With no deal in Washington to stop it, the sequestration of federal funds is about to begin. It could be enough to make you sick - literally.
Some of the automatic budget cuts won't be felt for months, if sequestration lasts that long. But several cuts involving health care will hit us much sooner. And they could hit us hard.
Here are five to be especially concerned about. (Figures for their impacts this year in Pennsylvania are available here.)
Vaccines for children
The federal government will be able to help fewer children from low-income families receive vaccinations against potentially deadly diseases like measles, mumps, rubella, tetanus, and whooping cough (5,280 fewer in Pennsylvania). It's not just the unvaccinated children would are at risk. If they get sick, they can spread those diseases to others.
The National Institutes of Health will fund $1.6 billion less in medical research. That means slower progress in medical innovation and the possibility of major cutbacks at Philadelphia's medical schools and hospitals.
Food and drug safety
The Food and Drug Administration will be able to conduct 2,100 fewer food safety inspections. Think about that on your next trip to the supermarket.
Cuts to Medicare won't take effect for another month, but when they do, doctors and hospitals will see their reimbursement cut by at least 2%. That may not seem like much, but it could be the last straw that pushes some doctors to stop treating Medicare patients. It could also cause the loss of an estimated 211,000 health care jobs nationwide.
Less money (about $1.2 million less in Pennsylvania) will be available for upgrading disaster response capabilities for infectious disease threats, natural disasters, and biological, chemical, nuclear and radiological threats. Let's hope there isn't another SARS outbreak before the sequestration battles are resolved.
And there are many more cuts with potentially dangerous consequences to think about, including these:
Less federal funding for HIV testing will mean around 16,000 fewer people being tested in Pennsylvania.
Substance abuse treatment
About 3,500 fewer people will be admitted to substance abuse programs.
Domestic violence support
About 1,000 fewer victims of domestic violence will be helped.
Nutrition for seniors
There will be $849,000 less in federal aid to help low-income seniors afford meals.
More than 5% will be cut from the budget for the Women's, Infants & Children program, which, as described last week in The Public's Health blog, would be enough to support the nutrition needs of 600,000 mothers and young children.