Dear Members of the Medical School Community,

In a recent paper titled "Positioning Academic Health Centers for the Future," health-care economist Uwe Reinhardt notes that in an era of managed care where "commerce is king," academic medical centers have been silent about the public goods they produce and have remained silent at key moments of policy-making.

Major U.S. teaching hospitals, which account for 6 percent of all hospitals, provided $94 billion in care in 1996. About 60 percent of our admissions are medically underserved patients. Teaching hospitals provide more than half of burn and trauma care and organ transplant surgery, and one-third of the inpatient care for patients with rare conditions. In addition, teaching hospitals and medical schools offer a vast array of urban and rural outreach services.

Congress is currently considering including graduate medical education (GME) funding in the annual appropriations process. If this occurs, funding for GME will become subject to year-to-year fluctuation. The UW's Academic Medical Center is one of the best in the nation and one of the most careful in the financing and allotment of residency positions. Now is the right time for us to stop, take stock, and clearly remind Congress that academic medical centers are a unique and essential public good.

The National Bipartisan Commission on the Future of Medicare is expected to submit recommendations to Congress early next month. In the coming weeks, as discussions take place and decisions are made on these recommendations, it is important for us to remind our leaders in Congress, including representatives and senators from each of the WWAMI states, that our "products" -- improved knowledge, the best physician training in the world, rigorous biomedical research, and first-class health care -- are perennially necessary public goods.

Sincerely,