Aid to Medical Education

While Congress has made repeated attempts to beat its omnibus health bill into acceptable form, the financial crisis in medical education has grown seute. Almost all the seventy-nine medical schools in the nation have been running in the red for the past decade and now need federal aid to supplement inadequate private contributions if they are to survive. Since inflation and high taxes have increased operating expenses and cut into private donations, the schools have had to keep salaries low and skimp on research and expansion. Tuition fees, which covered about seventy percent of the costs of medical training in 1910, meet only twenty-five percent today. Since tuition must remain low to attract students, the medical schools have to find aid elsewhere.

In response to this need for money, the American Medical Association appealed to the profession for contributions. If each doctor gave one hundred dollars a year, the A.M.A. reasoned, the total sum raised would alleviate the financial problem somewhat. But this plan was hardly sufficient. Therefore, several prominent men established the National Fund for Medical Education with the intention of canvassing corporations for gifts. This organization has already received a million dollars, one-fifth of its yearly goal. To make allocations of all the funds easier, the A.M.A. has channeled its resources to the N.F.M.E. The A.M.A. has held onto its own money-raising plan, however. Although the profession has demonstrated its desire to find private capital and avoid federal aid, the estimated annual sum still necessary to keep the medical schools in operation is forty million. This figure is far beyond the reaches of any private effort.

If the solution lies in a federal aid, the grant must not involve any government control of educational policy. Obviously, the proposal would necessitate the supervision of a board to cheek on expenditure of the money by the medical schools. The bill must also be temporary so that private means like the National Fund can bear most of the load when they are able. At present, such a bill exists. S. 337, which is the tortured infant of the old H. 5940, provides for direct aid with no government influence. To cover instruction expenditures the bill will allocate money to medical schools according to the number of enrolled students. By this outright grant, S. 377 prevents a government agency from interfering with teaching and from bowing to political considerations in general. Another provision sets up an allowance for construction and expansion. The Surgeon General of the U.S. Public Heath Service would determine the allocations, subject to ratification by a Public Health Council. Since private donations have covered almost all research projects, planned in the past, there would be little need for federal aid in this respect.

The government has few functions in the proposed bill. Not less than every two years, the Public Health Council, must make a report to Congress on the financial status of medical schools receiving aid. Every three years an investigation must be made to make certain that the grant has been used correctly. This plan for and would end in 1956.

Since the A.M.A. and other organized medical groups have continuously trembled at the prospect of federal aid in any form, this bill has, and will have, determined opposition. Arguing that once the government extends its purse, socialized medicine will inevitably follow, the A.M.A. continues to fight the Senate bill and offers no suitable alternative. But the life of S. 377 is only five years and it would involve a minimum of control. Amendments to the bill insure that it will not endanger the freedoms in medical education. The alternative of letting the medical schools go bankrupt would entail a much more severe form of federal control, especially in a time of war.