Whatever happened to the peace dividend?
It wasn't long ago that the world appeared safe for democracy, or at least relatively protected from the horrors of Soviet-style tyranny. And with a percolating economy, the healthcare industry was braced for better days ahead in its relationship with Uncle Sam. Along with education and infrastructure improvements, conventional wisdom said, healthcare would gain more federal financial support as the military was downsized.
It didn't work out that way, thanks to a Republican revolution and a Democratic administration determined to look under every rock for fraud, deceit and other forms of illegal healthcare behavior.
And now that William Jefferson "Santa Claus" Clinton has firmly returned to the presidential sleigh, he's more anxious to give presents to the military than to healthcare providers. In his proposed budget for fiscal 2000, Clinton seeks the biggest jump in military spending in 15 years. Outlays for defense would increase by $12.6 billion in 2000 and by $112 billion over the next six years. Most of the infusion would be earmarked for higher military pay and pensions, as well as new weapons.
Meanwhile, the budget surplus has Republicans eyeballing a hefty tax cut and possibly sweetening the defense pot even more than the administration has suggested.
Rather than a peace dividend, healthcare gets a lump of coal.
The president wants to freeze Medicare hospital inpatient payment rates for fiscal 2000 as part of a package of more than $9 billion in provider payment reductions. Remember that inpatient rates also were frozen last year.
On the medical research front, the administration seeks a modest 2% budget increase for the National Institutes of Health after a big hike in the current fiscal year. In addition, providers can expect a continuation of strong fraud-fighting efforts and aggressive collection of user fees in fiscal 2000.
A lean and efficient government is a good thing. Maybe the best healthcare providers can hope for is that Uncle Sam monitors all federal contractors as closely as it does hospitals.