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House Joins Senate to OK Bill That Avoids Fiscal Cliff
Date:1/2/2013

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Jan. 2 (HealthDay News) -- Twenty-one hours after the U.S. Senate did its part to steer the country clear of the so-called fiscal cliff, the House of Representatives settled on an 11th-hour agreement late Tuesday night that averted widespread tax increases and spending cuts that were set to kick in Jan. 1.

But the House vote was in doubt much of the day and into Tuesday evening, with many Republicans opposing the tax increases contained in the bill while favoring steeper spending cuts to further reduce the nation's debt.

The bill will now go on to President Barack Obama who is expected to quickly sign it into law.

"This shouldn't be the model for how to do things around here," Senate Republican leader Mitch McConnell of Kentucky said just after 1:30 a.m. Tuesday, The New York Times reported. "But I think we can say we've done some good for the country."

McConnell worked with Vice President Joseph Biden to secure the Senate's 89-8 vote, a rare show of bipartisanship in Washington. He recommended that the entire Congress act quickly to pass the measure and "continue to work on finding smarter ways to cut spending" in the coming months, the Associated Press reported.

The House vote was more fractured, with Democrats voting for the bill by an overwhelming 172-16 margin while Republicans opposed it 151-85, the AP reported.

The bill prevents a 27 percent cut in fees paid to doctors who treat Medicare patients. It also blocks middle-class taxes from going up but raises taxes on wealthier Americans. And it delays legislatively mandated spending cuts for two months, among other measures.

Failure to reach agreement on heading off spending cuts could have had a significant effect on health care in the United States, according to Kaiser Health News.

For instance, Medicare providers would have seen an $11 billion cut in payments in fiscal year 2013. According to a September report from the Office of Management and Budget, hospitals would have been hit hardest by the cuts, with payments slashed by about $5.8 billion, Kaiser Health News reported.

Seniors would have experienced no changes in their benefits, however, and Medicaid would not have faced any automatic cuts on Jan. 1.

The National Institutes of Health would have had to contend with a $2.5 billion cut in funding for 2013, which would mean the agency would "have to halt or curtail scientific research," according to the OMB analysis.

Other federal agencies would have faced funding cuts as well, such as the Centers for Disease Control and Prevention ($490 million), and the Food and Drug Administration ($318 million), Kaiser Health News said.

Dr. David Katz, director of Yale University School of Medicine's Prevention Research Center, tried to put the debate over the fiscal cliff and its potential impact on health care in layman's terms.

"To some extent, talk of a 'fiscal cliff' and its implications can seem remote. But there is a very personal element to all of this. If Medicare reimbursement is slashed, the federal government will, in essence, be cutting the income -- along with raising the taxes -- of physicians who don't work for the federal government. This certainly makes Washington gridlock personal for all of my fee-for-service colleagues. If they, in turn, translate resentment of this heavy-handed imposition into practice, this may get personal for Medicare patients who have a harder time accessing care."

And, he added, "massive cuts to the NIH (National Institutes of Health) budget may seem remote and impersonal -- unless the research that isn't funded as a result would have saved your life, or that of someone you love. Cuts to CDC (the Centers for Disease Control and Prevention) may seem remote -- unless you are a victim of a neglected disease outbreak, or of a preventable chronic disease no longer the focus of research and programming.

"And cuts to the FDA (Food and Drug Administration) budget may be someone else's problem, until the drug you need is languishing in the approval process; a drug is approved that should not have been and imposes its toxicity on you; or the uninspected food on your table is a vehicle for salmonella or E. coli," Katz said.

More information

For more on how the so-called fiscal cliff might affect health care in the United States, visit Kaiser Health News.

SOURCES: David Katz, M.D., M.P.H., director, Yale University School of Medicine Prevention Research Center, New Haven, Conn.; The New York Times; Associated Press; Kaiser Health News


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