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GAO-09-438R 1 (2009-05-04)

handle is hein.gao/gaobaannf0001 and id is 1 raw text is: 



  AGA
  ~GA 0
4        Acountabity I Integriy * Reliability
United States Government Accountability Office
Washington, DC 20548



           May 4, 2009

           The Honorable George Miller
           Chairman
           The Honorable Howard P. Buck McKeon
           Ranking Member
           Committee on Education and Labor
           House of Representatives

           The Honorable Robert Andrews
           Chairman
           Subcommittee on Health, Employment, Labor
           and Pensions
           Committee on Education and Labor
           House of Representatives

           The Honorable Charles W. Boustany, Jr.
           The Honorable Joe Courtney
           The Honorable Tom Price
           House of Representatives

           Subject: Graduate Medical Education: Trends in Training and Student Debt

           The federal government invests significantly in medical education through various programs
           to help ensure that the anticipated supply of new physicians meets the nation's health care
           needs. Medicare, the federal health care program for elderly and certain disabled people,
           subsidizes training for medical school graduates in hospitals and other teaching institutions
           by helping to support the increased costs associated with postgraduate medical training.
           These subsidy payments provided hospitals and other teaching institutions with an additional
           $8.76 billion' for postgraduate medical training in fiscal year 2008.2 In addition, Medicaid, a
           joint federal and state program that finances health care for certain low-income individuals,
           provides funding for graduate medical education.3 In order to pay for medical school tuition



           'These payments include direct and indirect Medicare graduate medical education payments. Direct
           payments are provided to teaching institutions for costs directly related to medical training, such as
           teachers' salaries and administrative costs, while indirect payments are provided for the increased
           patient care costs associated with medical training. For fiscal year 2008, indirect payments were about
           71 percent of total Medicare graduate medical education payments. In addition, Medicare graduate
           medical payments also subsidize podiatric and dental training.
           2In part to constrain costs, Congress limited the number of postgraduate medical training positions
           supported by Medicare with the 1997 Balanced Budget Act. Medicare support for podiatric and dental
           training positions was not affected by this legislation.
           3According to the Congressional Research Service, federal and state Medicaid payments for graduate
           medical education were estimated to be about $3.2 billion in 2005. This estimate was based on 2005


GAO-09-438R Graduate Medical Education

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