Cuts to bruise health care
Officials brace for budget ax to hit Medicare, research funds
WASHINGTON — As the Obama administration begins to implement $85 billion in cuts to federal spending this year, no part of the federal budget other than defense will take a bigger hit than health care.
And the sequester appears likely to have a disproportionate effect on areas of the health system already hobbled by years of retrenchment or underfunding, including public health and medical research.
By contrast, although the Medicare program will account for the largest chunk of dollars cut from health care simply because of its size, the slated 2 percent reduction in its payments to doctors and hospitals is smaller than what many public health and research programs face.
Laboratories at major universities and medical centers are laying off scientists, and local public health officials, hit by years of cutbacks, are scaling back immunization campaigns and other efforts to track and control infectious diseases.
“They are doing cuts on top of cuts on top of cuts,” said Dr. Eric Hoffman, director of the Center for Genetic Medicine Research at Children’s National Medical Center in Washington. Hoffman’s labs have Spending cuts may dim the health care industry’s outlook on Washington as medical officials brace for Friday’s sequester. had to delay several including the American projects, including new reMedical Association, the search into muscular dysAmerican Hospital Associatrophy in children. tion and the American
Compounding the chalNurses Association, have lenges is a lack of direction warned that the Medicare from Washington. Adminiscuts will lead to lost jobs. tration health officials have But many hospitals and provided little guidance other providers, such as about how they plan to Adventist Health System’s implement many cutbacks Florida Hospital in Orlando, and when they will hit. had already planned for
A Health and Human these cuts. “We assumed at Services spokesman said the beginning of the budget only that the agency would cycle that this would occur,” be sending general notisaid Richard Morrison, vice fications Friday to those president of Adventist. who rely on federal money. What worries some The agency is expected to medical leaders more is that cut about $15.5 billion, with Congress and the White about two-thirds of that House could reach a larger coming from Medicare, deal to avert the sequester. which covers the elderly Any such deal might involve and disabled. steeper cuts in Medicare or
Major medical groups, Medicaid, which was ex- Bad idea: 52% empted from the sequester.
For now, the budget ax will fall most heavily on programs already battered by years of government cutbacks.
Nationwide, as many as 46,000 public health jobs have been eliminated in the past five years, the Association of State and Territorial Health Officials and the National Association of County and City Health Officials estimate.
Now, the federal Centers for Disease Control and Prevention plans more cuts.
HHS Secretary Kathleen Sebelius has told Congress that the CDC cuts could result in 424,000fewerHIV tests by state and local health programs the agency funds. Of the agency’s $6 billion budget, 70 percent goes as grants to state and local health efforts.
“These cuts are going to have a real impact,” said Washington state health secretary Mary Selecky, whose department has seen a 38 percent cut in state funding over the past six years. “In the next 6-8 weeks, we’re going to have to say we’re closed on Fridays or we can’t provide this or that service anymore.”
Anxieties also run high among researchers who rely on grants from the National Institutes of Health. NIH Director Francis Collins told reporters this week his agency is looking at losing $1.6 billion by the end of the year after a decade of flat budgets.
“It is so frustrating,” said Heidi Hamm, chairwoman of pharmacology at Vanderbilt University in Nashville, Tenn. NIH cuts may force her to lay off one of eight researchers working to develop drugs to prevent the blood clots responsible for heart attacks, she said.