—Our study documents that the majority of Medicare funding for nursing education supports hospitals affiliated with an increasingly smaller, idiosyncratic subset of nurse training programs located in a handful of states. In 1991, 145 hospitals associated with diploma nursing schools received $114 million from Medicare for nursing education— more than double the amount appropriated to all schools of nursing through the federal Title VIII program in that year.Preferential Medicare funding of diploma nursing education has not stemmed the decline of these programs, from 813 in 1965, when Medicare was created, to 135 in 1992.1 Health care market forces and student preferences have eroded the viability of diploma programs and will continue to do so in the future. Yet there is no evidence that the decline in the number of diploma schools has adversely affected the supply of nurses, as might be inferred from Ms Weber's letter.
Aiken LH, Gwyther ME. Medicare Funding of Nursing Education-Reply. JAMA. 1995;274(18):1425. doi:10.1001/jama.1995.03530180019015