Health Reform-Graduate Medical Education

ARKANSAS CHILD HOSPITAL 800 Marshall Street, Little Rock, Arkansas 72202-3591, (501) 320-1100 or TDD (501) 320-1184 Jonathan Bates, M.D. President / Chief Executive Officer October 12, 1998 Betty A. Lowe, M.D. Senior Vice President / Medical Director Phillip K. Gilmore, M.S., M.H.A. Executive Vice President / CCO/COO First Lady Hillary Rodham Clinton Scott Gordon, L.C.S.W. Senior Vice President / Business Development The White House Interim President ACH Foundation Gena Wingfield Washington, DC 20500-2000 Senior Vice President Chief Financial Officer Blanche Moore Senior Vice President/Government Relations Dear Hillary: Christie Berner, M.S.N., R.N., Senior Vice President Patient Care Services Tom Bonner It was wonderful having you on our campus again, and Anne Hickman Senior Vice President Public Affairs was delighted to have you kick off her lecture series. Your appearance Board of Directors lent so much importance to the event. Barbara Moore Chairman John Bale, Jr. I also want to thank you for your interest in the unintended but Vice Chairman Tom Baxter nonetheless very serious inequity in federal graduate medical education Secretary (GME) funding, which increasingly places independent children's Harry C. Erwin III Treasurer teaching hospitals, such as Arkansas Children's Hospital, at a serious Richard Leithiser, M.D. competitive disadvantage. With this letter, I am providing the Chief of Staff Robert L. Shults additional information you requested. Past Chairman Guy Amsler, Jr. Jonathan Bates, M.D. We hope you will encourage the President to make the elimination of Wayne Cranford this inequity a priority in his FY 2000 budget request to Congress. To Robert G. Cress M. Edward Drilling do so would require including about $285 million in annual funding for Debra Fiser, M.D. Barnett Grace eligible institutions in the FY 2000 budget request, paid for out of Judge Marion Humphrey general revenues. Such funding should be on a time-limited, capped Dorsey W. Jackson Michael Joshua basis and continue only until comprehensive GME financing reform for Jim Keet Drake Keith all teaching hospitals is enacted. Betty A. Lowe, M.D. Diane Mackey Pat McClelland Health care competition is based more and more on costs of care. Most Mark Murphy Robert D. Nabholz payers of health care are increasingly unwilling to cover the added costs Netia Olvey of GME. That means teaching hospitals rely more and more on Skip Rutherford Mark Saviers Medicare GME support, which averages about $76,000 in Medicare Phil Schmidt funds per resident trained in a teaching hospital. But independent Betty Tucker Rett Tucker children's teaching hospitals receive, on average, less than $400 in Harry P. Ward, M.D. Charles B. Whiteside III Medicare GME support per resident, because they care for children Phyllis Zaffaroni exclusively, instead of the elderly. In today's competitive market place, this enormous difference in federal GME support creates a very unlevel playing field for children's teaching hospitals. Emeritus Stanley M. Bauman, Jr. Hillary Rodham Clinton Anne Hickman Louis Rosen Frank D. White A major teaching affiliate of the University of Arkansas for Medical Sciences