Policy & Public Affairs
Thank You Letter to Congressman Stark
May 17, 2001
The Honorable Pete Stark
U.S. House of Representatives
239 Cannon House Office Building
Washington, D.C. 20515
Dear Congressman Stark:
On behalf of the American Society of Nephrology (ASN), I wish to thank you for introducing the Medicare Critical Need GME Protection Act. This legislation would be an important step toward improving the Medicare Graduate Medical Education (GME) program. It would also help to improve health care in the U.S. By giving the Secretary of Health and Human Services (HHS) flexibility to allocate funds that would help attract and train professionals in medical specialties and subspecialties which have a demonstrated shortage in the workforce, your legislation will improve patient care.
The ASN agrees with you about the importance of protecting our nation against a shortage of qualified health care professionals who are trained to use modern, effective means of treating costly and deadly diseases. Medicare's earlier goal -- of increasing the attractiveness of primary care physicians by reducing a hospital's reimbursement to half (50%) for training beyond the initial residency period - has been successful. The ASN has conducted a detailed study of the "manpower" that will be available to care for patients with kidney disease, and we have found that the number of qualified physicians will be insufficient for the projected growth of patients with kidney failure, but even more so for qualified nephrologists to prevent the loss of kidney function in the first place.
Unfortunately, this deficit cannot be overcome by primary care physicians, given the specific and complex medical problems associated with kidney disease, the interactions of different drugs, and the new strategies to prevent loss of kidney function. We agree about the importance of an adequate supply of primary care physicians, but also believe in maintaining sufficient flexibility in programs to ensure that no serious shortage of trained physicians in particular specialties and subspecialties occurs. As noted, our investigations indicate there will be a severe shortage in nephrology, for example.
ASN commends you for your continued leadership on this issue and we endorse the Medicare Critical Need GME Protection Act. This legislation will be a solid step toward ensuring that our nation is training the health care professionals that meet our needs.
Sincerely,
Robert J. Alpern, MD
President, ASN