Financing teaching hospital missions: a context.

The issue of what teaching hospitals do, how much it costs, and how it should be financed has been the subject of ongoing debate. This Perspective provides a context for considering the implications of the latest contribution to that debate: the paper by Lane Koenig and colleagues that presents new estimates of teaching hospitals' mission-related costs. I address the system through which teaching hospital activities are financed, the difficulty in identifying and estimating the costs of teaching hospitals' missions, and the problems involved in determining how those missions should be underwritten.