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President's Budget Proposal Pushes Health Care Responsibility
By KEVIN FREKING, Associated Press Writer
WASHINGTON - People would assume more responsibility for the costs of their health care under President Bush's budget proposal. He would help them make that transition by increasing tax cuts for health savings accounts.
The administration also wants to trim Medicare spending by $35.9
billion over five years. Under that scenario, Medicare spending would
grow at a rate of 7.7 percent - instead of 8.1 percent, as currently
projected.
In pushing health savings accounts, the Bush administration says people
will become more responsible shoppers because they'll pay more of the
initial costs of their health care. They'll look harder to find a
generic drug rather than a brand-name, or they'll think twice about
seeing a doctor if they're not that sick, said Roy Ramthun, the
president's health adviser.
"We know Americans spend their money differently than they spend somebody else's money," Ramthun said.
To open a health savings account, a consumer also must buy a
high-deductible insurance policy that requires an individual to pay for
at least $1,050 in medical expenses; families would have to pay the
first $2,100. Some policies carry even higher deductibles. After the
deductible is met, insurance would kick in.
Bush wants to let consumers put enough money in their health savings
accounts to cover all their health insurance costs, not just the
deductibles, as provided by current law. This would allow them to set
aside more money tax-free.
The move to slow the growth of Medicare spending also would give some
beneficiaries more responsibility for health care costs. Higher-income
seniors would see increased premiums. The administration stressed that
the Medicare program would continue to grow.
"If we take incremental steps now, steady steps now, we can make the
program sustainable without having to go to drastic changes in taxes or
drastic changes to benefits," said Mark McClellan, administrator for
the Centers for Medicare and Medicaid Services.
Health care providers view the administration's proposal in starker
terms. They say the changes could spell the difference between
operating at a profit or operating at a loss.
The changes would trim payments to hospitals by $8 billion; to
suppliers of medical equipment such as wheelchairs and oxygen tanks by
$7 billion; and to nursing homes by $5 billion. Other providers that
would take a hit in their reimbursement rates include ambulance
companies, home health providers and hospice programs.
Chip Kahn, president of the Federation of American Hospitals, said
hospitals have been losing and will continue to lose money caring for
Medicare beneficiaries. At the same time, hospitals must invest in
health information technology, provide care for the uninsured and shore
up capacity to respond to natural disasters or potential flu pandemics.
The administration's proposal "is the wrong policy at the wrong time," Kahn said.
"Hard choices had to be made, and this budget reflects our effort to make those in the wisest way," said Mike Leavitt, the secretary for Health and Human Services.
The president also recommended level funding for the National Institutes of Health,
next year - $28.6 billion. However, funding for many of its research
centers would drop, including a $40 million reduction for the National Cancer Institute and an $11 million cut for the National Institute of Diabetes and Digestive and Kidney Diseases.
The largest study of U.S. children ever performed also would be shut
down. In January, mothers-to-be were to begin enrolling in the National
Children's Study. The study would track 100,000 children from their
mothers' wombs to age 21 to see how such things as the mother's diet or
toddler's television viewing influence child health.
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