Sequester cuts will hit medical care and research

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1996 (Published 26 March 2013)
Cite this as: BMJ 2013;346:f1996

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  1. Janice Hopkins Tanne
  1. 1New York

On 1 April $85bn (£56bn; €66bn) in this year’s mandatory budget cuts will kick in, affecting doctors, hospitals, research centers, Medicare, the Food and Drug Administration, the Centers for Disease Control and Prevention, and other essential parts of US healthcare. Only defense spending will be hit harder.

The cuts must be made in the current fiscal year, which ends on 30 September. More cuts will happen in the next 10 years as part of the $1.2 trillion reduction in spending spread over the next decade.

Nationally the sequester cuts will affect research and innovation, food safety, and mental health as well as payments to doctors and hospitals. The White House has estimated that the cuts would lead to 2100 fewer food inspections and 12 000 researchers and scientists losing their jobs. Cuts to mental health would leave nearly 400 000 mentally ill adults and severely emotionally disturbed children without treatment, leading to more hospitalizations, involvement with the criminal justice system, and homelessness, the White House said.

This year the sequester cuts will reduce Medicare payments to doctors and hospitals by 2%. Public health and research programs face big cuts.

A joint report from the American Medical Association, the American Hospital Association, and the American Nurses Association estimated that 766 000 healthcare and related jobs could be lost by 2021 as a result of the 2% cut to Medicare.1

Jeremy Lazarus, president of the AMA, said, “The across the board cut will hit physicians particularly hard because of the fundamentally flawed Medicare physician payment system. Since 2001 Medicare payments for physician services have only increased by …

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