The Sequestration - Dangerous Cuts to Health Care

Posted on Mar 06, 2013 by Ailee Slater (G+)

In 2012, the United States experienced eight outbreaks of the food borne illness salmonella. If that doesn't sound like a lot, well, it is. With eight outbreaks, 2012 had more instances of salmonella than any other year in recorded history; thanks to cantaloupes, peanut butter and yellowfin tuna, more than 400 people fell ill after consuming food infected with salmonella.

With salmonella breaking U.S. records, the federal government will surely increase funding this year to improve the quality of food inspections programs. Right? Wrong. Thanks to mandatory federal budget cuts on the 1st of March, food inspections agencies are just one of the many programs losing millions of dollars in 2013. Known as the sequestration, these budget cuts amount to a shocking $85.3 billion dollars. The cuts came into effect last Friday when the U.S. Congress was unable to come to an agreement on how to balance the federal budget. President Obama and congressional Democrats advocated trimming excess from public programs while also raising taxes; House and Senate Republicans, however, refused to agree to any plan that increased taxes. With this stalemate, the government was left powerless to stop the cuts. United States defense programs will be hurt the strongest by sequestration cuts, with budgets losses of $46 billion, a reduced working week for civilian defense workers, and delay in the exports of important defense tools.

After defense, it is public health programs which will be affected most by sequestration, with $2.4 billion disappearing from public health budgets. To begin, the sequestration will cut $424 million in funding to support single and low income women raising a family. Known as Head Start and Early Head Start, these programs provide access to health care, education and nutritional support to over 1 million children and their families. With hundreds of millions of dollars lost in federal support, 70,000 people will be cut from the programs. Unfortunately, the health of women and those in a low income bracket will be affected by sequestration in other ways as well. These budget cuts will remove $8 million dollars from the Breast and Cervical Cancer Screening program, a service mostly used by women who cannot afford such tests without this federal assistance. Women will also lose $50 million from the Title V Maternal and Child Health Services Block Grant, a grant from the federal government that provides prenatal health care and other maternity related services to low income families.

Besides losses to public health services, important research in medical science and health care will also be hurt. The sequestration cuts $1.6 billion from the National Institute of Health; a move that will cut funding in all 50 states. A recent article in the L.A. times quotes one University Chair of Psychology in Nashville explaining that cuts will mean a reduction in lab staff  who are currently developing drugs to prevent heart attacks. Across the country, the Oregon Health and Science University, also the state's biggest employer, will have to cut $33 million dollars worth of jobs, research, education and outreach programs. Mental illness, an important health topic after last year's series of mass shootings, will see treatment resources reduced. The group Mental Health America estimates that 684,000 individuals using community mental health services will lose housing assistance, case management support or school-based support; individuals with mental illness will also see a reduction in legal advocacy and protection services, as well as substance abuse treatment programs.

Children and adolescents will be affected as well - Mental Health America calculates that suicide crisis lines will be reduced, thousands of at-risk youth will not receive mental health screenings, and trauma-based recovery services for youth will be lost. As exemplified by the salmonella outbreaks of 2012, food safety is an important part of health care. Unfortunately, sequestration will result in the loss of thousands of inspections of food manufacturing facilities, through cuts to the Food and Drug Administration as well as the Department of Agriculture. The FDA has estimated that sequestration cuts will result in 2,100 fewer food safety inspections per year, and slow the process of approving new drugs and medical devices. Of course, the sequestration will hurt not just the health care of the United States, but global health care as well. $600 million dollars will be eliminated from U.S. programs that provide humanitarian assistance and benefit health around the world; Secretary of State John Kerry has commented that the sequestration cuts will have a big effect on U.S. efforts to reduce the spread of AIDS and prevent child mortality. $2.6 billion dollars will be cut from the State Department and USAID, an act that might leave hundreds of thousands forced to give up AIDS medication; the deaths as a result of this would then lead to the sad state of thousands of orphaned children. Clearly, sequestration cuts are bad for health.

Reduced domestic health programs will affect the poorest and most vulnerable members of the population worst, and the long term consequences of reducing prenatal care and cancer screening can only lead to higher health costs in the future. Internationally, sequestration cuts will reduce U.S. health aid and lead to legitimately tragic consequences for people who have come to rely upon that health care support. Possibly the only piece of good news for U.S. health care is the fact that Medicaid, as well as the Children's Health Insurance Program (CHIP), are completely exempt from the sequestration. Likewise, although the Medicare budget will be affected, cuts are limited to just 2 percent. It's a manageable number, however these Medicare cuts will lead to the loss of the Health Care Fraud and Abuse Control program.

It's a peculiar thing to cut, seeing as this particular program recouped $4.1 billion dollars in fraudulent payments over just one year. That means that for every one federal dollar funding the Health Care Fraud and Abuse Control program, seven dollars are returned to the federal government. The fact that sequestration will cut this program highlights the glaring impracticality of these budget cuts. And what is merely impractical for the government is potentially fatal to millions of people who stand to lose their health care services.