Financing graduate medical education: a federal health policy perspective

Since 1984, the federal government has incrementally linked funding of Medicare to considerations of medical manpower supply, training, and specialization. To beneficially implement such policy, the government should: reaffirm that general medical education costs are an integral part of care costs in teaching hospitals; discontinue federal support of medical education in foreign schools with unacceptable standards; create programs to allow fully trained physicians to replace trainees in the provision of services to inner city poor; and require teaching hospitals to affiliate with medical schools.