The participation of the united states government in providing financial support for medical education

Abstract

This paper examines the different issues and topics related to the support of medical education with specific emphasis on federal support. The importance of such an analysis lies in the fact that the current legislation, the Health Professions Educational Assistance Act of 1976 (P.L. 94-484), expires on September 30, 1980. Preparations for new legislation are currently under way. Therefore, discussions, such as those presented in this paper, are appropriate and should be part of the current literature with the hope of generating ideas from potential readers.

Education, as developed in the US, has been strongly viewed throughout history as a public right (an inherent individual right) which produces public benefits. A discussion of this issue is presented along with an historical analysis of federal support for higher education, including medical education. The purpose is to establish the case that federal involvement (investment) has been and is at such a level that discontinued support could not be absorbed at the local or state level. Conditions and restrictions of federal support are also included in this section.

Another section of the paper discusses the financial structure (sources of support, costs) found in most medical schools with an emphasis on the need for federal support both in terms of the amount and type of aid desired. The major points stressed are related to preserving institutional autonomy, diversity, and integrity and maintaining equality of educational opportunity. Alternative sources and types of financial support are discussed. The paper concludes with a summary of major points leading to the authors' position of continuing, unrestricted federal support for medical education on an institutional basis.