Copyright 2000 Globe Newspaper Company
The Boston
Globe
November 27, 2000, Monday ,THIRD EDITION
SECTION: METRO/REGION; Pg. A1
LENGTH: 925 words
HEADLINE:
CONGRESS WEIGHS BOOST IN FUNDS FOR CHILDREN'S
BYLINE:
By Sue Kirchhoff, Globe Staff
BODY:
WASHINGTON -
Children's Hospital in Boston could get a much-needed infusion of as much as
$20 million in federal aid from an improbable source - fiscally
conservative Republicans led by a budget hawk from Ohio - when Congress returns
next month to wrap up its legislative business in a rare lame-duck session.
The money is part of a $285 million appropriation that
would be directed to pediatric centers across the country as a group of
lawmakers, led by House Budget Committee chairman John R. Kasich of Ohio, move
for a dramatic expansion of a federal program to train doctors in independent
children's hospitals.
That level of funding would be a
huge increase from the nearly $40 million in new teaching
grants to pediatric hospitals awarded this year. Of that amount, Boston received
$3.2 million -the largest single award. Nationwide, children's
teaching hospitals long have complained that they have been shortchanged under
federal policies for underwriting the training of physicians. Graduate
medical education largely has been subsidized through the Medicare
health care program for the elderly. Because pediatric centers treat young
patients, they have received scant benefit.
The average independent
children's hospital gets about $400 per resident physician in
federal money while the average adult hospital gets $87,000 per
resident, according to the federal Health Resources and Services Administration,
which oversees health training programs.
"It is a huge difference . . .
a lot of these hospitals are in urban areas where there are a lot of uninsured
kids or serve kids who come in because of the severity of their condition," said
Dr. Claude Earl Fox, administrator of the agency.
Children's Hospital in
Boston, one of the country's preeminent pediatric centers, is trying to cut
costs and improve fund-raising as part of a broad effort to stanch tens of
millions of dollars in annual losses. The Harvard teaching hospital announced
Nov. 7 that it ended its 2000 budget year with a $28.4 million
operating loss. Still, that figure was a major improvement from the previous
year's $61 million shortfall.
With a deep endowment to
draw from, the institution is not in danger of closing its doors. But its
financial difficulties are an indicator of the problems facing other such
teaching centers around the country. In many cases, hospitals also face reduced
payments under the Medicaid health program for the poor.
"Receiving this
additional support for graduate medical education is really
enormously critical. Without it our ability to sustain excellent training
programs will otherwise be challenged," said Dr. Philip Pizzo, physician in
chief at Children's Hospital and chairman of the department of pediatrics at
Harvard Medical School.
Pizzo estimated that the hospital could receive
from $15 million to $20 million in new funding
in coming months if Congress approves the pending legislation.
The
National Association of Children's Hospitals has made a concerted public
relations push to get Congress to approve the money before adjourning, including
ads with a picture of a bouncing baby under the headline "Keep Up the Cry." It
also has set up a toll-free number that supporters can call to lobby lawmakers.
While advocates are optimistic that they will win, the
$285 million now pending in Congress is far from a done deal.
The money is just one part of a massive annual labor, health, and education
spending bill that has gotten gummed up in end-of-session negotiations between
the White House and congressional Republicans.
There is strong support
for the funding. There also is growing worry that Congress, deeply split over
the standoff in the presidential election, will not be able to reach agreement
on the spending measure and other legislation. Some supporters fear that
lawmakers could simply give up and pass a stopgap bill to continue programs next
year at current levels.
"Congress could be poised to approve as little
as $40 million, which could happen if there is a [stopgap]
bill, or as much as $285 million, or something in between,"
said Peters Willson, vice president for policy at the National Association of
Children's Hospitals.
Securing the money has become a priority for
Kasich, who is retiring from Congress. A fiscal hawk, he has, in the past, shied
away from lobbying for specific programs. During the past several months,
however, he has pushed House leaders to more than double the amount of funding
Congress had been expected to approve for pediatric training.
Ohio has a
large concentration of children's hospitals and Kasich is the father of young
children. Fellow Ohio Representative Deborah Pryce, a member of the House GOP
leadership who lost a daughter to cancer last year, has also been pushing
Speaker J. Dennis Hastert, Republican of Illinois, to secure the money.
While those lawmakers are at the forefront of the current drive, the
years-long effort to increase funding for children's hospitals has had broad
bipartisan support. Democratic Senator Edward M. Kennedy was a main sponsor of
the 1999 bill that created the pediatric training program. The measure was
supported by the entire Massachusetts congressional delegation.
The 1999
law allowed for funding but did not guarantee it. Unlike Medicare's system,
where aid is automatic, Congress each year must decide how much money, if any,
to give children's hospitals.
Many teaching hospitals are cutting costs
or consolidating to survive.
LOAD-DATE: November 27,
2000 
