Paying for Pediatric Training and Care

[摘要] In choosing the topic for this discussion I have deliberately ignored many of the issues which face the members of the Ambulatory Pediatric Association each day: how to be more effective teachers, how to run more effective and efficient ambulatory care programs, how to conduct research relevant to the needs of children and those who care for them. Each of these topics is important. Each of them has been thoughtfully addressed by past-presidents and speakers at meetings of this association. Each forms a substantial part of the agenda of its meeting.I have chosen to address economic and, thereby, political issues which face ambulatory pediatrics because I am convinced that how pediatric care and training are paid for will determine its scope, its content, its distribution, and the way that its practitioners are prepared.In this discussion I hope to persuade you of the following:• That many of the teaching, patient care, and research issues that concern us are basically economic and thereby political issues;• That the current methods of paying for the training of house officers is a major barrier to matching their training to the needs of the children, families, and communities they will serve;• That current methods of paying for basic preventive services for children and their families are a major barrier to the achievement of better child health;• That there are reasonable alternatives to our present methods of paying for pediatric care and training, and that these are economically and politically feasible.

[学科分类] 儿科学