Members of Congress know that in their zeal to balance the budget in 1997, they cut funding to home health care so severely that they nearly wrecked a service that millions of people depend on. Now with a sizable surplus and the ability to repair some of the damage, Congress has yet to help rebuild the agencies it dismantled.

A measure introduced by Sen. Susan Collins and adopted as part of the proposed budget stops further scheduled cuts to home health. A good and needed measure. But it only begins to address the cuts over the last four years. More than 173,000 full-time positions in Medicare-certified agencies have been lost since ’97, according to the National Association for Home Care, with the total number of visits to the infirm cut by 55 percent nationwide.

In Maine, whose elderly population grew significantly in the 1990s, payments for home health fell more than $40 million during that time, with the number of visits cut in half.

Home health care was supposed to be the cost-effective alternative to more formal nursing home or hospital settings for Medicare patients who needed care but did not need constant supervision. Treating people in the familiarity of their own homes is a sensible, humanitarian alternative that Maine, like many other states at the federal government’s urging, embraced a decade ago as part of a larger reform of care for the elderly.

But in just the last five years, according to the home care association, the number of certified agencies here dropped from 51 to 36, even as the number of elderly has increased. The elimination of the further 15 percent cut will help agencies plan and should stop further losses, but how long will it be before the next study by the federal government concludes once again that the nation would benefit from more home health care?

Again, members of Congress know all of this. Now, instead of trying to balance the budget, they are occupied with trying to send back the surplus through tax cuts. They are saying there is an extra $1.2 trillion or $1.6 trillion just lying around even though the commitment to Medicare patients is not being met. It is a shortsighted policy that harms senior citizens and eventually drives up costs by forcing Medicare patients into more expensive treatment.

Health care agencies need more funding, more predictable funding and funding based on actual costs. Congress can and should help before it commits the entire surplus to tax relief.