Another area that came out well in the Medicare budget debates was freestanding children’s hospitals with residency training programs. These 60 or so hospitals have a graduate medical education component but are not affiliated with a medical school. Congressional budget mavens favored these institutions with an increase of $235 million, which boosted the total well beyond what the Clinton administration had proposed spending this fiscal year. This is the second year in a row that Congress gave the administrators and staff of these children’s hospitals something to smile about. As part of last year’s budget allocation, the Clinton administration successfully urged Congress to approve $40 million to support the teaching and research missions of these facilities. As a result of severe cutbacks in funds controlled by managed care organizations, these programs had been devastated by rapidly shrinking budgets (Psychiatric News, March 17, 2000).