Jewish World Review
Sept. 18, 2000 / 17 Elul, 5760
New York: Land of medical pork
HILLARY CLINTON AND RICK LAZIO agree on one thing: New York deserves
The two U.S. Senate candidates debated this week, both eager to highlight
what the First Lady called their "big differences." But on the issue of
restoring public subsidies for one of the state's most powerful special
interests – teaching hospitals -- Hillary and Rick are bosom buddies.
Under Medicare, the federal government covers both the direct and indirect
costs of educating future medical doctors. Taxpayers funding of graduate
medical education totals $7 billion a year. Roughly one-third of that goes
directly to medical school teachers, classroom overhead, and residents'
salaries. Teaching hospitals receive up to $100,000 per year for each
resident trained, and after paying their salaries (an estimated $50,000 per
resident), hospitals can pocket the rest of the federal funds.
New York has more teaching hospitals -- 57 -- than any other state.
Fifteen percent of the nation's doctors are trained there. The average
Medicare payment for each trainee is reportedly more than four times as
much at some New York hospitals as compared to teaching hospitals in other
Why should the rest of the nation's workers pay for graduate medical
education and residents' salaries? Hospital lobbyists argue that the
subsidies help offset the costs of enhanced care. But when an independent
panel set out to verify that claim, it learned that no study or survey
existed that had ever quantified the cost or value of enhanced care at
teaching hospitals. One healthcare lobbyist told Modern Healthcare magazine
last fall that architects of the medical training subsidy program picked
numbers ''out of the sky.''
The doctors' lobby argues that the profession provides a vital public good
that deserves federal support. Funny how this "public" good reaps such
huge private rewards for M.D.'s. The education subsidy is a fancy way of
getting taxpayers to foot the tuition bills for supposedly impoverished
graduate medical students -- who then go on to make median incomes of
$170,000 a year.
Other medical professionals who provide vital health care services for much
lower salaries – from emergency medical technicians and midwives to biotech
researchers – don't receive public funding for their education and
Both Mrs. Clinton and Rep. Lazio claim to advocate fiscal discipline. In
perhaps the most laughable moment of this week's debate, the First Lady
declared herself a "New Democrat who supports a balanced budget." But
neither she nor Rep. Lazio criticized Congress for reneging on the 1997
Balanced Budget Act and restoring $15 billion in Medicare cuts to whining
teaching hospitals that couldn't survive in the marketplace without the
It's bad enough that teaching hospitals and medical schools get hefty
helpings from the public trough to train doctors. But can you believe that
Congress and the White House also agreed to pay teaching hospitals around
the country hundreds of millions of dollars [ital]not[ital] to train
doctors? The program, also part of the 1997 Balanced Budget Act, was
intended to reduce a purported glut of doctors by offering financial
incentives to reduce residency slots by up to 25 percent over six years.
The Balanced Budget Act earmarked $400 million in Medicare funds for New
York teaching hospitals that participated in the project.
Mrs. Clinton, who in her former life as health care reform czarina proposed
to cut the supply of doctors and specialists by 25 percent and 50 percent
respectively, now calls teaching hospitals the "crown jewels" of New York's
health care system. She pledges to do all she can for the Empire State to
keep the money coming. At the same time, Mrs. Clinton yammers endlessly
about preserving Medicare. But she ignores the questions of why Medicare
continues to funnel billions to pay for training doctors' salaries – with
no proof that it actually benefits Medicare recipients – and at the same
time, pays hospitals not to train doctors.
The choice for New Yorkers is clear: a native son who has always been
honest about his desire to bring home the bacon or a forked-tongued
carpetbagger willing to hustle for hospital dollars in her monomaniacal
JWR contributor Michelle Malkin can be reached by clicking here.
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© 2000, Creators Syndicate