Bush budget focuses on variety of health reforms

The president's proposal would fix physicians' Medicare payment problems and modernize Medicare and Medicaid.

By Joel B. Finkelstein and Markian Hawryluk, AMNews staff. Feb. 17, 2003.

Washington -- As members of Congress debate the fate of physician Medicare payment in 2003, President Bush has proposed a measure that would eliminate cuts scheduled for 2004 and 2005 as part of his fiscal year 2004 budget proposal.

The $2.23 trillion budget would set aside $539 billion for health and welfare programs, including funds for Medicare and Medicaid reform, a Medicare outpatient prescription drug benefit and the physician payment increase.

The president's budget includes several other administration priorities, including health insurance tax credits and more money for community health centers, global AIDS/HIV initiatives, drug and alcohol treatment programs, and bioterrorism preparedness efforts.

At the same time, the administration hopes to slow health spending growth, with smaller increases in research funding, and reforms within Medicaid and the State Children's Health Insurance Program that create future savings.

Bush's proposal relies heavily on sweeping changes made to these big-budget programs to reduce expenditures over the long term. But many of these changes must be approved by Congress. Health and Human Services officials said they would pursue administrative approaches if congressional action is not forthcoming.

Specifically, to prevent further cuts, the Bush administration proposed using actual data instead of estimates in the formula for calculating physician Medicare payment.