Medicare Compliance & Reimbursement

Funding to fight potential outbreak has docs fretting.

Members of a House appropriations subpanel on health worried April 12 that the Bush administration's public-health budget, including funding for pandemic-flu preparation amounts to a "shell game." The administration's fiscal year 2006 proposal seems mainly to shift funds from one high-need area to another while supporting few adequately, complained Rep. David Obey (D-WI), top-ranking Democrat on the full House Appropriations Committee.

Fear is heating up that the vicious bird-flu virus now abroad in Asia could quickly mutate into a form that could potentially kill millions of people. "Many scientists believe that it may be one mutation away from developing the ability to efficiently transmit from person to person," said Bruce Gellin, MD, who heads the Department of Health and Human Services' National Vaccine Program office.

The virulent flu is known to have infected 79 people, mostly young healthy adults, and has had a 66-percent mortality rate, said Julie Gerberding, MD, chief of the Centers for Disease Control and Prevention. Thus far, there is only one certain and one highly likely case of human-to-human transmission, but in the past few months the disease has shown "growing efficiency in moving into the mammalian species," Gerberding said.

Meanwhile, the administration's budget, which focuses on pandemic-flu preparation, is inadequate to meet growing public-health needs, said Obey. "We see an emergency here, and we pay for it by pulling money out of some other program in your agency," he told Gerberding. 
 
Health subcommittee Chair Ralph Regula (R-OH) joined Democrats in questioning one of numerous examples of shifted funding in the very tight budget proposal.

Administration officials testifying were adamant that strong public-health surveillance and response capabilities at the state and local level are crucial, yet the budget proposal would cut funding to build state and local biosecurity capacity by $129 million over last year. "It doesn't seem to be consistent," he said.

In May 2004, HHS said large amounts of state and municipal biosecurity grants from FY 2002 and FY 2003 remained unspent, and therefore reallocated $55 million in grant money to other biosecurity uses. However, a March 30 Government Accountability Office report found that, as of August 30, 2003, only 14 percent of the last two years' money remained unobligated, and a "substantial amount" of the money had already been spent.

Gerberding said that the total FY 2006 preparedness budget would increase under the administration's proposal. She also said that the exact allocation of preparedness grants hasn't been finally determined but that the administration doesn't expect to cut support to local or state laboratories. And while state and local grants overall would decrease, more funding than in the current fiscal year would go to building a national stockpile of vaccines, flu treatments, and [...]