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Funding Boost for National Health Service CorpsExpanded program will put more physicians into underserved areasBy Martha Frase-Blunt
President Bush's 2003 budget proposal includes $192 million for the National Health Service Corps (NHSC) - a $44 million increase that will fund medical school scholarships and loan repayment programs for doctors and other health care professionals who intend to practice in medically underserved communities. The program's goal is to supply more generalist providers to areas of need in rural regions and inner cities. A key consequence of the program is that it has attracted greater numbers of underrepresented minorities into primary care fields. According to Jonathan Fishburn of the AAMC's Office of Government Relations, the NHSC program satisfies about 12 percent of the physician need in approximately 3,000 federally designated health care services shortage areas: "So the more money the government can put in, the more needs we can meet." Over the years, the NHSC scholarship program has proved so popular with medical students - who agree to a minimum two-year service commitment after graduation - that less than 20 percent of applicants could be accepted in a typical year. With the funding boost, "acceptances should rise," Fishburn predicts. In fact, the Health Resources and Services Administration, which administers the NHSC for HHS, says if the president's proposal is enacted, the number of scholarships for FY 2003 will rise to 1,804, up from 1,341 in 2002 - a 35 percent boost in the number of primary care physicians going into underserved areas. Approximately two-thirds of NHSC providers choose to continue practicing at their assigned site for at least three months after completing their commitment. The NHSC's other component, the loan repayment program, reimburses the education loans of trained health professionals if they choose to serve at an eligible shortage site. Thanks to the increase, the program anticipates funding some 450 new loan repayment awards in FY 2002, 75 more than FY 2001. Graduates receive up to $25,000 for each of their first two years of service, and up to $35,000 for each subsequent year they apply until the debt is satisfied. In addition to loan repayment, these clinicians receive a competitive salary, some tax relief benefits, and a chance to have a significant impact on a community. "In the past, there hasn't been enough money to repay loans for everyone who wanted to do this," Fishburn noted, adding that "the entire $44 million budget increase will go to repayment and scholarships." "The sizable increase for the NHSC called for in the president's budget is welcome news," says Jordan J. Cohen, M.D., president, AAMC. "This program is ideally positioned to alleviate the shortage of physicians in many medically underserved areas but has had sufficient funding to accommodate only a fraction of those young physicians who are prepared to practice in these areas. The proposed $44 million in additional funding represents a strong step in the right direction." The AAMC for years has advocated for an NHSC budget increase, but funding for the program has remained level for the past several years. "We've always supported increased appropriations in every budget cycle," Fishburn reports. This year the program was recognized and rewarded as part of President Bush's initiative to strengthen the health safety net. "$192 million is a great leap forward," Fishburn notes, but promises that the AAMC will continue to press for further support and funding increases that will offset rising tuitions and growing community needs.
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