Opinion: What is the point of cutting geriatrics programs?

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What’s the point of this?

Our population is aging, a fact of which most are well aware, and this change is accelerating. Years of reports have stressed the need to adapt to this shift. Yet, we have fewer health care providers specializing in the care of older adults, especially in medicine. There is one geriatrician for about every 12,000 older adults, and even fewer geriatric psychiatrists. As of 2022, Minnesota had an estimated 130 geriatricians for the entire state. Every year, the number of geriatricians decreases while the population of older adults increases. I’m a geriatrician. One of vanishingly few.

Numerous cuts to many significant federal programs across the Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) show an appalling disregard for the needs of Americans now and in the years to come. Recently, an internal HHS restructuring proposal for 2026 (confirmed by the Washington Post) threatened another substantial area of need — all geriatrics programs.

Federal geriatrics programs have invested in preparing the health care system to care for a growing older population, especially in the face of decreasing older adult specialists. One is the Geriatrics Workforce Enhancement Program (GWEP) funded through the Health Resources and Services Administration (HRSA), part of HHS. Minnesota is fortunate to have received two multimillion-dollar HRSA grants, leading to the creation and advancement of the Minnesota Northstar GWEP at the University of Minnesota. GWEP educates all sorts of health care providers about aging including, but not limited to, physicians. The expressed aim of this program is to enhance the care of all older adults across Minnesota. We should support and invest in such a worthwhile goal. Especially at the cost of 0.0023% of the total HHS budget of $1.8 trillion.

Personally, I have been fortunate to receive a HRSA Geriatrics Academic Career Award; a grant specifically targeting early-career geriatricians. This grant affords me the time and funds I would never have otherwise had to develop geriatrics-focused educational programs and research projects at the University of Minnesota and across the state. Hopefully I can also promote the field of geriatrics and recruit medical students and residents into the specialty, helping alleviate an enormous gap. All this I plan to do with a small, though monumental, grant of less than $100,000 per year — about 1 millionth of a percent of the HHS budget.

We young geriatricians, my co-grantees and I, have already been cast into a chaotic stream of wordsmithing, financial mysticism and cynical hopefulness as we see others’ grants torn away. Our energy to imagine, create and actuate plans to improve older adults’ care, your care, is being exhausted as we continue running toward an unknown. This proposal is crushing. I ask: What is the point?

What is the point of this callousness toward us? What efficiency is gained by keeping us in a perpetual lurch? What waste is being found by dangling our small, but life-altering, grants over a shredder? If there’s any abuse, it’s that which is being rendered against us by our own government.

And, given our population’s needs, the already significant lack of geriatricians, the need to train all health care providers in geriatrics care, why eliminate these programs? Why dissuade anyone from this field? Especially with their extraordinarily low costs to achieve their goals. So again, I have to ask: What is the point?

These budget drafts are preliminary — nothing is gone yet. Even if ultimately these programs survive, such consideration shows a calamitous disregard for a broad group of individuals with unique needs for which our health care systems need robust, not weakened, investments. This proposal shows a character of government that neglects the present and growing future needs of its citizens. To even consider cutting geriatrics programs is not being efficient, not reducing waste, not promoting health, not preparing for the future and not providing you the services you expect from your tax dollars.

If you are an older person, care for someone who is older or will ever be an older person, such proposals affect you. You should wonder: What is the point?

Dr. Benjamin Rosenstein is an assistant professor of family medicine at the University of Minnesota. His views are his own and do not necessarily represent those of the University of Minnesota.