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Paul Barach, MD, MPH

JAMA. 1999;282:1592.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The nation's teaching hospitals are facing financial shortfalls brought on by the growth of managed care and government efforts to cut costs in its health care programs. As many as 100 teaching hospitals could be in the red by 2002.¹ Others face a bleak and uncertain future. Congress can help by restoring some of the cuts made to Medicare in the Balanced Budget Act of 1997. But the long-term financial health of teaching hospitals will depend on finding new ways to finance their special missions and requiring that they operate under reasonable cost controls.

All hospitals are facing the same pressures—cuts in government payments and managed care's demand for lower hospital fees and shorter hospital stays. Many have responded by reducing staff and merging with other institutions.

Some teaching hospitals have taken these steps, but their problems are compounded by the extra obligations that they have . . . [Full Text of this Article]

Department of Anesthesia
and Critical Care
Massachusetts General Hospital
Boston, Mass