RE “INSPECTOR faults managed care cost” (Page A1, Aug. 3): Uneven Medicaid payments to large teaching hospitals require more than a cursory review. They are related, in part, to the cost of graduate medical education.
The Balanced Budget Act of 1997 placed a limit on the number of residents for whom hospitals can be reimbursed through Medicare. Every teaching hospital has to use some of its general revenues to cover the cost of training residents, the next generation of caregivers.
As has been reported recently (Page A8, July 29), the current doctor shortage will only intensify under the new federal health care law. Society, as well as federal and state lawmakers, must realize that there is a significant cost attached to training our future physicians, and reimbursement to teaching hospitals must reflect that.
The writer is in the department of surgery at Brigham and Women’s Hospital, and is professor of surgery at Harvard Medical School.