TABLE 1


Table 1. Rationales for Medicare Support of Graduate Medical Education

Ensuring beneficiary access to teaching hospitals
Ensuring the viability of teaching hospitals
Supporting the production of physicians to meet beneficiary needs

TABLE 2


Table 2. Total and Medicare Inpatient Margins by Hospital Type, Fiscal Year 1995 [percentage]

Hospital Type Margin	Total Margin	Medicare Inpatient
All	5.6	7.9
Major Teaching	3.7	18.6
Other Teaching	5.6	7.6
Non Teaching	6.5	3.7
Urban	5.4	8.7
Rural	7.0	3.0

SOURCE: Prospective Payment Assessment Commission 1997.

















TABLE 3


Table 3. Real Median Physician Income, by Selected Specialties and Selected Years [1995 dollars in thousands]

Specialty	1981	1985	1990	1991	1992	1993	1994	1995
Primary Care
Family practice	$118	$107	$107	$108	$108	$115	$113	$124
Internal medicine	139	139	138	138	140	157	154	150
Pediatrics	106	106	115	116	121	126	113	129
Surgery
General surgery	194	213	196	188	194	236	226	225
Ophthalmology	*	*	202	221	188	191	180	194
Orthopedics	*	*	311	259	269	283	279	250
Other Specialties
Anesthesiology	194	192	230	232	237	231	205	203
Obstetrics/gynecology	181	169	212	221	204	210	187	200
Psychiatry	116	122	123	122	129	126	123	124
Radiology	191	207	230	247	258	252	226	230
All Specialties	152	155	150	154	159	164	154	160

SOURCE: American Medical Association Socioeconomic Monitoring System.
*Not available.
NOTE: Values have been adjusted for inflation using the gross domestic product deflator.

















TABLE 4


Table 4. Implications of Financing Graduate Medical Education From a Trust Fund

Creates opportunity to correct various problems with current policy
Shifts financing from open-ended entitlement to a fixed amount of funding
Financing from general revenues creates new political dynamic for stakeholders
Creates administrative structure that could be used for accepting and distributing revenues from other payers

TABLE 5


Reimbursement Associated With Residency Reductions

Demo Year 1 (1997-1998)	Demo Year 2 (1998-1999)	Demo Year 3 (1999-2000)	Demo Year 4 (2000-2001)	Demo Year 5 (2001-2002)	Demo Year 6 (2002-2003)	Post-Demo Years
100%	95%	85%	70%	50%	25%	0%