The New Bush Budget: Cutting Health Care for 9/11 Responders, Medicare, and Veteran's Health Programs

The buzz is everywhere now that U.S. President George W. Bush has unveiled his budget plan for the coming fiscal year. Huge cuts in health care spending are part of the package, and the prevalent attitude across the media seems to one of shock.

Let's begin in New York with The Queens Gazette where John Toscana addresses the massive reduction in health care funds for 9/11 survivors:

New York lawmakers in Washington who have been persistently pressing the White House for increased funding for healthcare programs for ailing 9/11 World Trade Center workers were jolted last week when President George W. Bush's proposed budget slashed those programs by 77 percent. [...]

"This dramatic and unwarranted cut flies in the face of common sense, compassion and just plain fairness," Senator Charles Schumer declared as he promised to "fight these cuts tooth and nail to ensure these heroes receive the health care they need and clearly deserve".

An editorial yesterday in the San Jose Mercury News lists some of the extensive health care cuts:

The single most damaging portion of the Bush budget is his proposal to cut an additional $200 billion from Medicare and Medicaid programs. That will cause irreparable harm to public hospitals that are required by law to provide medical care to uninsured residents. And it will further reduce the number of doctors willing to treat a growing senior population, let alone the poor on Medicaid.

[...] Cutting Medicare and Medicaid isn't the only ill-advised health care proposal. Incredibly, Bush calls for a decrease in veterans' medical programs, despite the toll of war and revelations of inadequate care.

He calls for a freeze in the National Institutes of Health budget, which will result in fewer research grants to find better treatments for cancer and other diseases. His proposed funding for the State Children's Health Insurance program falls far short of the bipartisan agreement that has the approval of Congress, including Republicans such as Sen. Orrin Hatch of Utah. One out of every eight children in the nation now has no health insurance, a national embarrassment.

The proposed cuts in veterans' health care come at a time when the Veteran's Administration is facing litigation for arbitrary denial of care and benefits to wounded veterans, an issue that will be joined in a hearing March 7th.

Next stop on the tour is Oregon's Portland Business Journal, where Republican Sen. Gordon Smith's reception of this news is frosty:

"Good policy should drive the budget, not arbitrary cuts to programs that protect our seniors, our children and the most vulnerable," Smith said in a statement. "Cuts to Medicare and Medicaid start an unwelcomed ripple effect in state budgets and doctors offices.... We should strengthen, not bring down the programs that keep America healthy."

In upstate New York hospitals are looking at a loss of $2.4 billion in funding over the next five years if the proposed budget gets passed. Christian Livermore of the Hudson Valley Times-Herald-Record brings us that perspective along with more commentary by Senator Schumer:

Sen. Chuck Schumer yesterday called the proposed cuts -- the largest, he said, since he has been in the Senate -- "a punch to the gut of upstate New York hospitals."

"Our hospitals are already struggling to get by," Schumer said in a conference call with reporters. "Many are in red ink. You put these cuts in and you're pulling the rug out from under them, not just the hospitals themselves, but the doctors, the nurses, the technicians and the people who sweep the floors at night, who depend on these hospitals for their livelihood."

Bush's cuts to New York hospitals and health systems could total $10 billion statewide, much of it from rate freezes and reductions in reimbursements for indigent care, and would cut Medicare and Medicaid by $200 billion nationwide over the next five years.

It will be interesting to see what happens when this reaches Congress. Senators Smith and Schumer are far from the only critics on Capitol Hill.

SOURCE: "NY Lawmakers Shocked At Bush's 77% Cut In 9/11 Health Funding" 02/06/08
SOURCE: "Editorial: Bush's budget takes money away from health care" 02/06/08
SOURCE: "Veterans not entitled to mental health care, U.S. lawyers argue" 02/05/08
SOURCE: "Smith criticizes proposed health care cuts" 02/04/08
SOURCE: "Proposed cuts could sting: Local hospitals face decisions they'd rather not have to make" 02/07/08

photo courtesy of U.S. State department (Official Portrait, Public Domain)

Best Health Care in The USA? Surprise! It's the VA!

The Veterans Administration, an organization that has been castigated for years on the subject of its low quality care, has made a turnaround. Be prepared, this story is replete with words and phrases that have gained a massive political charge in recent months, chief amongst them "socialized medicine."

ABC News brings us a thought provoking report (video here | text here ) on how the VA has moved from one of the worst health care programs in the country to being the best in the nation. I can sum it up in one phrase for you, electronic medical records. If you have the bandwidth I highly advise checking out the video linked above, if a picture is worth a thousand words then hundreds of them strung together as video should be worth millions.

Here are a few quick nuggets of data drawn from the text version online at the ABC News website:

Experts generally agree that electronic records are absolutely essential to significant health care reform. However, only about 5 percent of the nation's hospitals now have them.

[...] in most private hospitals 20 percent of lab tests are repeated simply because doctors can't find a patient's results.

But in the VA system, every patient's records are as close as a computer. It saves millions of dollars.

[...]Study after study puts the VA system at the very top for fewer medical errors, for effective treatments, for lower costs and for patient satisfaction. And the VA delivers all of this for at least $1,500 less per year per patient than Medicare.

Our own Mr. Halvorson is one of the experts who see electronic medial records (EMRs) as an essential part of the reform equation. The fact that the VA, has been implementing EMRs with such positive results supports the veracity of those claims. Granted, the VA system could not be implemented "as is" on a national basis, but the fundamental concept has now been proven to be sound. If a system of EMRs that follow each patient for their lifetime, as VA records do, is implemented nationwide, a significant potion of our current health care crisis can be averted.

SOURCE: "Veterans Affairs Healthcare System No. 1: How the Once-Maligned VA Healthcare System Becomes Best in Nation.
" 12/12/07
photo courtesy of scladesma, used under this Creative Commons license

When Johnny Comes Marching Home

After the Walter Reed Hospital scandal earlier this year President Bush created a bipartisan commission which determined that the treatment of our wounded veterans needed "fundamental change."

Tuesday President Bush sent legislation to Capitol Hill and began pushing Congress to help update the current system.

Deb Reiechmann reports for the Associated Press:

"Medical advances have enabled battlefield medics and hospitals to provide our wounded warriors with care that would have been unimaginable just a decade ago," Bush said, standing in the Rose Garden with wounded troops, including two that rode in on Segways.

"Yet our system for managing this care has fallen behind. It's an old system. It's an antiquated system. It's an outdated system that needs to be changed."

According to the President his legislation is focused on streamlining both the evaluation and compensation processes. There are many elements to the plan, some of which will be directly implemented by the administration, some of which require congressional approval.

James Gerstenzang, a staff writer for the Los Angeles Times describes some of the fine print in the President's appraoch:

The White House also said that the Veterans Affairs department would establish "recovery coordinator" positions -- patient advocates assigned to oversee the management of individual veterans' care, help them handle paperwork and other requirements of the federal bureaucracy, and ease their transition to civilian life. Creation of such a position was a key recommendation of the commission.

In legislation being sent to Congress, the administration would replace Pentagon disability payments with pensions, beginning with Iraq and Afghanistan war veterans. Additional payments would be awarded to cover the losses of potential earnings and quality of life as a result of service-related injuries.

Veterans would be reassessed every three years, and the rating system would be adjusted to reflect "modern concepts of medicine and disability," the White House said, describing the plan.

Bush said the new plan would move away from the current practice of wounded troops often undergoing two examinations -- by the Pentagon and by Veterans Affairs -- and filling out two sets of paperwork.

It will be interesting to see how the U.S. Congress responds.

SOURCE: "Bush Asks Congress to Help Fix VA System" 10/17/07
SOURCE: "Bush Unveils Plan For Wounded Troops" 10/17/07
photo courtesy of The Army's Soldiers Media Center on Flickr under this Creative Commons license