For a governor whose budget aims to help recession-flattened businesses get back on their feet, a pair of CEOs have a message: Health-care providers are businesses, too.

When I caught up with CEOs David Wessner of Park Nicollet Health Services and Mary Brainerd of HealthPartners, they were smarting over the wallop their businesses took in Gov. Tim Pawlenty's 2010-11 budget proposal, released Tuesday.

The sorest spots are their hospitals -- Park Nicollet's Methodist in St. Louis Park and HealthPartners' Regions in St. Paul. Along with other Minnesota hospitals, they are already struggling with a mounting burden of uncompensated care (see chart) and shrinking reimbursement for services to Medicaid patients.

Under the governor's budget, hospitals would take a $400 million-per-year hit in each of the next two state fiscal years, according to a Minnesota Hospital Association tally that adds the loss of federal matching funds that accompanies a state payment cut. That would come on the heels of two waves of cuts last year that took away $234 million in state and federal reimbursement.

The governor's willingness to tighten the squeeze on hospitals had the two CEOs crying uncle. "Why should the solution to this big, broad problem -- a problem caused by shrinking income levels and tax levels from all sources -- come down narrowly on vulnerable populations and the institutions that are the safety net for the state?" Wessner asked.

The needs of the people these health organizations serve ought not be lost in this column, because they're not lost on these execs. They worry about the plight of the newly uninsured unemployed, the chronically underserved mentally ill, and 85,000 -- or more -- working-poor adults who stand to lose health insurance under Pawlenty's budget-balancing plan. The human and moral dimensions of their work clearly matter to them.

But it seems that it's the jobs dimension that gets politicians' attention these days.

Brainerd and Wessner want Pawlenty and the Legislature to notice this: Even health-care jobs -- once thought to be havens of safety in hard times -- are at risk now. Park Nicollet laid off 233 workers and eliminated another 160 open jobs in December. HealthPartners hasn't seen a layoff yet, but Brainerd hints that job cuts may be coming.

At the Mayo Clinic -- whose 37,000 workers make it the state's largest private employer -- a contract hiring freeze is on and summer hiring has been canceled, said government relations director Frank Iossi.

What would be the employment implications of Pawlenty's proposed cuts? "A very significant number" of jobs would be lost, Brainerd said.

The Republican governor's case for cuts in state health-care spending is much about its impact on the state budget. The numbers on the health-care line are growing faster than any other budget category. Every other state government mission is at risk of being gobbled up by the health-care monster.

The health industry CEOs don't dispute that analysis. But they point out that capping hospital reimbursement and denying people health insurance won't make those costs disappear. It only pushes them off the state's balance sheet and onto someone else's.

If you have health insurance, that someone else is you. Uncompensated care becomes a hidden tax built into insurance premiums. You're also covering the difference between what government pays for health care and what it really costs -- a difference Pawlenty's proposal would widen.

"We can't run away from this problem," said Wessner. "We need to be thoughtful about how we're going to spread this burden. Then we need to get back to our reform work, so we can have permanent solutions."

Health-care reform was the rage at the Capitol last year. Two task forces, one appointed by Pawlenty, agreed that if everyone is insured and providers have incentives to keep people healthy and operate efficiently, cost increases can be slowed. That, in turn, would make Minnesota a better place to do business.

Pawlenty and the Legislature took a step toward that kind of reform last year. This should be the year for Step Two. What Pawlenty is proposing looks instead like a step backward.

Lori Sturdevant is a Star Tribune editorial writer and columnist. She is at lsturdevant@startribune.com.