Editorial: Budget cuts are merciless

Sunday, May 7, 2000 | 8:28 a.m.

In 1997 Congress passed legislation to rein in the skyrocketing costs of Medicare, which provides health coverage for the elderly and the disabled. At the time it seemed sensible: The solvency of Medicare was expected to be in jeopardy within 10 years if budget cuts weren't made. These cost controls, which limit payments to health care providers, have saved Medicare huge amounts of money. But the cuts have created an unexpected, terrible consequence: Many nursing homes, hospitals and home health care providers have drastically curtailed their care because of the severe cuts.

Particularly hard hit have been the health providers that offer care in an individual's home. The Congressional Budget Office reported in March that payments to home health care operators fell 15 percent in fiscal year 1998 and even more dramatically in fiscal year 1999, dropping 35 percent. Current figures aren't available on how many people nationally are receiving home health care, but one year after the cuts were passed in 1997, the numbers declined an alarming amount, from 3.6 million to 3 million.

A recent New York Times story found that Congress' reductions have resulted in home health care agencies refusing to care for those who have extensive and long-term care needs. Increasingly those who have diabetes are shunned, as are those recovering from strokes or other debilitating conditions. The director of a Medicare patient advocacy group in Connecticut told the Times that she had a client who couldn't obtain home care because she had lost a kidney and is blind from diabetes. Home health care agencies are being forced, because of the payment caps, to instead place a premium on individuals who may only need a few weeks of care.

Certainly Medicare savings are being realized, but the cuts shouldn't be so severe that they cruelly eliminate needed care. Congress should look at the impact on all providers from the cuts and make necessary adjustments. Meanwhile, legislation is pending that would prevent a 15 percent reduction in Medicare payments to home health care agencies from taking effect next year. Congress should pass this bipartisan legislation as a first step in restoring compassion to the Medicare program.