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Back in May, I wrote about Penn Medicine's commitment to provide the best care possible for our patients despite the uncertainty created by efforts to reform the nation’s health care system. Since that time, a lot has happened, including ongoing efforts to effectively repeal and replace the Affordable Care Act. Given the tumultuous past few months, I wanted to revisit the vital role government, at every level, plays in health care and reiterate Penn Medicine's responsibility to work with government officials and effect positive change in health care policy.

Early in September, Congress returned to Washington, D.C. following a brief summer recess and began working on a number of important matters, including the federal budget. The total federal budget is $3.7 trillion. Health care is the largest expenditure, accounting for 25 percent or $938 billion. These funds support Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and Affordable Care Act subsidies. Combined, these programs cover more than 135 million lives. Here at Penn Medicine Medicare accounts for nearly 40 percent of all discharges. As you can see, the federal government has a broad and deep impact on the nation's health care delivery system, including Penn Medicine. That makes any budgetary decisions made in Washington, D.C. vitally important for our patients and for sustaining our daily and long-term operations. 

The federal government isn’t the only significant player in health care policy and delivery. State government also plays an outsized role. Medicaid and CHIP are funded, in part, by state dollars and administered at the state level. In Pennsylvania, Medicaid covers 2.9 million lives, including low-income children, pregnant women, adults, seniors and individuals with disabilities. Around 143,000 inpatient days are funded by Medicaid annually at Penn Medicine. Nearly 30 percent of Pennsylvania’s budget is spent on Medicaid. Additionally, Pennsylvania appropriates funding annually to support safety-net health systems like Penn Medicine which provide a disproportionate amount of care to medically vulnerable patients, including trauma and obstetrics patients. 

The substantial role both federal and state governments play in health care cannot be overstated. Unfortunately, this means our nation’s health care system is not immune to the polarized political climate that has enveloped our capitals. In both Washington, D.C. and Harrisburg, officials have been unable to enact timely budgets that adequately fund health care. The inability to conduct routine business and provide stable funding for the health care system as a whole threatens its stability and the lives of the patients who depend on it.

We see firsthand the human side of health care on a daily basis. Our promise to provide the very best care doesn’t end at the bedside. That’s why I continue to engage with policymakers, to remind them that health care funding isn’t about politics, it’s about people. I remain optimistic that we can work together to overcome these challenges and fulfill our commitment.

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