This step is necessary to correct current underpayments for office-based services. Liability reform is also part of this agenda. But in a managed care world, additional reforms are necessary that take into account the increased complexity of medical decision-making, where factors beyond the control of doctor and patient may affect the likelihood of injury. The College is seeking additional authority for physicians to form and direct integrated health care plans. Restructuring the workforce There is only limited consensus within the medical profession on appropriate solutions to issues of GME financing and workforce supply.
Most people agree that the United States faces an oversupply of physicians.
Legislative solutions may create a cap on funding of current residency slots and gradually reduce reimbursement for indirect medical education expenses. However, the political clout of academic institutions is likely to prevent any dramatic reductions. ACP and other physician organizations have supported all-payer funding for GME, but capturing a percentage of private insurance premiums to pay for education is seen as a tax and not likely to win passage. More likely is new authority for Medicare to pay for training in non-hospital settings. Despite his powerful support, such a proposal remains controversial.