Medicaid Cuts Called Security Threat; Senate Panel Told

Hospital emergency rooms will not be ready to treat victims of a major terrorist strike or natural disaster if Medicaid cuts scheduled for this month take effect, medical professionals warned Capitol Hill lawmakers yesterday.”

Are [trauma centers] ready and could they meet the surge of 450-type victims that occurred on 9/11? I think the answer to that is no,” Wayne Meredith, chief of general surgery at Wake Forest University Baptist Medical Center, told a House panel.

“The effects of the Medicaid changes will be dramatic in our hospital,” he said. “I’ll just beg you to stop the Medicaid cuts.”

Colleen Conway Welsh, dean of Vanderbilt University School of Nursing, said plans to restrict Medicaid payments to public providers, eliminate funding for graduate medical education and cut reimbursements for outpatient hospital care threaten to gut the nation’s emergency rooms.

“If Medicaid dollars are reduced in these three areas, a reduction in personnel and readiness will occur in our hospitals and emergency departments across the country,” she said. “And even worse, it will occur in the midst of a serious and intractable nursing and nursing faculty shortage and limit our ability to respond to a disaster, particularly a blast or explosive injury with serious burns.

“The testimony before the House Oversight and Government Reform Committee was part of two days of hearings on upcoming changes to Medicaid reimbursements to hospitals and medical schools set for May 26.

The Department of Health and Human Services ordered the reduced payments to fight waste and fraud in the program. Critics, however, say it will undermine the health care system.

A bill that would delay the new Medicaid rules until April 2009 passed the House 349-62 last month and Senate Democrats are working on a strategy to pass it, possibly linking the measure to the administration’s $108 billion war request for the remainder of 2008.

President Bush said he will veto the House bill and the war-funding bill if it exceeds a $108 billion limit or if it is loaded with domestic add-ons.

Senate Republicans say the one-year moratorium puts off an opportunity to address a federal program that has long suffered from waste, fraud and abuse.

“We should be talking about fixing the regulations so they better address real problems in Medicaid, but instead the House is trying to kick the can to next year,” said Sen. Charles E. Grassley, Iowa Republican.

Georgetown University foreign service professor Bruche Hoffman told the House panel the federal government should beef up the country’s trauma centers and prepare medical workers to deal with the mass casualty events or MCEs.

“Moreover, given the increased financial stress on our nation’s health system in general – and urban hospitals in particular – any degradation of our existing capabilities will pose major challenges to our nation’s readiness for an attack,” he said. “Indeed, the opposite is required – a strengthening of our capabilities at hospitals and for the emergency services that we require to effectively respond to a terrorist MCE involving conventional bombing and suicide attack.”

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