From: Jim Choate <ravage@ssz.com>
To: cypherpunks@ssz.com
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UTC Datetime: 1997-08-24 15:10:09 UTC
Raw Date: Sun, 24 Aug 1997 23:10:09 +0800
From: Jim Choate <ravage@ssz.com>
Date: Sun, 24 Aug 1997 23:10:09 +0800
To: cypherpunks@ssz.com
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REPORT: U.S. TO PAY HOSPITALS NOT TO TRAIN DOCTORS
Doctor graphic August 24, 1997
Web posted at: 10:22 a.m. EDT (1422 GMT)
WASHINGTON (CNN) -- In an effort to reduce a glut of physicians in
the United States, the federal government will pay training
hospitals hundreds of millions of dollars not to train doctors, The
Washington Post reported Sunday.
The initiative, part of the new federal budget agreement, also for
the first time essentially forbids hospitals from increasing the
size of their residency programs, the paper reported.
Medicare underwrites residency training programs heavily. Taxpayers
spend $7 billion a year on the training, with each resident
translating into an average subsidy of $100,000 a year.IN CONTEXT
Medicare spends up to $7 billion a year on physician training
programs. But with one physician for every 380 people in the United
States, critics say the government is paying for more doctors than
it needs.
Under the new plan, Medicare will instead pay hospitals to shrink
their residency programs. Hospitals that voluntarily reduce
residency training programs by 20 to 25 percent over five years will
get the full amount of the lost subsidies for the first two years,
with payments tapering off over the next three years, the newspaper
said.
After five years, the payments will cease, leaving the program with
fewer residents to underwrite. Administration health officials and
leading Republicans say the program will save Medicare money in the
long run, the Post reported.
The payments are the government's first effort to constrict the
pipeline of people entering the medical profession, and one of the
few times the federal government has used subsidies as leverage to
shrink a particular work force.
New York tried program first
The program mirrors an experimental program in New York endorsed by
the Clinton administration earlier this year.
Under the agreement between the Greater New York Hospital
Association and the federal Health Care Financing Administration,
which runs Medicare, New York is to receive $400 million over
several years to train fewer doctors, especially in those in certain
specialties.
Of the state's 75 teaching hospitals, the Post reported, 42 signed
up for the program -- nearly four times as many as expected.
But the agreement drew fire from teaching hospitals in other areas
of the country who were cutting their residency rolls voluntarily
and absorbing the cost of the lost subsidies without federal
assistance.
Some say agreement may have been unnecessary
Some government officials quoted by the Post said the glut of
doctors, particularly specialists, in the United States was a
growing problem, and argued that the budget agreement was a valuable
cost-cutting tool. "It remains a voluntary matter of choice for
these teaching hospitals. It isn't a mandate," said Ari Fleischer, a
spokesman for committee chairman Rep. Bill Archer, R-Texas.
Others wondered whether it was necessary. The number of doctors
training to become specialists in some fields has declined
dramatically despite the subsidy program, the Post article said, due
to well-publicized warnings that jobs for specialists were only
available in less populated areas.
The United States boasts over 700,000 physicians, more per capita
than any other country.
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1997-08-24 (Sun, 24 Aug 1997 23:10:09 +0800) - index.html - Jim Choate <ravage@ssz.com>