Medical Tuition Flow

When we examine the flow of medical tuition (where it starts, where it goes, and where it finishes), the costs do not always end up where one might think.  These costs should be a major factor to be addressed in nearly any healthcare reform.  However, it is an issue that is often ignored by representatives and voters when discussing the issue.  If we fail to understand the role that medical tuition plays in the overall system, thus neglecting to improve upon it, then it is unlikely that any agreed upon reform will be successful.  By analyzing how the costs flow through the system, we can gain an understanding of where they originate and how any changes may alter the system.

We can start with where the costs originate - that would be with the schools themselves (although sometimes even higher up as we will get into in a second).  Training doctors is not a cheap endeavor.  While it could be argued that the costs could be recuperated in the long run (at least for public schools), most schools are not going to do this at a loss - so the cost for this education is passed on to the students.  Beyond that, for public schools, the medical institutions are often seen as a potential profit center for state and local governments - this is especially true in down economies such as the one where we currently reside.  This drives medical tuition costs up even further.

So, at this point, the medical tuition is sitting primarily on the students themselves.  With costs ranging anywhere from $10s of thousands to well into six figures, very few medical students are capable of paying their tuition without the use of student loans.  There are both public and private loan options that offer varying rates depending on what each individual student thinks are the best terms for them long term.  The belief is obviously that the future salary of a doctor will more than offset the loan costs and interest incurred.  Nonetheless, the end result is that each student comes out of medical school with thousands upon thousands of dollars worth of debt - debt that will be increase from anywhere in the neighborhood of five to twenty percent over the life of the loan thanks to interest.

While the cost of tuition is now the responsibility of student to pay off, it does not really end there.  No, it falls on you (or anybody who ever goes to a doctor).  That is correct; the thousands of dollars of medical debt are priced into your doctor bills.  Even in the case of doctors who have already paid off their debt, they can charge higher rates to make up for lost income when they were younger thanks to the loans incurred.  It is one of those vicious cycles that is passed on to the consumer, who has little knowledge of how or what just happened.  One could also argue that the cost is actually passed on to insurance companies who pay the doctor bills, but that still falls back to the consumer in the form of higher premiums.  The buck stops there.

I will need to add the disclaimer that this is a bit of an oversimplification of how the system works.  There are a number of other factors (i.e. grants, scholarships, etc) that would need to factored in before drawing any hard conclusions.  However, this is not an inaccurate basis from which to start.