Health manpower legislation.

Abstract

In response to the desires of Congress, medical schools dramatically enhanced their ability to perform biomedical research and to educate health professions personnel. Initially, Congress viewed health professionals as a national resource in terms of being willing to subsidize their education. Congress continues to view the health professions as a national resource, but the philosophy of Congress has become substantially modified: Congress is unwilling to subsidize the education of physicians, but perceives that it must regulate their specialty and geographic distribution. Medical students and medical schools have, in a major sense, been left "holding the bag." A cogent argument can be offered that the natural history of health-care evolution has been confused by excessive meddling with the system. Additional legislatively induced confusion should not be imposed, at least until the results of the previous meddling have been observed. Unfortunately, the foregoing presentation raises considerably more questions than it answers: Medical schools: What will be the source(s) of financial support? Medical students: What will be the impact of tuition indebtedness? Practicing physicians: What will be the result(s) of severe competition? Health professions educational institutions must address fundamental issues concerning their financial survival. That is, will they accept the carrot-and-stick philosophy and pursue federal funding? or will they seek financial independence toward the goal of assuming responsibility for their own destiny? The philosophy of federal funding "without strings attached" does not exist.