Focus: Washington

Focus: Washington – Political allies and enemies take on junior doctor surplus

BMJ 1997; 314 doi: (Published 15 March 1997) Cite this as: BMJ 1997;314:769
  1. John Roberts

    Change often comes in odd forms, and none is odder than the way the US government is dealing with paying junior doctors. In 1965, fearing a predicted shortage of doctors, it widened the scope of the Medicare programme, the government health insurance scheme for the elderly, and made it assume the bill for educating America's junior doctors.

    This was a great success. Training programmes grew rapidly as the government paid hospitals for each junior doctor on their staff: The more juniors they had, the more money came to the hospital. And since the subsidies were more than three times the junior doctor's salary, there was plenty of incentive to train more, and train them longer.

    The …

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