. He described heritage sites as “tourism attractions” and said, “It helps local economies … attracting millions of people to come visit New York state every year.”

Tariq Zahran, the director of Cultural Resources for the National Parks Conservation Association, agreed.

He described the National Parks $3 billion dollar budget as “a fraction of a fraction” — one-fifteenth of 1 percent — of the entire federal budget. “But,” Zahran went on, “it creates over $50 to $60 billion dollars in economic returns for local communities across the country.”

Zahran also referenced the QR codes that the Trump administration has installed at national parks so visitors can report “negative” comments from rangers or in displays or films.

Zahran said that responses through the QR codes, meant by the Trump administration to be a means of keeping rangers and park administrators in line with the Trump idea of history, are instead showing “Americans at large love what the Park Service stands for … We’re starting to see that there is this huge backlash against the erasure of our history and constituents across the board seem to respect that the Park Service are experts in doing this work and they’re able to convey it in a way that is factual and true.”

Ideally, federal and state governments should be complementary, working together, regardless of party, for the good of the American people.

But, under the Trump administration, the contrast is clear. New York state is working against the federal cutbacks and orders to preserve support, services, and freedom for all of its residents, not just the wealthy few.

We’ve looked here at the contrasts in ensuring good health care, sound nutrition, inclusive education, and accurate rendering of our history. But there are also contrasts in protecting our environment and protecting our liberties.

The common thread in all of these is that our state’s approach, unlike the federal government’s, is setting the stage for benefits that will show themselves in the future.

Taking just one example, well nourished children, beneficiaries now of free school meals, will be more successful as adults. Federal cuts that are made to serve the wealthy while increasing our national debt will not only cheat our children and grandchildren of a robust future but will chip away at the stability of our nation as a whole.

The tragedy is that individual states, acting alone against the federal government, cannot ensure a future free of widespread poverty, hunger, and disease nor from the heartbreaking effects of global warming.