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AMSA Supports S.210
The Medical Education
Trust Fund Act of 1999
The American Medical Student Association (AMSA) supports an
all-payer system of graduate medical education financing for the
following reasons:
* Graduate medical education benefits the
entire society. Graduate medical education, or GME, is the term
for the advanced training, or "residency", that is required of
doctors after graduating from medical school. The United States has
the most highly trained physicians in the world, well versed in the
cutting-edge technology available to health care providers today. It
is our excellent system of graduate medical education that makes
this possible. Therefore, a stable source of funding for graduate
medical education is essential to maintaining the high quality
physicians our society benefits from today.
* Medicare is the most significant
contributor to the funding of graduate medical education. The
federal government is the largest contributor to GME. The American
Association of Medical Colleges calculated that 34% of the average
academic medical center's residency training expenses were covered
by Medicare in 1997. It seems unfair that the cost of training our
future physicians should fall disproportionately on Medicare when
children, adults and senior citizens all benefit from highly trained
physicians. Because of the recent push to reform Medicare, now, more
than ever, we need an all-payer system in which all concerned
parties contribute their fair share to fund the education of our
physicians.
* Medical schools and teaching hospitals
are in dire financial situations. Many medical schools are
immediately threatened by the dire financial situations of their
teaching hospitals. In the highly competitive health care market,
the revenues these teaching hospitals previously relied on are
rapidly dissipating. Private insurers do not want to pay higher
costs to use teaching hospitals. Additionally, the revenues of the
faculty at these teaching hospitals, upon which the teaching
hospitals rely for part of their support, are shrinking under
managed care. Medical education is too valuable to be left
vulnerable to the volatility of the health care market or the
appropriations process. We need a stable, reliable system to fund
graduate medical education in which everyone contributes.
AMSA favors collecting funds from all health care plans,
including both Medicare and Medicaid as well as from private
insurance plans, into a medical education trust fund. This will
provide a broad base of support for medical education and disengage
GME funding from a single source. A medical education trust fund
will also remove the funding of graduate medical education from the
financial uncertainties of modern medical practice. AMSA also favors
the formation of a Medical Education Advisory Commission to improve
graduate medical education and ensure the trust fund is used in an
efficient manner. AMSA feels that the opinions of future physicians
and residents in training must be taken into account by the
commission. This could best be accomplished by including a permanent
representative from AMSA on the commission.
Thus, AMSA supports S.210, Senator Moynihan's Medical
Education Trust Fund Act of 1999:
- S.210 will collect $8 billion from Medicare, $4 billion from
Medicaid, and $5 billion from private insurance plans through a
1.5% assessment on premiums. These funds would be placed in a
trust fund set aside for medical education to provide an average
annual support of $17 billion for medical education. The relative
contribution from each of these sources will be in rough
proportion to the medical education costs attributable to their
respective covered populations.
- S.210 will establish a Medical Education Advisory Commission
to improve graduate medical education and study future sources of
funding for medical education and research. This commission will
consist of representatives from teaching hospitals, medical
schools, and health care insurers, advisory groups and other
interested parties. According to the bill, disbursements from the
fund will follow the current formula, but the Medical Education
Advisory Commission will assess the current disbursement schedule
and make revision recommendations.
The American Medical Student Association is the nation's oldest
and largest independent organization representing nearly 30,000
physicians-in-training from medical schools across the country.
For more information please contact Travis Harker, AMSA
Legislative Affairs Director, at 703-620-6600, ext.
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