Introduction Who holds the financial invoice for Graduate Medical Education (GME), government, taxpayers, medical institutions, or scholars? Are current policies influencing the future number of qualified physicians? The primary source of medical education finance has not change since 1999 with the enactment of the Balanced Budget Act. Economists, academia, the medical community, and physician trainees argue financing GME and disparaging salaries of trainee are the keys to solving the great economic problem of physician shortage. Others advocate for transformation through legislation, filling vacant trainee positions, and appropriately reallocating GME funds to medically train in where physician shortage occurs. The normative economics …show more content…
The responsibility transcended hospitals through the years with the enactment of Medicare to the BBA and present day Affordable Care Act (ACA). The current funding for GME is over $15 billion per year according to HRSA, 2013. The center of the debate is current state of GME financing and priority of medical responsibility. Several sources fund GME programs. According to the National Institute of Health (NIH), these sources include Medicare, Medicaid matching, discretionary appropriations, state-based programs, private sources, private insurers, universities, hospitals, and ancillary industry grants and gifts. Addressing the shortage of trained physicians to accommodate initiatives for access to care, population health, and cost containment is the problem, funding is not. Throwing money at the issue is not the remedy. Addressing the issues of financing and disbursements accountability are possible solutions. From: Graduate Medical Education That Meets the Nation's Health Needs. Committee on the Governance and Financing of Graduate Medical Education; Board on Health Care Services; Institute of Medicine. Freestanding hospitals only; residents in units are included in the general acute care