Washington, D.C., March 1, 2001--The Association of American Medical Colleges (AAMC) applauds President Bush for his FY 2002 budget proposal to provide a record $2.8 billion increase for the National Institutes of Health (NIH). This increase will provide essential momentum to the medical research community's efforts to double the NIH budget by 2003. While highly supportive of the recommended budget increase for NIH, the AAMC has major concerns regarding the limited support designated for critical public health programs and the impact of the associated funding decreases.

Fundamentally, the AAMC is troubled that the Administration's budget assumes only a $2.1 billion overall increase in discretionary health spending. Yet, the $2.8 billion increase in NIH, plus the increases proposed for community health centers and the Substance Abuse and Mental Health Services Administration (SAMSHA), suggests the Administration will ask for significant decreases in many other important health programs. Because the budget blueprint released by the Administration contains few specifics on individual programs beyond priority areas, further details on the full complement of federally supported health programs, such as the Agency for Healthcare Research and Quality (AHRQ), are not expected to be released until April.

"While the AAMC is gratified by the overall support the Bush administration has proposed for NIH, we are very concerned that the needs of those HHS health profession programs designed to increase the geographic distribution of health care providers and to help prepare the work force for the 21st century, may be at risk," said AAMC President Jordan J. Cohen, M.D. "The health professions education programs are vital to the nation's health and well-being, as they seek to: increase the number of primary care providers; address geographic maldistribution; provide care in medically underserved areas; and maintain diversity in the health care work force. Without designated federal support we fear that these health professions programs will be substantially weakened."

The AAMC appreciates the Administration's recognition of the need for continued funding for nurses and diversity but is discouraged that other health professions education programs appear to be eliminated. The budget states, "Today a physician shortage no longer exists. Morever, the Federal role is questionable in this area given that these professions are well-paid and that market forces are much more influential in determining supply." The AAMC believes there is substantial evidence that shortages in rural and underserved areas are not and cannot be addressed by market forces.

Medicare and the Uninsured

The AAMC is encouraged by President Bush's $11 billion increase in FY 2002 Medicare spending and is pleased the Administration has not proposed any reductions to provider payments. The AAMC assumes the increased Medicare spending will pay for Medicare modernization and the expansion of an outpatient prescription drug benefit. While the AAMC supports modernizing the Medicare program, the Association will be analyzing carefully how the administration's reform plan affects special payments to teaching hospitals.

The Association is also appreciative of Bush's support for addressing the issue of the uninsured. While specifics were not included in the budget, the administration intends to "encourage the purchase of private health insurance through health care tax credits and other proposals." While the AAMC looks forward to further details on the broad proposal, the Association is disappointed that the budget also eliminates funding for the Community Access Program, which seeks to strengthen the effectiveness, efficiency, and coordination of services for the uninsured and underinsured.

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The Association of American Medical Colleges represents the 125 accredited U.S. medical schools; the 16 accredited Canadian medical schools; some 400 major teaching hospitals, including 74 Veterans Administration medical centers; 91 academic and professional societies representing nearly 88,000 faculty members; and the nation's 67,000 medical students and 102,000 residents. Additional information about the AAMC and U.S. medical schools and teaching hospitals is available at the AAMC Newsroom.

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