After cutting almost $40 million from their budget over the past 18 months, the leaders of Vanderbilt University Medical Center have been told to find another $50 million in savings, starting immediately, because of the "draconian" spending cuts being made by a number of federal agencies. In a letter to the VUMC community, Vice Chancellor for Health Affairs Jeff Balser on Wednesday said it hasn't taken much time at all to feel the effect of the cuts stemming from the so-called sequester, which will slice $85 billion out of the federal budget between now and the end of September.