There has been much debate on the state’s budget in recent weeks. Many advocate, appropriately so, for the need to continue to fund social programs and to protect our most vulnerable citizens.
The question is how to pay for these important services and programs. The proposed solution is to ask those who can to give more. This translates into more corporate taxes, as well as taxes on the state’s hospitals and reducing their reimbursements for Medicaid patients — the most vulnerable patients.
Much has been said about the impact of corporate tax increases on corporations that are major employers in Connecticut, and their potential relocation to more tax-friendly states. Debate on the impact on hospitals has focused on CEO compensation and past profit margins. This focus misses an important fact; the role hospitals play in training the next generation of physicians for the state.
Connecticut is blessed to have hospitals and physicians that provide the highest quality state-of art of care. Connecticut also has three medical schools — Yale, UConn, and the Frank H. Netter MD School of Medicine at Quinnipiac University — that depend on these hospitals and physicians to train their students. These are the best places and the most qualified individuals to train the future physician workforce for everyone in Connecticut. However, the current budget debate could seriously harm the ability of the state to continue its rich tradition of training physicians, a serious unintended consequence.
Teaching medical students and resident physicians takes time, and time is money. Taxing hospitals and reducing reimbursement for services rendered means physicians need to do more, which means the need to see more patients, all of which takes time — time that would otherwise be spent teaching.
Something must give, and my greatest fear is that the education of our future caregivers will suffer, as was articulated in detail in the book by Kenneth Ludmerer, “Time to Heal.” In this book, he clearly articulates how the need to “make a margin” is negatively impacting medical education, by reducing the time needed to teach.
The decisions facing Connecticut’s budget debate are not easy. However, I hope the final outcome does not have unintended consequences for of future health care workforce.
Dr. Bruce Koeppen is dean of the Frank H. Netter MD School of Medicine at Quinnipiac University.