The economics of graduate medical education

摘要

Acentral health care-related policy question for the United States is whether the federal government's role in financing graduate medical education (GME) increases the number of physicians trained and influences their specialty choices by subsidizing the cost of training. Total federal GME funding amounts to nearly $16 billion annually. Medicare is the largest federal government contributor to GME, providing $9.5 billion — almost $3 billion for direct medical education (DME), to pay the salaries of residents and supervising physicians, and about $6.5 billion for indirect medical education (IME), to subsidize the higher costs that hospitals incur when they run training programs. Federal Medicaid spending adds another $2 billion for GME, and an additional $4 billion comes from the Veterans Health Administration and the Health Resources and Services Administration. States support GME through nearly $4 billion in Medic-aid spending.