Article Abstract:
The public and eventually the medical community supported federal funding for medical education during the 1950s and 1960s as a result of the physician shortage after World War II. The situation changed during the 1970s as the number of physicians increased. The Graduate Medical Education National Advisory Committee was established in 1976 to examine the association between the supply of and demand for physicians. Debates about health care reform in the 1990s have included little discussion about physician supply policy. Physicians are important to every aspect of health care provision, and they need to assume a leadership role in health care reform. Those involved in planning of health care reform need to focus on the supply of and demand for physicians and the training of new physicians. Despite a significant increase in the number of physicians, more are needed to practice certain types of medicine and in certain geographical locations. Changes are needed in the funding of medical education and amount of support provided by the federal government.
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Article Abstract:
It seems likely that the federal and state governments will continue to play a role in the US health care system. A market approach to health care was supposed to reduce costs by reducing expensive procedures and specialist consultations. However, since the rise of managed care organizations in the 1980's, total US health care costs have actually doubled, reaching $1 trillion in 1995. Most for-profit managed care organizations have little incentive to fund medical education, clinical research or charity care. Consequently, much of medicine's infrastructure will still be financed by the federal and state governments.
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Article Abstract:
Federal health policy should tie increases in health care funding to the gross national product in order to control costs. Medicare policy seeks to reduce federal health expenditures by 2002, increase funding for research, and expand coverage. Any health reform should consider the large number of uninsured persons in the face of excess hospital capacity. Reform should incorporate the uninsured, but maintain the public right to choose caregivers and pay for care beyond basic services.
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