Although President Bill Clinton's proposed budget slashes funds for family practice training, it also takes steps the Academy has applauded: It expands Medicaid coverage for children and tries to keep Medicare solvent.
Title VII. The budget for fiscal year 1998 would dramatically cut funds for family practice training programs--from the current $49 million to less than $8 million. The proposed $8 million would cover predominantly family practice but also training for general internal medicine/general pediatrics, preventive services, public health, and physician assistants.
The Academy asks you to contact your senators and representative to seek funding at current levels for family practice training. Your stories from your own educational experience will bring home to lawmakers the connection between students' exposure to family practice and their choice of the specialty.
Children's coverage. The proposed budget would provide assistance to states to help families keep their health insurance between jobs--funding that would cover 700,000 children in those families. The budget also would grant $750 million to states to develop creative approaches to covering uninsured children and those eligible for but not enrolled in Medicaid. Third, the budget would permit states to provide a full year of Medicaid or private coverage to "gap kids" whose families lose Medicaid because their income increases.
AAFP President Patrick Harr, MD, of Maryville, MO, praised the budget proposal for children as a step toward universal coverage. In a news release quoted in the Kansas City Star, Dr. Harr says, "This proposal would provide additional security to some of our nation's most vulnerable citizens--our children."
Medicare. The proposed budget would cut $138 billion over six years from Medicare payment increases for doctors, hospitals, and HMOs. The savings hit the midway mark between the administration's and Republicans' suggested Medicare cuts last year.
The fiscal year 1998 budget also would allow flexibility for creating provider-sponsored networks and would boost funds for preventive care and rural hospital care.
In a news release, Dr. Harr says, "While we have concerns about how much Medicare growth can be constrained while still ensuring that patient needs are met, we are pleased that the president's proposal offers creative approaches toward ensuring the solvency of the Medicare program into the 21st century."