Copyright 1999 The Baltimore Sun Company
THE
BALTIMORE SUN
October 24, 1999, Sunday ,FINAL
SECTION: EDITORIAL ,3C
LENGTH: 379 words
HEADLINE:
Saving teaching hospitals
BODY:
Here is an excerpt
of an editorial from the Los Angeles Times, which was published Wednesday.
AMERICA'S teaching hospitals are acclaimed for their use of advanced
medicine to save patients. In August, for instance, doctors at Children's
Hospital Los Angeles successfully labored around the clock on two young boys --
one of them critically wounded -- who were shot at a Granada Hills Jewish
center. Acclaim won't pay doctors or their instructors, however, and teaching
hospitals are major targets this year for the $60 billion that
Congress plans to cut from Medicare's hospital payments over four years under
the 1997 Balanced Budget Act.
Some $14 billion in cuts
are slated to come out of the Medicare dollars the government now sends to
teaching hospitals. That unfairly burdens the academic medical facilities, which
perform vital roles such as teaching medical residents and treating a high share
of low-income uninsured people.
Last week, the Senate began considering
an amendment to the Budget Act introduced by Sen. Daniel Patrick Moynihan, a New
York Democrat, which would offset the cuts over the next decade with direct
payments from Medicare. It deserves prompt passage.
Medicare is not the
most efficient mechanism for supporting teaching hospitals. It pays hospitals
largely through "graduate medical education" subsidies that are
needlessly complex and difficult for federal regulators to oversee.
Nevertheless, this measure is the only viable proposal at hand for
correcting this serious problem. Teaching hospitals should not be stripped of
money just because Washington's allocation system is imperfect.
The
ideal solution would be to develop a payment system that calculates the
hospitals' social benefit and then compensates them. For example, independent
children's hospitals represent less than 1 percent of all hospitals, but they
train 30 percent of the nation's pediatricians and nearly half the pediatric
specialists.
A solution will be years in coming, given Congress' recent
failure to agree on any Medicare reforms despite a year of intense negotiation.
Meanwhile, the Moynihan bill is a good stopgap measure to protect these
indispensable hospitals while Washington wrangles over more fundamental reform.
LOAD-DATE: November 2, 1999