January 18, 2006

Congress Slashes Geriatric Education Funding

Within a 2-week period, we witnessed 3 seminal events in the development of U.S. policy toward older people. First, in mid-December, the White House held a Conference on Aging. This is an event that takes place every 10 years and is attended by delegates from all over the country who pass resolutions designed to give guidance to Congress on how best to improve the quality of life of older Americans. This year’s theme was “The Booming Dynamics of Aging.” The top 10 resolutions passed included 2 that focused on educating health care providers: “Support geriatric education for all health care professionals” was one. The other was “Attain adequate numbers of healthcare personnel in all professions who are skilled, culturally competent, and specialized in geriatrics.” Interestingly, President Bush did not set foot in the meeting, the only sitting president to miss the event in 50 years, according to Ruth Garrett, writing in the Tennessean.com (“Frist gives care for the elderly a congressional kick in the gut,” December 29, 2005.)

The second milestone was the trashing of 3 major government programs that have been funding geriatric education for years. Reportedly, Senate Majority Leader Bill Frist knew that the senators wanted to deal with the budget and did not want to have to come back after the holidays, so he rushed through a voice vote on the measure. The vote was tied 50-50, with Vice President Cheney casting the tie-breaking vote. The 3 programs that were consigned to the dustbin collectively cost $31.5 million in 2005. The total estimated federal spending over the next 5 years will be $14.3 trillion.

One of the victims is the Geriatric Training Program for Physicians, Dentists, and Mental Health Professionals which offered 1- or 2-year programs to train geriatric academicians. I was Director of the Harvard Geriatrics Fellowship Program for years and we relied heavily on government support to provide stipends to young doctors and dentists who wanted to specialize in geriatrics. We were able to offer our fellows a broad exposure to hospital care, outpatient care, rehabilitative care, and nursing home care, as well as a year to begin developing expertise in research. Our fellows went on to become prominent researchers, teachers, and practitioners. The government funded 13 such programs in 2005 and will fund 0 in 2006.

The second program that was axed is the Geriatric Academic Career Award initiative, which provided stipends to junior faculty members who were committed to teaching geriatrics. There are very few opportunities for physicians to develop expertise and experience in teaching. This was one way to be launched on a teaching career. In 2005, awards were given to 102 promising young professionals. In 2006, there will be none.

Finally, funding for the nation’s Geriatric Educational Centers was eliminated. These Centers offered educational programs to health care professionals to train them in issues of importance to the health of older individuals. Since the Centers were introduced 20 years ago, they have touched the lives of over 425,000 professionals in 27 disciplines, according to the National Association of Geriatric Education Centers. All 50 states had such Centers. They will all disappear. (See the article in the Boston Globe on January 13, 2006 by Sue Levkoff, “Assault on the Elderly.”)

The third landmark is that on January 1, 2006, the first of the 76 million baby boomers turned age 60. There was a fair amount of hoopla about this in the media. Congress and the President do not seem to have noticed.

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