Charles P. Clayton
Amid concerns about 10-year costs in excess of $1.5 trillion and an unprecedented rush to completion, the US Senate Committee on Health, Education, Labor, and Pensions (HELP) met Wednesday, June 17, 2009, to consider the initial version of its health care reform legislation. Similarly beset by high cost projections, the US Senate Committee on Finance has postponed its series of hearings for several weeks to identify savings and new revenues to pay for their proposals. Finally, several committees in the House of Representatives will hold hearings next week to discuss proposals recently released by House Democrats.
The Alliance for Academic Internal Medicine (AAIM) encourages all faculty and staff in departments of internal medicine to participate in the national discussion of health care reform. In particular, the alliance welcomes your involvement in encouraging these committees to include an expansion of Medicare-funded training positions in the final health care legislation. Please visit the AAIM website for more information on how to add your voice to this discussion.
As previously reported, the Senate Finance Committee working papers on health care reform do not include an expansion of Medicare-funded residency positions. The committee did include a redistribution of unused residency slots among its proposals. Likewise, the Senate HELP Committee deferred from a workforce expansion in its draft bill. That committee’s proposal includes a workforce commission, an extension of the primary care training programs administered by the Health Resources and Services Administration (commonly called the Title VII programs), and student loan reforms.
The proposal from House Democrats includes five workforce points:
1. Expand the National Health Service Corps.
2. Boost the training of primary care physicians.
3. Expand the pipeline of individuals going into health professions.
4. Support workforce diversity.
5. Expand scholarships and loans for individuals in needed professions and shortage areas.
House Republicans also released the outline of a health care reform plan June 17. The proposal includes "incentives to physicians who enter the field of primary care, helping to ensure all Americans have access to the doctors they need."
While cost projections have delayed the rapid consideration of health care reform proposals, observers still expect significant congressional action over the summer. The committees of jurisdiction have been extremely willing to consider input from the health care community. AAIM encourages its members to contact their legislators to support the expansion of Medicare funding for GME.