$220,000 in student loan debt

[haulingthescoreup]

Thanks! We're all delighted. Big Al's School of Medicine was always high on her list, due to its reputation in the area of social medicine.

I remember standing on the sidelines next to a soccer dad several years ago. He's the head of vascular surgery, transplant surgery, and the surgical residency program at our local teaching hospital. He proudly but sadly announced that he had just paid off his last Harvard Medical School student loan. As I recall, he was 57, 4 kids, three grown (oldest age 28) and last one a high school junior.

I told DD that the way to regard the loans is as if she has an invisible house, with a very visible mortgage. The hope is that she will get on with CDC or another public health agency, and after 10 years of paying her loans, someone will be ready to talk deal.

[Anonymous]

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@holuh3 wrote:

It's hilarious that it's called an award. Congratulations, by the time you're finished with your grueling training, it will have cost you over $250,000, and yet people will sneer at you and insist that you must be rich. My loans will be paid after I am eligible for Social Security-I'm thinking of trying to get a discount by having Socialy security send the direct deposit over to Sallie Mae.

I'm really not this bitter. I love my job and my patients, but I don't think people realize what a sacrifice it takes, and then physicians are so dogged in society. It's kind of disheartening. But don't tell your daughter that. I'm hoping for change.

But tell her I said strong work on Albert Einstein; she'll get an awesome medical and cultural education. WTG.

Message Edited by holuh3 on 06-12-2008 05:37 PM

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Personally, I think it's because you SHOULD have the market by the short and curlies. Think about it ... could we live without banks? Computers? Lawyers? Stockbrokers? Yep. Absolutely. Might not be fun, practical, or wise, but we could do it.

Now, I ask you: Could we live without doctors? Not for very long. And I'd like to see someone try!!

So, I think it's common for people to assume that if they can't live without YOU, you must have the cat by it's tail!!

But I really think that most people see what the HMOs are making off doctors' services and mistakenly assume that the docs are getting more than just a taste of that. :/

[Anonymous]

WOW!! Congrats, Hauling!!!

But really ... did we really expect any less from YOUR child?
Takes a great person to have a great kid ... which doesn't explain how I got so lucky with mine!

[holuh3]

I'm sure that's true; we live with a wasteful and expensive medical system, but believe me, the money is going to the CEOs of Anthem and Humana and to Pharma. If patients understood the economics of the health care system, they'd be camped out on the steps of the Capitol Building right now, demanding change; it's criminal. If there ever is Universal Health Care (and I support it), it will come as a huge financial shock.

[Anonymous]

I hope you're not talking about "socialized medicine!"

Hubby was overseas when he blew out his ACL/MCL and went to the local hospital where they couldn't even give him aspirin or painkillers!! They DID give him a set of crutches (the kind with the cuffs) that were durn nigh worthless. When he asked for the (cheaper) set of armpit crutches, he was told that they're "not allowed to dispense them due to litigation issues." We thought WE (the US) were litigious!!

Due to "litigation issues" they're not even allowed to advise (and this is at a HOSPITAL) placing ice on a swelling limb. Nor are they allowed to give anything stronger than aspirin.

According to DH, who used to be a strong proponent of "socialized medicine," it SUCKS.

[holuh3]

Well, I mean single-payer health care, which is the only way we're going to keep health care costs from sinking (further) the economy, IMO.  If you blow out your ACL in this country without insurance, guess what happens?  You go to the ER, they treat your pain, put you in a brace, send you home, bill you for $8,000, send the bill to a collection agency...

[haulingthescoreup]

It can be done right, if people think it through in advance.

I grew up as an Army brat. My dad was a trauma/thoracic surgeon. It never occurred to me that there might be an issue in getting treated for a problem --we just showed up, and eventually it was taken care of. (This was during Vietnam, and always, always, the soldiers were seen first, as was entirely proper.) I had a hard time adjusting to civilian medical care and insurance, and I still remember debating waiting out a child's sore throat and high fever, hoping that it wouldn't be strep, because we couldn't afford the $20 co-pay.

Now that I work in the healthcare field, for the world's largest integrated health care system (VA), I support a two-tier program. I believe there should be a bare-bones program for all, emphasis on preventive care, no exotic bennies like transplants, unfortunately, and then a second level of paid health insurance for those who go get jobs and can pay the dividends. This might seem cold and cruel, but I know from professional experience that one high-intensitive medical case can wipe out basic care for dozens of people. At some point, you have to triage the health-care dollars.

At least this gets basic coverage for everyone.

[MidnightVoice]

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holuh3 wrote:

Well, I mean single-payer health care, which is the only way we're going to keep health care costs from sinking (further) the economy, IMO.  If you blow out your ACL in this country without insurance, guess what happens?  You go to the ER, they treat your pain, put you in a brace, send you home, bill you for $8,000, send the bill to a collection agency...

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Some of us have lived with "socialized medicine" and have friends and relatives who are alive because of it.

A group of US politicians were visiting France to look at their medical system (currently ranked about #2 in the world, the US is #36).  When the doctor described the system an American said "But that is SOCIALIZED medicine!!".  The doctor looked down her nose at him and said "We prefer to call it CIVILIZED medcine".

[holuh3]

We're already spending the money.  We spend more money per capita on heath care than any country in the developed world, and yet I can't get a wheelchair for a kid who can't walk.  The problem is that the model is that of a business, and so there is always a profit motive.  If there were single payer, there would definitely have to be 'rationing' of care, but at least it could be done on an evidence-basis, instead of on the basis of class/age/disability, which is how it is done now. The VA is now experiencing the issues that the "private" sector has been dealing with.  When the Iraqui Vets are living in cardboard boxes, maybe we'll start doing something. It's shameful.

[haulingthescoreup]

It's always a question of $$$. When it comes to the VA, Congress threw open the eligibility doors (which I support!) about 15 years ago, but they conveniently forgot to vote the funding for it. So we're in a continual scramble for funds to support services.

With the current wave of veterans, we have two very different problems: TBI (traumatic brain injury) and other major multiple physical disability issues, which need massive funding, and PTSD, which needs psychiatrists, psychologists, and clinical social workers, all of whom are in terribly short supply. As one example of truly dreadful irony, in my area, most of the psychiatrists are Middle Eastern of Arab descent, and their patients are PTSD from the Iraq/ Afghanistan theatres. If you are tormented by memories of seeing your buddies and civilians torn to shreds from an IED, is this going to work for you? (And the providers do try; there are just some things that simply don't work.)

Getting back to basic medical care in this country, one huge problem is that primary care providers (family practitioners, internists, pediatricians, and gynecologists) are reimbursed at a shamefully low rate compared to that which specialists earn, yet they do a lot of the heavy lifting. Many managed care plans require members to go through a PCP first, but these providers can barely break even in their daily expenses. A whole lot of resource reallocation needs to be going on in this area!