Memorandum of Disapproval of a Bill To Extend Certain Nurse Training Programs

MEMORANDUM OF DISAPPROVAL

I am withholding my approval from S. 2416, a bill that would extend a series of programs authorizing special Federal support for the training of nurses.

Although I support a number of its provisions, this bill would continue several Federal nurse training programs whose objectives have been accomplished an(1 for which there is no longer a need. Moreover, the funding authorizations are excessive and unacceptable if we are to reduce the budget deficit to help fight inflation.

For the past 22 years, the Federal government has provided substantial financial support for nursing education. From 1956 through 1977, almost $1.4 billion was awarded for student traineeships, loans, and scholarships; for construction and basic support for nursing education programs; and for projects to improve nursing education and recruitment.

With the help of this support, the number of active nurses has more than doubled since 1957 to over 1,000,000 in 1978.

Ten years ago, in 1968, there were 300 active nurses per 100,000 population in the United States. By the beginning of 1977, this ratio had risen to 395 per 100,000 population.

The outlook is also good for adequate, sustained growth in the supply of nurses. There is, therefore, no reason for the government to provide special support to increase the total supply of professional nurses.

This year the Administration proposed to extend only the authorities for special projects in nursing education and for nurse practitioner training programs, in order to focus Federal nurse training support on areas of greatest national need. This proposal was based on the concept that future Federal assistance should be limited to geographic and specialty areas that need nurses most.

S. 2416 would authorize more than $400 million for fiscal years 1979 and 1980, mostly for continued Federal funding of a number of unnecessary special nurse training programs, at a potential cost to the taxpayer far above my budget. At a time of urgent need for budget restraint, we cannot tolerate spending for any but truly essential purposes.

I must point out that nursing training is primarily undergraduate education, and nursing students are eligible for the assistance made available by the government to all students, based on need. I recently signed into law the Middle Income Student Assistance Act, which will significantly expand our basic grant and student loan guarantee programs. Nursing students are also eligible for National Health Service Corps scholarships.

Disapproval of this bill will not cause an abrupt termination of funding of the nurse training programs, since funds are available for fiscal year 1979 under the continuing' resolution.

If the Nation is to meet its health care needs at reasonable cost, Federal nursing and other health professions programs must make the greatest contribution to adequate health care at the most reasonable cost. This bill does not meet that test.

The Administration is now conducting a major review of its support for all health professions training, including nursing. Legislative proposals in this area will be made to the 96th Congress. These proposals will recognize the key role of nurses in our society and the need for nurses to play an even greater role in the efficient delivery of health care services.

JIMMY CARTER

The White House,

November 10, 1978.