Financing Graduate Medical Education: The Search for New Sources of Support

Health Affairs

Volumn 16, Issue 4, 1997, Pages 48-63

  Desmarais, Henry R ^a   Hash, Michael M ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BUDGET; COMMUNITY CARE; COST CONTROL; ECONOMICS; EDUCATION; FINANCIAL MANAGEMENT; HUMAN; LEGAL ASPECT; MEDICAL EDUCATION; MEDICARE; TAX; TEACHING HOSPITAL; UNITED STATES;

BUDGETS; COST CONTROL; EDUCATION, MEDICAL, GRADUATE; FINANCING, GOVERNMENT; HOSPITALS, TEACHING; HUMANS; MEDICARE; TAXES; TRAINING SUPPORT; UNCOMPENSATED CARE; UNITED STATES;

EID: 0347738335     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.16.4.48     Document Type: Article

References (18)

1. Congressional Budget Office, Reducing the Deficit: Spending and Revenue Options (Washington: U.S. Government Printing Office, August 1996); and S. Burner and D. Waldo, "National Health Expenditure Projections, 1994-2005," Health Care Financing Review (Summer 1995): 221-242. Equity is a function of the degree to which a tax or other levy is applied according to the payer's ability to pay. Adequacy refers to the degree to which a policy option will achieve revenue targets, both initially and over an extended period of time. Collectibility is a function of the level of administrative costs and burdens associated with a revenue option. The effects/consequences criterion considers the degree to which a revenue option alters economic activities or produces other positive or negative effects (for example, the impact on job creation, capital formation, and employers' willingness to provide health benefits).
2. Congressional Budget Office, Reducing the Deficit: Spending and Revenue Options (Washington: U.S. Government Printing Office, August 1996); and S. Burner and D. Waldo, "National Health Expenditure Projections, 1994-2005," Health Care Financing Review (Summer 1995): 221-242. Equity is a function of the degree to which a tax or other levy is applied according to the payer's ability to pay. Adequacy refers to the degree to which a policy option will achieve revenue targets, both initially and over an extended period of time. Collectibility is a function of the level of administrative costs and burdens associated with a revenue option. The effects/consequences criterion considers the degree to which a revenue option alters economic activities or produces other positive or negative effects (for example, the impact on job creation, capital formation, and employers' willingness to provide health benefits).
3. See, for example, Council on Graduate Medical Education, Managed Health Care: Implications for the Physician Workforce and Medical Education (Washington: COGME, September 1995); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew, November 1995); M. Whitcomb, "A Cross-National Comparison of Generalist Physician Workforce Data: Evidence for U.S. Supply Adequacy," Journal of the American Medical Association 274, no. 9 (1995): 692-695; R. Cooper, "Perspectives on the Physician Workforce to the Year 2020," Journal of the American Medical Association 274, no. 19 (1995): 1534-1543; A. Tarlov, "Estimating Physician Workforce Requirements: The Devil Is in the Assumptions," Journal of the American Medical Association 274, no. 19 (1995): 1558-1560; Institute of Medicine, The Nation's Physician Workforce: Options for Balancing Supply and Requirements (Washington: National Academy Press, 1996); and D. Goodman et al., "Benchmarking the U.S. Physician Workforce: An Alternative to Needs-Based or Demand-Based Planning," Journal of the American Medical Association 276, no. 22 (1996): 1811-1817.
4. See, for example, Council on Graduate Medical Education, Managed Health Care: Implications for the Physician Workforce and Medical Education (Washington: COGME, September 1995); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew, November 1995); M. Whitcomb, "A Cross-National Comparison of Generalist Physician Workforce Data: Evidence for U.S. Supply Adequacy," Journal of the American Medical Association 274, no. 9 (1995): 692-695; R. Cooper, "Perspectives on the Physician Workforce to the Year 2020," Journal of the American Medical Association 274, no. 19 (1995): 1534-1543; A. Tarlov, "Estimating Physician Workforce Requirements: The Devil Is in the Assumptions," Journal of the American Medical Association 274, no. 19 (1995): 1558-1560; Institute of Medicine, The Nation's Physician Workforce: Options for Balancing Supply and Requirements (Washington: National Academy Press, 1996); and D. Goodman et al., "Benchmarking the U.S. Physician Workforce: An Alternative to Needs-Based or Demand-Based Planning," Journal of the American Medical Association 276, no. 22 (1996): 1811-1817.
5. See, for example, Council on Graduate Medical Education, Managed Health Care: Implications for the Physician Workforce and Medical Education (Washington: COGME, September 1995); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew, November 1995); M. Whitcomb, "A Cross-National Comparison of Generalist Physician Workforce Data: Evidence for U.S. Supply Adequacy," Journal of the American Medical Association 274, no. 9 (1995): 692-695; R. Cooper, "Perspectives on the Physician Workforce to the Year 2020," Journal of the American Medical Association 274, no. 19 (1995): 1534-1543; A. Tarlov, "Estimating Physician Workforce Requirements: The Devil Is in the Assumptions," Journal of the American Medical Association 274, no. 19 (1995): 1558-1560; Institute of Medicine, The Nation's Physician Workforce: Options for Balancing Supply and Requirements (Washington: National Academy Press, 1996); and D. Goodman et al., "Benchmarking the U.S. Physician Workforce: An Alternative to Needs-Based or Demand-Based Planning," Journal of the American Medical Association 276, no. 22 (1996): 1811-1817.
6. See, for example, Council on Graduate Medical Education, Managed Health Care: Implications for the Physician Workforce and Medical Education (Washington: COGME, September 1995); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew, November 1995); M. Whitcomb, "A Cross-National Comparison of Generalist Physician Workforce Data: Evidence for U.S. Supply Adequacy," Journal of the American Medical Association 274, no. 9 (1995): 692-695; R. Cooper, "Perspectives on the Physician Workforce to the Year 2020," Journal of the American Medical Association 274, no. 19 (1995): 1534-1543; A. Tarlov, "Estimating Physician Workforce Requirements: The Devil Is in the Assumptions," Journal of the American Medical Association 274, no. 19 (1995): 1558-1560; Institute of Medicine, The Nation's Physician Workforce: Options for Balancing Supply and Requirements (Washington: National Academy Press, 1996); and D. Goodman et al., "Benchmarking the U.S. Physician Workforce: An Alternative to Needs-Based or Demand-Based Planning," Journal of the American Medical Association 276, no. 22 (1996): 1811-1817.
7. See, for example, Council on Graduate Medical Education, Managed Health Care: Implications for the Physician Workforce and Medical Education (Washington: COGME, September 1995); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew, November 1995); M. Whitcomb, "A Cross-National Comparison of Generalist Physician Workforce Data: Evidence for U.S. Supply Adequacy," Journal of the American Medical Association 274, no. 9 (1995): 692-695; R. Cooper, "Perspectives on the Physician Workforce to the Year 2020," Journal of the American Medical Association 274, no. 19 (1995): 1534-1543; A. Tarlov, "Estimating Physician Workforce Requirements: The Devil Is in the Assumptions," Journal of the American Medical Association 274, no. 19 (1995): 1558-1560; Institute of Medicine, The Nation's Physician Workforce: Options for Balancing Supply and Requirements (Washington: National Academy Press, 1996); and D. Goodman et al., "Benchmarking the U.S. Physician Workforce: An Alternative to Needs-Based or Demand-Based Planning," Journal of the American Medical Association 276, no. 22 (1996): 1811-1817.
8. See, for example, Council on Graduate Medical Education, Managed Health Care: Implications for the Physician Workforce and Medical Education (Washington: COGME, September 1995); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew, November 1995); M. Whitcomb, "A Cross-National Comparison of Generalist Physician Workforce Data: Evidence for U.S. Supply Adequacy," Journal of the American Medical Association 274, no. 9 (1995): 692-695; R. Cooper, "Perspectives on the Physician Workforce to the Year 2020," Journal of the American Medical Association 274, no. 19 (1995): 1534-1543; A. Tarlov, "Estimating Physician Workforce Requirements: The Devil Is in the Assumptions," Journal of the American Medical Association 274, no. 19 (1995): 1558-1560; Institute of Medicine, The Nation's Physician Workforce: Options for Balancing Supply and Requirements (Washington: National Academy Press, 1996); and D. Goodman et al., "Benchmarking the U.S. Physician Workforce: An Alternative to Needs-Based or Demand-Based Planning," Journal of the American Medical Association 276, no. 22 (1996): 1811-1817.
9. See, for example, Council on Graduate Medical Education, Managed Health Care: Implications for the Physician Workforce and Medical Education (Washington: COGME, September 1995); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew, November 1995); M. Whitcomb, "A Cross-National Comparison of Generalist Physician Workforce Data: Evidence for U.S. Supply Adequacy," Journal of the American Medical Association 274, no. 9 (1995): 692-695; R. Cooper, "Perspectives on the Physician Workforce to the Year 2020," Journal of the American Medical Association 274, no. 19 (1995): 1534-1543; A. Tarlov, "Estimating Physician Workforce Requirements: The Devil Is in the Assumptions," Journal of the American Medical Association 274, no. 19 (1995): 1558-1560; Institute of Medicine, The Nation's Physician Workforce: Options for Balancing Supply and Requirements (Washington: National Academy Press, 1996); and D. Goodman et al., "Benchmarking the U.S. Physician Workforce: An Alternative to Needs-Based or Demand-Based Planning," Journal of the American Medical Association 276, no. 22 (1996): 1811-1817.
10. Prospective Payment Assessment Commission, Medicare and the American Health Care System: Report to the Congress (Washington: ProPAC, June 1996), 63, 71.
11. U.S. House of Representatives, Conference Report to accompany H.R. 3610, H. Rept. 104-863 (28 September 1996): 1090.
12. Physician Payment Review Commission, Annual Report to Congress (Washington: PPRC, 1996), 82.
13. Office of Management and Budget, The President's FY1998 Budget: Medicare Savings and Investment Proposals (Washington: U.S. GPO, February 1997).
14. Given data limitations, the Medicare AAPCC carve-out option is omitted from both Exhibits 1 and 2.
15. See, for example, M.A. Morrisey, G.A. Jensen, and R.J. Morlock, "Small Employers and the Health Insurance Market," Health Affairs (Winter 1994): 155; and Congressional Budget Office, Rising Health Care Costs: Causes, Implications, and Strategies (Washington: U.S. GPO, April 1991), 18.
16. See, for example, M.A. Morrisey, G.A. Jensen, and R.J. Morlock, "Small Employers and the Health Insurance Market," Health Affairs (Winter 1994): 155; and Congressional Budget Office, Rising Health Care Costs: Causes, Implications, and Strategies (Washington: U.S. GPO, April 1991), 18.
17. Under current law, the initial residency period is generally defined as the minimum number of years of formal training necessary to satisfy the requirements for initial board eligibility in the particular specialty for which the resident is training - but not more than five years.
18. Senator Moynihan's introductory remarks in the Senate, Congressional Record (21 January 1997): S361-S362.