Impact of the Sequester on Health Care: By the Numbers

By: Katie Booth 

The looming sequester will have a significant impact on health care, including cuts to Medicare, FDA, CDC, NIH, and Affordable Care Act programs. Budget cuts could slow down the drug approval process, impede the tracking of infectious diseases, and lead to layoffs for hundreds of thousands of workers in the health care sector. Read on for sequestration by the numbers…

Medicare:

  • Medicare cut by 2% ($11 billion) (not set to begin until April 1st, 2013, unlike other sequestration cuts, which are set to begin on March 1, 2013)
  • Physicians’ payments cut by 2%
  • Hospital Medicare reimbursement cut by $5.8 billion
  • Hospitals could end up with especially large cuts under the sequester because other parts of healthcare system run on longer term contracts
  • Loss of almost 500,000 health care sector jobs in the first year of the sequester according to an American Medical Association and American Hospital Association study, including job losses for 40,000 practitioners such as physicians and dentists

FDA:

  • FDA cut by 8% ($318 million)
  • FDA public funding cut by $206 million
  • FDA industry user fees cut by $112 million (for an interesting discussion of user fee cuts and the sequester, see Patrick O’Leary’s Bill of Health blog post)
  • Cuts by department (assuming 8% across-the-board cuts): $71 million to Foods, $39 million to Human Drugs, $17 million to Biologics, $11.3 million to Animal Drugs, and $26.5 million to Devices
  • Longer drug approval process is likely
  • Layoffs and furloughs likely
  • 2,100 fewer food safety inspections

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Conference — After the Storm: New Directions in Health Policy and Law at NEU Law

From the Northeastern University School of Law Program on Health Policy and Law:

Join us for a day of informative discussion and exploration with some of the nation’s leading policymakers and researchers in health policy and law. Engage in conversations that examine the new directions for health policy and law, regionally, nationally and globally in the wake of the tumultuous events of 2012, including the Supreme Court’s ACA decision and the US Presidential Election.

April 19, 2013. Please see conference website for agenda and registration information.

Experiential Training in Health Law?

Many law schools are thinking about experiential education, and health law would seem to be a great opportunity.  There is a bewildering range of ways to implement experiential training, from simulation-based courses, to in-house clinics, along with placement clinics and hybrid clinics, and externships too.  Many of these seem to blur together on the margins.

The Center for the Study of Applied Legal Education’s 2010-11 Survey of Applied Legal Education (available on SSRN) found that of the 156 law schools responding, 17 had clinics whose “single predominate substantive focus” was defined as “health law,” which amounts to 1.5% of all clinics in the study.  (See p7.)  Also listed were 24 “elder law” clinics and 20 “disability law” clinics, which I suspect may overlap.  The report also shows 29 field placement programs (out of 145 schools responding), which focus on health law.  (See p8.)  In particular, I am aware of Harvard’s Health Law and Policy Clinic.   And SLU’s excellent health law program places clinic students in hospital settings.  I have come across other programs at Pitt, Suffolk, GW, and Northeastern.

We do not have a health law clinic at University of Arizona, but I have helped place my JD students in unofficial externships with the Tucson Family Advocacy Program, a medical-legal partnership that addresses some of the social determinants of health (e.g., a letter to a landlord to stop a roach infestation, to help address chronic child asthma).  Some of my students have also externed in the general counsel’s office of our academic hospital.  I also like to bring students with me to our clinical bioethics meetings, and some of those interactions have led to research projects and student presentations to the committee.  I have also engaged some of our top law students in helping me lead discussion sections for undergrads on some of the big health law cases, such as Jacobson, Griswold, Roe, and Raich.  (I firmly believe that teaching is a kind of experiential education, which develops core lawyering skills.)

I would love to hear from our readers in the comments section .  Do you know of other experiential education programs that focus on health law?  What do you do?  What works well?