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Edwards appeals to S.C. Congressmen It's the best of times. It's the worst of times.  To look at the numbers, things couldn't be better for MUSC. The university's six colleges have a combined student body of about 2,300. The Medical Center, with its 600-bed hospital, Rutledge Tower Ambulatory Care Center and 18 off-campus primary care sites, sees more than 650,000 outpatient visits and 30,000 inpatient visits annually.   Just this year, research at MUSC broke past the $100 million mark in grants and contracts and appears to be still climbing. That's a measure of respect the institution has garnered at a time when other research institutions are struggling just to maintain their funding.   More than 8,000 people are employed at MUSC, which has an annual budget of about $800 million. The economic impact on the South Carolina economy—an estimated $1.2 billion.   Well, there you have it. Patient population is up. Research funding couldn't be rosier. MUSC is the largest single employer in the state, contributing to an unparalleled economic impact. What's more, the health care and research services MUSC provides remains desperately needed by people throughout the Southeast. Especially people with cancer, stroke, cardiovascular disease and hypertension.   So why was MUSC president James B. Edwards, DMD, at the Capitol in Washington addressing the S.C. Congressional Delegation on July 15? Why was he extolling the excellence of MUSC's Children's Hospital, Digestive Disease Center, Heart Center, Hollings Cancer Center, Institute of Psychiatry, Storm Eye Institute, and Transplant Center?    Edwards was speaking to the South Carolina Congressional Delegation because MUSC, like academic medical centers across the country, struggles under the weight of spending cuts coming on the heels of the Balanced Budget Act (BBA) of 1997.    The BBA cuts to Medicare Indirect Medical Education adjustment (disproportionate share) diverted $7,119,840 from MUSC in 1998, $10,213,518 in 1999 and will cut $17,319,674 in 2000. That's a three-year effect of nearly $35 million.            Edwards wants the financial blood-letting stopped.           He called for the elimination of further cuts; he called for payments for disproportionate share hospitals to be made payable directly to eligible hospitals beginning in fiscal year 2000; and he called for halving any additional cuts to Medicare funding to teaching hospitals. Those cuts directly affect 125 U.S. medical schools, 400 teaching hospitals, and more than 160,000 medical students and residents.   At the current rate, by 2002 some 30 percent of the country's teaching hospitals will be operating in the red with the average hospital collecting $46 million less from Medicare in the first five years after passage of the BBA.   While teaching hospitals represent only 6 percent of U.S. hospital beds: They collectively deliver 39 percent of the nation's charity care (10 times the overall average) which is expected to jump 50 percent even as BBA takes effect. They treat nearly 50 percent of the nation's uninsured. They house 61 percent of the nation's trauma centers. They have more than 50 percent of the nation's pediatric intensive care units. They lead the world in developing new treatments and cures. They train all doctors and most allied professionals. They serve as local doctor for millions of Americans in their emergency rooms.           Edwards also solicited the delegation's support of current organ transplantation distribution methods and of continued support of biomedical research by increases in the budget of the National Institutes of Health. He requested a medical innovation tax credit to encourage clinical trials being conducted in the United States, support of Veterans Affairs research and medical appropriations and requested support that would ensure South Carolina VA hospitals receive fair distribution of funding.           Last on Edwards' list was a request for transfer of Charleston's Navy Hospital and property to MUSC in the event the facility would no longer meet Department of Defense needs. By relocating Naval outpatient services and freeing the existing hospital and grounds to retrofit by MUSC as a specialty hospital and/or research facility, the university could save substantial new construction costs.      “The South Carolina delegation has always supported MUSC's efforts and we deeply appreciate their assistance,” Edwards said. “I believe the delegation members understand our present needs better now than they did before our meeting. I'm confident they will be helpful where possible.”          MUSC belongs to the citizens of South Carolina and has a responsibility to serve those citizens with the finest health care available. Their needs are great. South Carolina leads the nation in stroke, heart disease, and a number of cancers. More than a third of South Carolina's 3.6 million adults are hypertensive. The state's residents on average aren't expected to live as long as residents of other states. They trail by about two years. Cardiovascular disease alone shortens the life span of South Carolinians by about 6-1/2 years. And hypertension contributes to the deaths of 40 percent of African Americans and 20 percent of whites in the state.