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Why medicare supports graduate medical education

        Congress and the Johnson Administration in 1965 created the Medicare program as “America’s national health insurance plan for its disabled and elderly populations” (

        Health Care Financing Administration. Medicare: A Brief Summary. Available at: http://www.hcfa.gov/medicare/ormedmed.htm#medicare.

        ). To ensure that Medicare beneficiaries had access to high-quality care provided by an adequate supply of well-trained physicians, the program’s architects agreed Medicare should help support graduate medical education (GME).
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        References

        1. Health Care Financing Administration. Medicare: A Brief Summary. Available at: http://www.hcfa.gov/medicare/ormedmed.htm#medicare.

          • Iglehart J.K.
          The American health care system.
          N Engl J Med. 1992; 327: 1467-1472
        2. Coffman J, Mertz E, for the Pew Health Professions Commission. Beyond the Balanced Budget Act of 1997: Strengthening Federal GME Policy. San Francisco: Pew Health Professions Commission; 1998.

        3. Kessler G. Rosier future for Medicare is forecast. The Washington Post. March 31, 2000:A1.

        4. Academic Internal Medicine Organizations Form Coalition. News release, January 29, 1999. Washington, DC: Alliance for Academic Internal Medicine.

        5. Health Care Financing Administration. Medicare National Enrollment Trends 1966–1998. Available at: http://www.hcfa.gov/stats/enrltrnd.htm.

        6. American College of Physicians-American Society of Internal Medicine. ACP-ASIM Online: Where we fit in today’s primary care picture. Available at: http://www.acponline.org/public/int−med.htm.

        7. National Center for Health Statistics. Vital and Health Statistics: Ambulatory Care Visits to Physician Offices, Hospital Outpatient Departments, and Emergency Departments: United States, 1997.Available at: http://www.cdc.gov/nchs/data/sr13−143.pdf.

          • Fishman L.E.
          • Bentley J.D.
          The evolution of support for safety-net hospitals.
          Health Affairs. 1997; 16: 30-47
        8. Cohen J. Association of American Medical Colleges’ testimony before the National Bipartisan Commission on the Future of Medicare, September 15, 1998.

        9. Accreditation Council for Graduate Medical Education. Program Requirements for Residency Education in Internal Medicine. Available at: http://www.acgme.org/acgme.

          • Greenlick M.R.
          Educating physicians for the twenty-first century.
          Acad Med. 1995; 70: 3:179-3:185
          • Taylor D.H.
          • Whellan D.J.
          • Sloan F.A.
          Effects of admission to a teaching hospital on the cost and quality of care for Medicare beneficiaries.
          N Engl J Med. 1999; 340: 293-299
          • Kassirer J.P.
          Hospitals, heal yourselves.
          N Engl J Med. 1999; 340: 293-299
          • Blumenthal D.
          • Campbell E.G.
          • Weissman J.S.
          The social missions of academic health centers.
          N Engl J Med. 1997; 337: 1550-1553
        10. National Institutes of Health. NIH Extramural Data, 1998. Available at: http://grants.nih.gov/grants/award/award.htm.

          • Ralston H.J.
          • Beattie D.S.
          • Berns K.I.
          • et al.
          Capturing the promise of science in medical schools.
          Acad Med. 1996; 71: 1314-1323
          • Sutton J.
          • Killian C.D.
          The MD-PhD researcher.
          Acad Med. 1996; 71: 454-459
          • Committee on Addressing Career Paths for Clinical Research, Division of Health Sciences Policy, Institute of Medicine
          Careers in Clinical Research. National Academy Press, Washington, DC1994
        11. American Heart Association. Biostatistical Fact Sheets. Available at: http://www.americanheart.org/statistics/biostats/index.html.

        12. American Diabetes Association. Diabetes Facts and Figures. Available at: http://www.diabetes.org/ada/facts.asp

        13. American Society of Nephrology. Kidney Disease Facts & Statistics. Available at: http://www.asn-online.com/facts/index.html.

        14. American Cancer Society. Cancer: Basic Facts. Available at: http://www.cancer.org/statistics/cff99/basicfacts.html#hadcancer.

        15. AIDS Action Council. HIV/AIDS in the United States. Available at: http://www.aidsaction.org/profile.html.

          • Iglehart J.K.
          The American health care system.
          N Engl J Med. 1999; 340: 327-332
        16. Medicare Payment Advisory Commission. Report to Congress: Medicare Payment Policy. I: Recommendations. March 1998.

          • Kassirer J.P.
          Academic medical centers under siege.
          N Engl J Med. 1994; 331: 1370-1371
        17. Association of American Medical Colleges. Fact Sheet: Impact of the Balanced Budget Act of 1997 on Major Teaching Hospitals. May 1999.

        18. Kondracke MM. Congress should—but won’t—save teaching hospitals. Available at: http://www.rollcall.com/commentary/kondracke.html.

        19. Stark K. For teaching hospitals, a painful education. The Philadelphia Inquirer. October 10, 1999:E1.

        20. Bandler J. Here’s insiders’ prognosis for ailing Boston hospitals. The Wall Street Journal. (New England edition) October 13, 1999:A1.

        21. Association of American Medical Colleges. Issue Brief: America’s Teaching Hospitals Still Hurt from the BBA. Available at: http://www.aamc.org/advocacy/issues/medicare/ibba.htm.