The clock is ticking and the partisan blockheads on the deficit “super committee” continue to insist that it’s their way or no way. The only thing that has gotten bipartisan agreement among committee members is a refusal to compromise. They deny the existence of another point of view. They refuse to accept the possibility that someone other than them could possibly have an acceptable point of view. They think they can bully the other side into accepting their point of view. If they continue—and there is no indication whatsoever that either side will give in to the other—automatic cuts will kick in as of 2013, with half of the $ 1.2 trillion coming from defense and the other half coming from domestic spending.
The automatic cuts would not affect Medicaid spending, but there would be a 2% reduction in Medicare payments to hospitals and other providers, with more severe cuts to other programs. What’s at stake is the federal money that supports HIV patients to pay for their drugs, biomedical research, and various disease outbreaks (foodborne illnesses as well as infectious illnesses). Most actual first-year automatic cuts will be about 7.8%, dropping each year to 5.5% in 2021. Funds for disease prevention will be all but gutted—with little resistance. President Obama has already caved, saying he is willing to reduce spending on prevention by $3.5 billion over 10 years. Few people, even those in the health professions, appreciate just how big a hit discretionary health programs are going to take.
We are not paying attention, so we are likely to see cuts in areas that really must not be cut, while other areas will get funded because industry lobbyists are paying attention. So this a heads-up: Lobby now and lobby hard for the essentials. The super committee’s decision (or more likely lack of decision) must be made by November 23 and Congress will have until December 23 to approve any deal. Otherwise, we will have automatic cuts – and no possibility of influence (until, of course, the next Congress is voted in).