Irresponsible budget cuts increase healthcare waste

Last week, in lieu of a final budget for 2017, Congress passed a stopgap spending bill to keep the government open through Dec. 9. This left me and my colleagues just 10 weeks to make final decisions on how we will invest more than $1 trillion in programs that promote the safety, security and prosperity of all Americans.

Unfortunately, when we return on Nov. 14 from an irresponsible six-week break and begin drafting an omnibus based on the fiscal 2017 appropriations bills, we will face an uphill climb in reversing the bills’ deep funding cuts, which threaten our constituents’ health and pocketbooks.

{mosads}As the saying goes, “an ounce of prevention is worth a pound of cure.” Yet the fiscal 2017 Labor, Health and Human Services and Education appropriations bill put forward by my Republican colleagues to fund public health is penny wise and pound foolish. I am especially surprised by my colleagues’ continued assault on the Agency for Healthcare Research and Quality (AHRQ), a relatively low-profile scientific agency with a relatively small budget that plays a huge role in ensuring patient safety and the efficiency and effectiveness of our nation’s $3 trillion healthcare system.

The AHRQ’s mission, “to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable,” is vital to improving healthcare in America today. As is often noted, America spends more on healthcare per capita than other developed nations, yet experiences poorer health outcomes. Our lackluster performance is due in part to “wasteful” spending — the overuse, underuse and inappropriate use of healthcare. Among the negative results are hospital readmissions, hospital-acquired infections, improper treatment, unnecessary treatment and medical errors. In addition to the pain and suffering these results cause patients, experts tell us such wasteful spending costs Americans as much as $900 million a year. The AHRQ discovers ineffective and harmful treatments, studies ways to eliminate them and facilitates better health outcomes through evidence-based improvements in care delivery.

Despite the AHRQ’s critical, nonpartisan mission, and lawmakers’ shared interest in reducing budget deficits, my Republican colleagues have proposed cutting the agency’s budget by 16 percent in fiscal 2017. This would be in addition to the 8 percent cut in the AHRQ’s budget enacted in fiscal 2016 that has left the agency unable to continue longstanding programs that have demonstrably improved patients’ lives.

The HIV Research Network was one such program. It helped to improve care for one of the most vulnerable and at-risk populations: those living with HIV. As of 2014, 38,000 people were living with HIV in the city of Los Angeles alone. These Americans require specialized care that can be medically complicated and expensive. Working with 25,000 patients at 18 care sites nationwide, the AHRQ’s HIV Research Network succeeded in improving HIV care delivery and health outcomes for people with HIV. It also identified and addressed existing disparities in HIV care by race and gender. Furthermore, with just $2 million in annual funding, the network reduced prescriptions of inappropriate medication by one-third across the 18 sites, prompted changes in treatment guidelines for adolescent patients with HIV, and generated evidence that led to recent changes in organ donation law. Now, HIV patients awaiting life-saving organ donations can receive transplants from deceased HIV-infected individuals, increasing the likelihood they won’t die on a waitlist.

These successes, replicated in healthcare systems across the country, can save lives and money spent on HIV care. Unfortunately, funding cuts to the AHRQ’s budget enacted in 2016 necessitated the termination of the HIV Research Network, after 15 years of success. If funding had been continued, the HIV Research Network would have been able to research new and emerging challenges facing HIV care, including predatory drug pricing practices as more Americans living with HIV enter their golden years.

As we face another round of cuts to this critical agency, what other lifesaving and value-enhancing research will be lost in the name of reducing deficits in the short term? Will the AHRQ have to stymie its efforts to combat antibiotic resistance? Or end new research on ways primary care practitioners can best treat opioid abuse? Or shut down ongoing initiatives proven to reduce hospital-acquired infections and medical errors? In writing spending legislation, my colleagues say we have to make tough choices because we simply can’t afford to do everything we’d like to do. I say we can’t afford not to invest in the AHRQ if we hope to drive down healthcare costs and improve Americans’ health.

Roybal-Allard represents California’s 40th Congressional District and has served in the House since 1993. She is a member of the Appropriations Committee.