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July 31, 1967

Effects of Medicare and Title XIX on House-Staff Training Programs

Author Affiliations

From Mercy Hospital, San Diego, Calif.

JAMA. 1967;201(5):310-313. doi:10.1001/jama.1967.03130050044012

The amended Social Security Act of 1965, or Public Law 89-97, includes Title XVIII, the Medicare bill; and Title XIX, the Medical Assistance Program. Title XVIII (Medicare) went into effect in all states on July 1, 1966. On the other hand, the effective date of Title XIX (the Medical Assistance Program) is an individual matter for each state legislature to decide sometime before 1975. To date, approximately 19 states, including California, have put Title XIX into effect. The Medical Assistance Program became effective in California on March 1, 1966, and thus California has had as much experience with both Titles XVIII and XIX as any other state. However early, it is not premature to report the effects of this legislation on intern-resident training programs, and to outline some of the problems which have resulted.

It is assumed that the basic purposes and rules of Title XVIII are understood, but this