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April 1998

Half a Loaf: Is Compromise the Best Policy?

Arch Gen Psychiatry. 1998;55(4):303-304. doi:10.1001/archpsyc.55.4.303

THE BALANCED budget act of 1995 would have created federal funding sources for graduate medical education (GME), including support from general revenues. It was vetoed by President Bill Clinton, however, and instead of becoming law it engendered an Institute of Medicine (IOM) report, delivered in time to inform the Balanced Budged Act of 1997, which did become law. However, the 1997 law was informed by more than the IOM report; it was also shaped by changes in the political climate. Herdman and Stevens trace this story and evaluate the results, emphasizing the many ways in which the new law responds to the "guiding principles" formulated by the IOM. Although only a first step, this is a step in the right direction.