President Bush's 2009 budget proposes $196 billion in cuts to Medicare and Medicaid - reductions local health care providers say will be disastrous for Manatee County.

Bush is proposing freezing the rates Medicare pays for hospital, nursing home and hospital services over the next three years.

"These cuts would be disastrous for Manatee County, said Mary Ruiz, chief executive of Manatee Glens. "We are already experiencing problems under the current Medicare system where payments are too low."

Manatee Glens is the county's psychiatric hospital.

The cuts are necessary if Medicare is to survive, warned Health and Human Services Secretary Mike Leavitt. "Medicare, on its current course, is 11 years from going broke."

But Dr. Thomas Braxton, a Bradenton kidney doctor and former chief of staff at Manatee Memorial, warned that local physicians are already going broke. "It would make it impossible to recruit the new doctors Manatee County so badly needs, let alone encourage those who now practice here to keep their doors open. I would personally look into relocating if these cuts go through."

Braxton predicted Manatee Memorial Hospital, the local safety net for poor and uninsured patients, would be hard hit if the cuts go through.

Moody Chisholm, Manatee Memorial's chief executive, called the Bush entitlement cuts misguided. "It disregards the needs of average citizens, especially seniors, and it wrongfully dismisses recent recommendations from the Medicare Payment Advisory Commission, which called for funding increases for hospitals next year."

But the problem still remains that Medicare - as it is structured now - cannot be sustained, according to the Congressional Budget Office.

"Over the past four decades, Medicare's and Medicaid's costs per beneficiary have increased about 2.5 percentage points faster per year than has per capita gross domestic product," wrote Director Peter Orszag, in his recent report to Congress. "If those costs continued growing at the same rate over the next four decades, federal spending on those two programs alone would rise from 4.5 percent of GDP today to about 20 percent by 2050; that amount would represent roughly the same share of the economy as the entire federal budget does today."

Elsewhere, cuts in the Bush budget would eliminate a $302 million program that gives grants to children's hospitals to subsidize medical education. A $300 million program for public health improvement projects would be eliminated, while grants to improve health care in rural areas would be cut by 87 percent.

The Centers for Disease Control's budget would face a 7 percent reduction of $433 million. The budget for a program to treat and monitor the health of first responders and others exposed to toxins at the World Trade Center after the Sept. 11 attacks would be cut by 77 percent, from $108 million this year to $25 million in 2009.

The National Institutes of Health, which funds health research grants, would see its budget frozen at $29.5 billion.

Bush also recommended increasing from $5 billion to $9 billion the average annual spending on the popular State Children's Health Insurance Program. Bush twice vetoed bills by Congress last year to increase it to $12 billion.

The administration said it also wants to limit coverage under that program to children from families who earn less than two and half times the poverty rate. For a family of three, that would limit eligibility to those with less than $44,000 annual income.

[...]

Rep. Kathy Castor, D-Tampa, who also represents portions of Manatee County, agreed. "We need a budget that will help families, not hurt them . . . The proposed Bush 2009 budget is dead on arrival due to its misguided priorities."

- The Associated Press contributed to this report