Copyright 1999 Times Mirror Company
Los Angeles
Times
October 20, 1999, Wednesday, Home Edition
SECTION: Metro; Part B; Page 8; Editorial Writers
Desk
LENGTH: 356 words
HEADLINE: THE VALUE OF TEACHING HOSPITALS
BODY:
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. About $ 14 billion in cutbacks 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
like teaching medical residents and treating a high share of low-income
uninsured people. Today, the Senate plans to consider an amendment to the Budget
Act introduced by Sen. Daniel Patrick Moynihan (D-N.Y.) that 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% of all hospitals, but
they train 30% of the nation's pediatricians and nearly half the pediatric
specialists.
A solution will be years in coming, given Congress's recent
failure to agree on any Medicare reforms despite a year of intense negotiation.
In the meantime, the Moynihan bill is a good stopgap measure to protect these
indispensable hospitals while Washington wrangles over more fundamental reform.
LOAD-DATE: October 20, 1999 
