He says that many Washington lawmakers believethat hospitals have been over supported byMedicare. He says this is a conviction he wouldlike to change.
"We are looking for ways to see what can bedone," Rudenstine says. Martin is heading a smalltask force to look into the issue.
"We're talking to individuals, key people inthe House and Senate," Rudenstine says. "It'sCongressional budget problem."
Rudenstine says the bulk of the University'seffort will consist of making legislators aware ofthe situation. For now, the University isconcentrating on finding short-term remedies tothe situation.
Rudenstine says Harvard would like Congress toestablish a trust fund-a stream of money separatedfrom the Medicare funds and earmarked to bail outteaching hospitals.
Rep. Benjamin L. Cardin (D-Md.) has proposedone solution.
Earlier this month, he introduced a bill thatwould tax private health insurance premiums tocreate a trust find for graduate medicaleducation.
The bill would place a one-percent tax onprivate health-insurance premiums, giving teachinghospitals two-thirds of the revenue from the tax.
"It's the only workable solution that's outthere," Cardin says. We have reached a crisis."
Though he says relaxing Medicare cuts wouldprovide a possible short-term solution, in thelong run, Medicare cannot be called upon to fixthe problem.
"You're asking seniors and disabled to pay morethan their fair share," he say. "I don't thinkthat's right."
But Martin, who endorses such a plan, says itis unlikely to pass. Cardin concedes it willrequire "political courage," but is moreoptimistic, citing what be considers the loudvoice of benefactors of academic medical centers.
"I have heard directly from Harvard and theyare clearly one of the premier facilities and atarget of what we are trying to do," Carding say."Ultimately, it's going to happen. It may nothappen in 1999, but it will pass."
If Cardin's predication is correct, timing willbe crucial, because, as Rudenstine says, thehospitals cannot wait for more fundingindefinitely.
But, in whatever form, Harvard and hospitaladministrators say help must come soon.
"It's possible that the Congress could say forsome things we're going to allow ourselves tospend a bit more," Rudenstine says.