Mon, Feb 4, 2008 (2:01 a.m.)

The new $3 trillion 2009 budget that President Bush is expected to present today includes a call for significant cuts to the Medicare and Medicaid programs.

The programs, which cost $627 billion last year, account for almost a quarter of all federal spending. Bush says the programs are unsustainable and must be cut in order for the nation to achieve his goal of a budget surplus by 2012, The New York Times reported last week.

The president proposes to cut $1.2 billion next year from Medicaid, which provides health insurance coverage to poor people, and he will call for cutting $14 billion from the program over five years.

Medicare, the president says, must be cut by $6 billion next year and by $91 billion from 2009 to 2013.

These cuts, however, would not apply to the federal payments that private insurers receive through the Medicare Advantage plans that have been rife with overpayments. A Congressional Budget Office analysis in 2007 showed that medical services offered through these plans cost 12 percent more, on average, than traditional Medicare. Some plans are overpaid by 50 percent.

The cuts instead would occur in the Medicare payments made to hospitals, nursing homes, home health care services, hospices and ambulance services — the services and facilities used by the sickest of the sick.

William Dombi, vice president of the National Association for Home Care and Hospice trade group, told the Times that under Bush’s proposal “75 to 80 percent of home health agencies would be doomed” and unable to make payroll or continue operating.

A splendid plan, Mr. President. Slash the services that allow people to live at home longer and avoid expensive nursing home care, then cut reimbursements to nursing homes so that they have room for fewer patients.

Congressional Democrats have said Bush’s proposal hasn’t a chance of survival, and we hope that’s true. Bush’s proposal would be a terrible, cruel way to treat our nation’s sick.