We are probably fortunate that government shutdowns don’t happen more often. Prior to this week, you had to go back to the mid-90s for the last shutdown, but they were much more common before that. There have now been 12 government shutdowns since 1981. Notably, nine of those lasted three days or less; the current shutdown is in day four.
The impact on U.S. healthcare has been significant. The Department of Health and Human Services has had to furlough more than 40,000 staff, and the Office of the National Coordinator for Health IT is operating with a skeleton crew of just four people. The Centers for Medicaid & Medicare Services (CMS) is suspending funding for healthcare fraud prevention efforts, while the National Institutes of Health is not taking new patients for clinical trials.
For the moment, it seems President Barack Obama and Democrats in Congress are going to hold firm as Republicans look for more compromises. In exchange for a continuing resolution that would fund the government, House Republicans are asking to delay key components of the Affordable Care Act.
However, the time for negotiation is long past. The healthcare reform bill has been debated endlessly and has survived numerous challenges, both legislative and judicial. Shutting down important government services and healthcare research to create a manufactured crisis is not an effective way to govern. Hopefully we can move past the politics and put people back to work at improving U.S. healthcare.
Just before the government shutdown, CMS provided the other big headline of the past week, shutting down hopes that it would reverse course on a decision not to fully reimburse amyloid PET scans for the diagnosis of Alzheimer’s disease. The official decision that came down last Friday, however, confirmed that CMS would offer only limited coverage, reimbursing one scan per patient stipulated as coverage with evidence development.
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) issued a statement expressing its disappointment in the decision and SNMMI president elect Peter Herscovitch, MD, told Molecular Imaging that the coverage decision will discourage radiopharmaceutical companies and the field of nuclear medicine and molecular imaging as a whole. Meanwhile, a review of existing literature published online Sept. 30 in JAMA Internal Medicine argued that current evidence is insufficient to prove amyloid-beta PET imaging for Alzheimer’s disease leads to better clinical outcomes.
These are the discussions we should be having, not fretting over how long congressional bickering will limit government services.
Editor – Health Imaging