Thank you for your video contribution, you bring up an excellent issue- funding nursing education. I was so surprised that this is still an unresolved issue considering the fact that nurses make up the largest segment of the healthcare workforce. Going through the history of nursing education funding dating back to 1965 when Medicare legislated Social Security Act- Title XVIII as a healthcare safety net for older Americans to 2020 is so complex and very difficult to follow. The government wanted to fund education of future medical and nursing professionals to provide care to the aging baby boomers contributing to the increasing elderly population. Title VIII programs safeguard the public providing a sustainable nursing workforce by providing opportunities for nurses to further education. Congress believed that the cost of patient care should encompass the educational activities of healthcare professionals increasing quality of care in an institution. In medical education, Graduate medical education (GME) money pays the salaries of interns and residents employed by the hospital to provide patient care and teach medical students. Originally GME money paid hospital employees in charge of teaching nursing students, student expenses, salaries of nursing faculty when nursing was a hospital-based diploma program. Federal policy specified that costs be covered by the hospital insurance program until the community is able to take on the educational cost burden utilizing a different approach. With the closure of hospital-based diploma programs, responsibility for the costs of college operated nursing and allied health programs are being borne by “the community” rather than the federal government. Thus, the cost for educating nurses has been shifted to academic rather than health care institutions as a matter of public policy. Three key concepts must be addressed: the cost of nursing education for both service and educational institutions, defining nursing education in federal rules and regulations, and the community’s role in supporting nursing education. Responsibility for producing an educated and skilled nursing workforce must be shared by the community of academic, health care, professional and government institutions, and organizations, a policy supported by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) (Thies & Harper, 2004).”


Thies, K. M., & Harper, D. (2004). Medicare funding for nursing education: proposal for a coherent policy agenda. Nursing Outlook, 52(6), 297-303.

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