<p>The only time anyone should even think of subsidies is when the supply demand situation is out of whack. In the case of debt/cost for med school, this is clearly not the case in medicine given the selectivity rates even in 4th tier med schools. The income of docs is still largely within their control rather than governed by the insurers - by this I don’t mean they can charge what they want, but the nature and location of the practice provides a huge range of lifestyle/money choices. </p>
<p>If a physician wants to work 9-5 as an employee, the lifestyle is easier, but the compensation is low. If the same physician does one or more of these things - goes a bit rural and gets loan relief, runs his own practice, charges for facility and professional charges (eg. does ultrasounds, stress tests, or scopes in an office that he owns), employs extenders or other physicians, the med school debt issue would be irrelevant compared to these gains. </p>
<p>The physician of yesterday will certainly find changes that are detrimental, and many will threaten to wind up, and some will, but this shouldn’t be a deterrant for change. It’s a milder version of the CEO of AAPL having a 99% salary drop from the previous year - it’s not something that should send us scrambling to subsidize CEO salaries. The important thing for today’s budding physicians is the comparison should be with their peers in other fields rather than with their mom/dad physician, and I still don’t see the former as being unattractive.</p>
<p>I don’t want to get started on the issues of this industry as a whole, but in regard to this one issue, loans should be available, not subsidies. If you want to decrease the cost of education, look at making more direct 6/7 year programs directly out of HS like a lot of the rest of the world, so that the pre-med cost to study years of calculus, physics, art, and history is eliminated from those who are firm about their career (as it is in many overseas systems). If you increase the number of med school and residency positions, and extender positions, any short term drop caused by disgruntled older docs retiring early will be overcome.</p>
<p>We don’t need the taxpayers to pay for the tuition of med school any more than we need them to pay for the tuition of computer science school. Why do people look to place even more burdens on the taxpayer - as if there aren’t enough already?</p>
<p>Med schools seem to manage to fill their programs every year with paying students - there’s no need to have taxpayers subsidize them.</p>
<p>I am quite amazed that anyone would think it is wise to determine the worth of a doctor, if they are deserving of tuition subsidy, based on specialty. Sure we need more primary care physicians but isn’t it just as important to have skilled anesthesiologists put you to sleep, a skilled surgeon to remove a tumor and a pathologist who knows how to diagnose cancer on a microscopic slide.</p>
Has nothing to do with worth in the “importance” sense, it has to do with worth in the economic sense. A thoracic surgeon making $500+K/year has much less need for help than a PCP.</p>
<p>Isn’t one reason that fewer doctors are becoming PCPs is because they don’t make enough to handle the debt?</p>
<p>If there is already a shortage of PCPs, and Obamacare adds 30 million people to the insured rolls, who are these people going to get care from?</p>
<p>I somewhat take issue with the “won’t become one because of the cost” argument. my H was a pediatrician, serving in underserved areas in a public clinic. He chose that even though we funded his education through loans, and had two children by the time he finished med school. We never lived the doctor “lifestyle” but we got the loans paid off, and with a lot of extremely frugal choices, got two kids through college.</p>
<p>I would wish that people become doctors only because that’s what they truly want to do, not for the money. But reading on CC, it becomes clear that sometimes the money/lifestyle is the major factor, not an intrinsic passion to practice medicine. There are some posters I’ve read who are choosing it for what they’d get, not what they will give, and I think that may not lead to the best medical care, particularly in primary care.</p>
<p>There is a report that has just been released comparing health and healthcare of Americans compared to other first world countries. It is a pretty damning report.</p>
<p>I am not going to highlight it or post a link because it can lead to a political discussion. I am just giving a heads up for those that are busy but might be interested. I am sure the report can be googled.</p>
<p>dstark, I’d be very surprised if there’s anything new in there. (I will look it up though). Our health care system is, quite frankly, abysmal in most markers with the exception of a few conditions.</p>
<p>^^ I worked in several countries in Asia a couple of decades ago, and it wasn’t unusual for the person diagnosed with terminal cancer to be not told so. So it’s possible if you’re not in the USA, you “wont get cancer”, and you’ll be kept as comfortable as possible and die of “old age” …</p>
<p>I wouldn’t say abysmal (although it is not great overall), but it is extremely expensive for the results we get. This means that rationing decisions become more important – either self-rationing if you are self-paying for medical care, or rationing decisions imposed by private or government insurance companies if insurance is paying for medical care.</p>
<p>that indicates words to the effect that everyone has healthcare for basic needs, but if you want more freedom of choice, you need supplemental insurance that’s not automatic. This sounds pretty reasonable except our guys have a history of buying support by including everything supplemental into the basic without worrying about costs.</p>
<p>Update - check with the state assistant office - assets count in considering food stamp. However, unless I sit down with details - they can’t say for sure if the $$ in retirement account counts as assets.</p>
<p>DadII, you don’t need food stamps. Would you consider retiring to one of those spots? </p>
<p>Dadof3, the biggest difference between France and the US is people involved in healthcare in France make less money. Administrative costs are less. France also covers more people. Cost of education for doctors in France is nothing for med students? It is something close to zero. </p>
<p>France is rated number 1 and the US is rated in the 30’s.</p>
<p>It is hard to get to France’s healthcare system even though the private sector is heavily involved in France because people don’t want to make less money.</p>
<p>dstark, my DH works for a french company. Your post is really lame actually. Not trying to be rude but you have no idea what is going on in France. The country is imploding. They cannot sustain their entitlements, cannot even begin to. Are trying mightily to tax to oblivion the rich who are fleeing and corporations are also trying to leave. France is not Utopia.</p>