It is hard to reconcile the Bush administration's ''compassionate conservatism" with its very uncompassionate assault on the safety net for our nation's most needy and vulnerable citizens, low-income Americans and the elderly. Recent budget cuts by Congress to the departments of Labor, Health and Human Services, and Education target programs aimed at this growing segment of society.

It is not just elderly and low-income Americans who will be touched by these deep cuts in federal spending. It is each one of us. We are all aging, and many of us will become caregivers for an older parent or an aging spouse. What is less well known is that these budget cuts eliminated the only federal initiatives that fund geriatric education programs, which play a vital role in addressing the profound shortage of healthcare professionals trained to respond to the healthcare needs of today's older adults -- and tomorrow's rapidly graying America.

This vote begins the dismantling of a 20-year-old infrastructure that includes 50 geriatric education centers, located in almost every state across the United States, that have trained nearly half a million healthcare professionals. Also eliminated are geriatric training programs that support physicians, dentists, and mental health professionals who are equipped to train the next generation of leaders in geriatric care. Fellowship awards that support the academic career development of physicians committed to teaching geriatrics in medical schools across the country have also been discontinued.

The irony of these cuts is overwhelming. We are on the crest of an age wave, with the oldest members of the nation's 78 million baby boomers turning 60 this year, and starting to require care designed to meet the needs of the aging. Eliminating special geriatric training programs will only increase medical errors made by healthcare providers who lack knowledge of the special health challenges facing older adults. Lack of appropriate treatment will undoubtedly lead to an increase in the need for costly long-term care.

The paradox becomes even more bizarre. Slightly more than 1 percent of the nation's practicing physicians have certification in geriatric medicine. Similarly, fewer than 1 percent of nurses are certified in geriatrics. The dearth of healthcare professionals and faculty trained in geriatrics, in social work, pharmacology, and other health-related professions makes the situation even more dire. Why, on the eve of an expected demographic explosion, are we dismantling programs that support the training of the next generation of healthcare providers?

Something is terribly amiss here. These cuts in geriatric education are at complete odds with recent recommendations made by the President's White House Conference on Aging. In December, delegates from across the country adopted a list of 10 recommendations, two of which included a call for increased training for geriatric healthcare professionals. Perhaps most ironic of all, when proudly touting its new Prescription Drug Benefit of the Medicare Modernization Act, the Bush administration acknowledges the serious healthcare challenges facing older adults.

Does the president really believe that the recent Senate vote is a ''victory for taxpayers, fiscal restraint, and responsible budgeting?" Vice President Dick Cheney flew back from a diplomatic mission in Pakistan, eager to break the 50-50 tie vote, in favor of a budget designed to cut the federal deficit by $39.7 billion. According to budget experts, these cuts will barely dent the federal deficit, cutting less than one-half of 1 percent from an estimated $14.3 trillion in federal spending over the next five years. Elimination of geriatric education programs will have rippling effects on the health of the current and future waves of elderly.

Perhaps some of the lawmakers who voted for these cutbacks will rue their decision when they too are faced with a life-threatening decision for their aging parents, their aging spouse, or themselves, and cannot find an adequately trained healthcare provider to help them with making the right decision. But then it will be too late.
Sue Levkoff is an associate professor at Brigham and Women's Hospital and director of the Positive Aging Resource Center.