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It's back-against-the-wall politics, in the alley, brass knuckles and no holds barred.

It's face-off and stare-down, a high-stakes game of chicken that points the blame where it belongs -- at Albany.

Joel Giambra didn't make it out of the West Side projects by huddling in a corner. He didn't go from Common Council gofer to county executive by cowering from a commotion.

Which is why he -- as promised -- dropped a budget bomb Friday. The threatened explosion, as he put it, "ends county government as we know it."

Giambra's proposed all-cuts "red" budget means no more libraries, snowplows, sheriff's road patrols, school nurses, Philharmonic Orchestra. No more jobs for 3,000 county workers or 3,000 agency hires who depend on county dollars. Everybody -- big or small, young or old, black or white, rich or poor -- feels the pain.

Will it happen? Not likely.

But the madness of the method drives home a point in every home, from Elma to Amherst: Medicaid is breaking us, and it's Albany's fault.

Workers on the chopping block and culturals whose doors would close complain about being caught in the middle. Wake up and smell reality. The "red" budget is a face-slap to a sleeping public, a wake-up call to change that Albany must be forced to answer.

The bill for the county's share of Medicaid is up $82 million since Giambra took office. With no fix, it will inflate another $75 million in four years.

The cost of public health care -- for the kids of minimum-wage workers to gray hairs in nursing homes -- is buckling counties from here to Long Island. New York has benefits beyond just about any other state. Cuts can only be made in Albany. The bill comes here, but the buck stops there.

Giambra won't be the fall guy. His "red" budget forces the 15 county lawmakers to either help him push for a one-penny sales tax hike, or to double property taxes, to fill the county's Medicaid-dug budget hole.

Giambra won't take the Medicaid hit without hitting back. He jabbed at Friday's news conference, saying "the state is holding the people of Erie County hostage." He strikes through a melodious female voice on a radio ad: "The state makes the (Medicaid) rules, we pay the bill. . . . Contact your state legislator."

By pointing the finger, Giambra pokes at the source of the problem -- Albany -- and its solution. The state either takes over the Medicaid share the counties pay, or makes the cuts to bring down cost.

"We need to draw a line in the sand with Albany," Giambra said of the "red" budget, "to get their attention."

There was, of course, another way to fill the budget hole. Giambra rode to office on the back of a 32 percent tax cut. It kept $280 million in the wallets of county homeowners the past five years. He made up the loss by slicing $30 million a year in costs and siphoning from an overstuffed county surplus. But there's no more stuffing to siphon, and the Medicaid load gets heavier.

Giambra could have softened this budget hit by reinflating property taxes the past few years. There's a decent argument that he should have. This wasn't a 9/1 1 sneak attack, the Medicaid bill has relentlessly risen. But there's a reason, beyond avoiding the political hit, Giambra didn't raise property taxes: It doesn't solve our larger problems.

"We're already 47 percent above the national (property tax) average, which hurts our ability to keep and attract business," said Giambra. "And raising (property) taxes takes the state off the hook for the (Medicaid) problem of its making."

His back is against the wall, brass knuckles on. Message to Albany: You hurt me, I hurt you. Bring it on.


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