Fear and loathing at the fiscal cliff

January 8, 2013 —

The many consequences unfurling from the legislation that kept the nation from falling over the fiscal cliff last week include changes to health care (you can find links to coverage by various media outlets here). While resolution of the nation’s fiscal situation is far, far away, the bill’s effects on health care include the following:

  • To avoid a 27 percent drop in Medicare payments to doctors – which some policymakers feared would cause physicians to refuse to take on Medicare patients – Congress reduced payments to hospitals.
  • While the hospital industry decried that deal, about 200 small, rural hospitals rejoiced that the legislation extended for one year a program that pays hospitals with fewer than 100 beds, that are located in rural areas and that treat a high proportion of Medicare patients.
  • The fiscal cliff deal terminated the CLASS Act (Community Living Assistance Services and Supports), which was included in the 2010 health care reform law to give working adults a basic cash benefit for future long-term care needs.

All parties in health care – from physicians to the pharmaceutical industry – know additional changes are likely in the coming weeks. The fiscal cliff bill failed to address several big issues, according to CNN Money analysts, such as when and how lawmakers will raise the nation’s debt ceiling and whether they’ll tackle real tax and entitlement reform. Further, CNN Money states, the bill “creates a new cliff deadline over spending cuts around the same time the debt ceiling will need to be raised.”

Will federally funded graduate medical education fall off a fiscal cliff?

Will federally funded graduate medical education fall off a fiscal cliff?

That so-called sequester, the across-the-board cuts that soon will return to the bargaining table, raises concerns about federal funding for the training of young doctors, nurses and other medical professionals. Cleveland internist David Bronson, president of the American College of Physicians, told NPR’s Julie Rovner that funding is “listed as a potential place where cuts could be made, and GMU [graduate medical education] is vital to the medical workforce in this country. And we need to be expanding it, not reducing it.”

This possibility should get the attention of the DMU community and other health care educators and students. But it also should alarm citizens: At a time when our nation needs more health care providers, and we all have an obvious interest in ensuring they’re well-trained, GME is worthy of federal support.


Endlessly curious and easily entertained, Barb Dietrich Boose loves being a member of the friendly, fascinating DMU community and its creative communications team. The University's publications director and DMU Magazine editor, Barb is always on the hunt for story ideas, good books and new recipes to try out on her family, such as her surprisingly tasty pork-and-bean bars.

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