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Copy of the letter AMSA sent to
the members of
the Senate Finance Committee
We, the American Medical Student Association (AMSA), write you today to
express our support for Senator Moynihan's bill, S. 210, the Medical
Education Trust Fund Act. AMSA is the nation's largest, independent
student organization and is composed of 30,000 physicians and residents in
training. We are concerned about recent proposals to expose the funding of
graduate medical education (GME) to the federal appropriations process.
Graduate medical education is a public good that benefits our entire
society. It is our system of graduate medical education that provides this
country with superior medical research and clinical care. The key to
maintaining this system of training doctors and researchers is a reliable
source of funding.
Funding for GME and our nation's teaching hospitals is especially
important as our health care system struggles to control costs and
redesign how we pay for medical care. As a result of this transition, some
of our most valuable health care resources are at risk. Our most
prestigious, treasured institutions, the very backbone of medical research
and clinical education in this country are at risk of being shut down. In
the Oct. 12, 1998 issue of Time, Ralph Snyderman, the Duke medical-center
chancellor said, "The whole managed-care system has the potential to kill
us." The simple fact is that it costs a little extra to establish
residency training programs and research departments. Unfortunately,
managed care organizations do not want to pay the slightly elevated costs
that teaching hospitals must charge to fund their extra responsibilities.
In this new environment, it is more crucial than ever that GME receives
federal assistance to train the doctors and researchers that keep our
nation healthy. Fortunately, Senator Moynihan has introduced legislation
to continue our system of graduate medical education.
Senator Moynihan's bill would do more than guarantee a stable source of
funding for graduate medical education. It would guarantee that everyone
contributes their fair share to this public good by instituting an
all-payer system. Currently, the federal government contributes the most
to fund GME. But the physicians trained by these federal funds then work
for the private sector. HMOs contribute little to GME financing; yet they
benefit by employing the highly trained doctors that our federally funded
system of graduate medical education produces. Senator Moynihan's bill
ensures that all parties pay their fair share to fund GME by instituting a
1.5% assessment on health insurance premiums, Medicare, and Medicaid.
Senator Moynihan's legislation will also ensure that GME funding is
distributed in an efficient, equitable manner. Currently there is no
oversight mechanism to ensure that GME funds are distributed efficiently.
Proponents of moving GME financing into the appropriations process claim
that this would provide accountability. Unfortunately, this would also
introduce uncertainty and potentially devastating fluctuations into the
funding of one of our countries most vital programs. Senator Moynihan's
bill, S.210, the Medical Education Trust Fund Act, creates a Medical
Education Advisory Commission to oversee distribution of GME funds. This
will guarantee that GME funds are distributed fairly without jeopardizing
the quality of medical training in this country.
At AMSA, we feel that the issue of financing graduate medical education
is crucial to the health of the American public, especially with the
proposed plans to alter Medicare. It is vital that GME funding is not lost
in the shuffle as Medicare is reorganized. Mr. Chairman, we hope you will
make every effort to expedite Senator Moynihan's legislation, S. 210, the
Medical Education Trust Fund Act. If you or your staff have any questions
or comments please contact P. Travis Harker, AMSA legislative affairs
director, at 703-620-6600, ext. 211.
Sincerely,
P. Travis Harker
AMSA Legislative Affairs
Director |