Anyone who has tried to follow progress of the most recent stimulus bill knows that the rapid pace of revisions has made it nearly impossible to keep up. As of this writing, a compromise bill is under debate in the Senate. If it passes, that compromise must be reconciled with a version passed by the House. Any entity that expects to benefit directly from the bill would be wise to keep the checkbook closed until President Obama's signature is set to paper.

Among items a bi-partisan cabal of Senators pared down or eliminated from early versions of the bill are: $98 million for school nutrition, $100 million for National Institute of Standards and Technology, $200 million for National Science Foundation, $1 billion for Energy Loan Guarantees and—unexpected in the current green culture—$300 million for a federal fleet of hybrid vehicles and $3.5 billion for energy-efficient federal buildings.

Of note, both the House-approved draft and the most recent Senate version include sizable allocations for healthcare spending. There's $87 billion in temporary and targeted Medicaid relief to states and funds to assist newly unemployed individuals maintain private insurance. The NIH, which currently awards almost $24 billion annually in grants for biomedical research, is earmarked to receive more funding as part of the recovery plan. A movement is afoot to implement new regulations on disclosures of conflicts and financial interests of researchers who receive NIH funding. Finally, a proposed $20 billion will be funneled into healthcare technologies, such as EMR, which have been touted to improve care and reduce costs.

While these and other healthcare allocations may not directly impact neurologists, they could help protect the vitality of the healthcare sector, which needs any assistance it can get. Hospitals nationwide are reporting dwindling endowments as patients postpone elective and even in some cases medically necessary procedures. Individual medical practices anecdotally report that patients are skipping follow-up appointments to save on co-pays, and surveys suggest that some patients are even skipping or cutting doses of medications to save money. In a recent listing by US News and World Report, a national pharmacy chain is among companies that may not survive 2009.

Whatever stimulus Congress provides in the days or weeks ahead, there's little question that the national economy is dismal at best and unlikely to rebound sharply in the next few months. Proposed short-term investments in healthcare won't cure the system's long-term problems, but investment in healthcare is a welcome departure from the usual belt-tightening.