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THE LONG ARM of the federal government is about to touch efforts dealing with the future funding of medical research, education, and the more complex health care services provided by academic health centers. The move carries the hope that some relief may emerge for the mounting funding problems these centers face.
Academic health centers—with the triple task of patient care, teaching, and research—have higher costs than facilities that provide health care only. With the increased emphasis on competitive pricing for medical care, institutions that have also traditionally undertaken teaching and research are at a disadvantage in the health care market. Along with diminishing subsidies for research, these institutions lose the funds that come from insured patients, lose the patients needed for clinical teaching, and are burdened with an increase in uncompensated care because managed care systems cover only segments of the population.
As managed care has multiplied, the issue has
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