Proposal for a clinical enrichment fund
The clinical enterprise associated with the University of Colorado, University Physicians, Inc. (UPI) provides a portion of its clinical income to the School of Medicine to support its research and educational mission. This revenue, called the academic enrichment fund, or AEF, totalled $16.7 million dollars in fiscal year 2006-7. Over the last 25 years, the AEF has been primarily spent on department chair recruitment packages (43%), departmental programs (29%) and school-wide programs (26%) -- including $1.5 million dollars to create the computational bioscience program. The clinicians working as clinical faculty have donated not only their time to training students, but also a substantial part of their income to supporting the school, more than $165 million over the last 25 years. UPI executive director Lilly Marks points out that, "If they were in private practice they could take that money home."
Although the individual clinicians practicing with UPI have been very generous with the research enterprise, there are pressing needs in the community for additional clinical support. There are many in our local community and beyond who are denied access to health care; more than 800,000 in Colorado alone. In recognition that research sometimes also leads to income streams, we propose a change to the royalty distribution policy of the University to give back something of value to the communities that support us. The current distribution generally splits royalty income into four equal pots: the inventor personally, the technology transfer office, the inventor's research account, and a campus research account. We propose to divide this royalty stream into five equal pots, funding a "clinical enrichment fund." The royalty distributions have exceeded $20 million in each of the last three years, suggesting that the clinical enrichment fund would receive about $4 million per year.
The purpose of the clinical enrichment fund is to create more equity in both access to health care and individual health across Colorado. It is anticipated that the fund would be used to defray the costs of providing care to the uninsured, create particularly valuable new community clinics (e.g. in underserved or rural areas), or invest in public health measures that would benefit Colorado communities. We propose that the funds be allocated by a board that consists of representatives of the University research community, the University clinical community, and the general public.
Such a scheme would help promote greater justice and fairness in our community while government agencies consider whether and how to reform health care. Although there is strong public consensus on the view that there should be more access to health care, theories of justice that policy makers frequently appeal to are diverse and lead to disparate policy solutions. Government agencies are not the only mechanisms by which we can promote greater equity in health care, however. Rather than relying on appeals to justice, organizations like the University of Colorado Denver can be motivated by beneficence and charity-based considerations and reach the same outcome of improved health for more people, targeting the underserved in the process.
Besides benefiting the health of individuals, the enrichment fund would also help build good will with the university’s neighbors. By purposefully raising resources to be invested in the local community, as well as sharing authority with community representatives for how to invest those resources, relationships will be built that can help build and sustain trust essential to the University’s ongoing efforts to make new discoveries and inventions that can improve human health and well-being for current and future generations.
