Avoiding the plunge
Looming fiscal deadlines pose challenges for healthcare, nation
As the Federal Reserve reminded us last week, the nation’s “fiscal cliff” is steadily looming larger on the horizon. And every so often, the talking heads also want to make sure we’re aware of what lies ahead—a judgment day they like to call “Taxaggedon.” Not familiar with what they’re talking about? It’s the collective year-end expiration of the tax cuts first enacted by former President George W. Bush, the Social Security payroll tax “holiday” and the final extension of emergency unemployment benefits.
And let’s not forget we’ll also hear the starting gun for “sequestration,” the automatic budget cuts set to hit both discretionary and defense spending thanks to lawmakers’ inability to achieve a debt-reduction deal this year. Physicians also face another deadline to avoid double-digit cuts in their reimbursement.
Scary stuff, for sure, but it’s far too early to panic. Remember the message from this page last week: For the sake of your cardiovascular health and general sanity, try to stay upbeat about an ultimate resolution of this mess. Congress has plenty of time—if lawmakers can find the will and constituents keep up the pressure—to finally achieve some form of grand bargain on spending priorities and the national debt.
Then again, we are talking about Congress, in an election year. Maybe it really is time to start sweating.
While the Fed last week gave a somewhat more optimistic outlook in the near term, with joblessness possibly dipping below 8% by year’s end and modestly improved growth in gross domestic product year over year, it’s the longer-term prognosis that is clouded with much more uncertainty.
“If no action is taken by fiscal authorities, the size of the fiscal cliff is so large that the Fed would have no ability to offset that effect on the recovery,” Fed Chairman Ben Bernanke said.
If that happens, healthcare will certainly feel the pain, meaning providers and patients. No sector will escape unscathed.
And let’s not overlook another critical set of what-ifs. As in what if the U.S. Supreme Court does rule against the health reform law, likely derailing many of its laudable objectives, especially provisions to slash the number of uninsured by more than 30 million. The question has been raised many times: What’s in the playbook from lawmakers and the presidential contenders should that happen? How will they address the lack of access, tame the monster of runaway healthcare costs, and somehow not revert to the era of cruel insurance policy rescissions and rejections because of pre-existing conditions?
As the Fed reinforced, we’re still in a fragile economic recovery, and no matter who is in the White House next January, that will still be the case for some time. No political spin can change that.
Signs of continuing struggles with healthcare because of unemployment or under-employment are still abundantly clear.
Just one example was a short story published last week on the website Northjersey.com: “Virtually every weekend around North Jersey, there’s a pasta supper or a pancake breakfast to benefit someone overwhelmed by medical bills. Friends and neighbors gather to help toddlers with devastating genetic conditions, teens felled by catastrophic accidents, parents leveled by rare cancers. Some have insurance, some are uninsured. …
“In part, the fundraisers are a natural outgrowth of an American healthcare system that has left nearly 50 million uninsured and another 29 million under-insured, with high copayments and deductibles. …”
That’s only one section of one state. Such stories are certainly nothing new, but we need to keep asking: Given what we spend on healthcare in this country, don’t we want to do better than that?