The continuing public policy debate over how graduate medical education (GME) should be financed shows a lack of consensus on the principles for restructuring GME funding and the appropriate role for Medicare as a vehicle for federal support. Policymakers need information on the strengths and weaknesses of the spectrum of approaches to help them weigh the advantages and disadvantages of alternatives as they consider reforming the current system. Our report provides a conceptual framework for assessing the strengths and weaknesses of the current financing system, potential refinements to Medicare's current GME funding, and possible alternative policies for financing direct GME costs. It also applies the framework to the current system and a set of alternative approaches. The report should primarily be of interest to policymakers and other parties involved in graduate medical education financing issues.
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