Okay we’re going to fix health care. Well, a part of it anyway. The biggest expense of most any organization is personnel costs, and in health care, that includes your physicians. Some of the discussion in the professional world (physicians and veterinarians) is that the costs associated of professional school are so outrageous that it doesn’t make financial sense to become a doctor anymore. Why on earth would you go to school for 10 or 12 years, just to be horribly in debt and working 80 hours a week just to service that debt for the next 20 years? Lots of kids are looking at many other options besides becoming a doctor or veterinarian. It’s not because they don’t love medicine – they are just getting financially smarter and know they need to make a living. It makes more sense to take your student loan and buy a pizza shop. However, we still need doctors, and I’m wanting my doctor to be American trained. This is where I have to throw some numbers at you and hopefully with my Aggie math, I can show you how we can shave some of the expense off the medical costs in Texas, keep our best and brightest in the healing arts, AND show the way to increase rural health care — that’s the bonus. I’m also going to show how this works in the veterinary profession, which is a lot easier to calculate because we don’t play insurance games and don’t have to play Obamacare.
There are 70,000 licensed physicians in Texas. Texas graduates about 1200 physicians a year, and they each average about $200,000 or more in debt. That debt and the related monthly payment has to be included in the doctors’ salaries. If they didn’t have that debt, then of course their salary would not have to be as high to retire that debt. Following me? Less overall cost of employing a physician means overall less expense associated with medical care. Another bonus of taking that financial pressure off the doctors will be reducing their patient load. With today’s pricing structure from insurance companies, the only way doctors make more money is to cram as many patients into their day as possilbe. With a decreased patient load, a doctor would have more time for each individual patient.
Rural health care has many restrictions, almost all financial. If you’re in a small town, there may not be enough patient load (money) to pay the physician. That pesky debt load again limits who can practice in small town Texas. We continue to expand the role of nurse practitioners, physicians assistants, and even pharmacists to increase the numbers of primary care givers. There is a need for primary care physicians, but the Physicians and veterinarians are not going to “disadvantaged” or rural areas basically because the money is not there. Now the state has a fix – they’ll recognize disadvantaged areas and usually throw in debt forgiveness dollars to entice physicians and veterinarians alike to set up in rural areas. Not every area qualifies, and in those areas that do qualify, now you have a “subsidized” professional competing with someone who isn’t subsidized. Crazy outcome of good intentioned politicians trying to get more rural health care. It wouldn’t matter if your small town was Hico, Hamilton, or Comanache, you’ll look around one day and wonder why you’re getting the short end of the medical stick.
Of course medical education is expensive, and Texas (or the feds) just can’t afford to fund medical education outright. This is where “pay it forward” comes into play. If every licensed physician would pay an additional $2000 a year into a scholarship fund for Texas physician students, it would build that fund at a rate of $140 MILLION dollars a year. In short order, this fund could pay for the entire professional education of all the Texas doctors. Once selected to medical school, all fees related to education are covered. The new doctors would have zero debt associated with medical school. If every physician sees ONLY 20 patients a day, a mere 50cents per patient visit would generate that fund.
With a minimal amount of student debt, new physicians would have the ability to service rural areas, the “home towns” and small towns we all love. No longer would that physician have to practice in larger cities or groups just to generate enough income to pay a $2000 a month student loan payment.
On to the veterinary profession. Our new veterinarians are graduating with $150,000 in debt. Really. So when you graduate, going to your small town to practice is no longer an option. If veterinarians did the same “pay it forward”, we could be graduating Texas veterinarians with zero debt associated with professional school. If the veterinarian no longer has to generate the extra thousands of dollars per month just to service the student loan debt, the cost of veterinary medicine will be reduced. Just for inside baseball talk, it takes about $5000 of income in a clinic to generate $1000 in the veterinarian’s net salary. How would it help? It will allow veterinarians to comfortably practice in rural America again, without the huge stress of making enough money to satisfy outrageous debt.
You may have to dwell on this one a bit. The golden ticket to medical or veterinary school is won by hard work and good grades. The students will still be the best and brightest, and now are there for the love of the profession. There are a lot easier ways to make decent money, but I think about those who love medicine, but chose a different path because earning a living is still a part of life. I can offer this perspective because of the conversations we are having in our professional worlds. It doesn’t make financial sense anymore to be a veterinarian. The cost of school is almost prohibitive to maintaining replacement doctors in our profession. It doesn’t make financial sense to be a physician either, especially since the government keeps jacking with payments. Why is it do we have so many foreign doctors here? Relatively speaking, they got a cheaper education and the money they make in the United States is pretty decent. Why don’t we have as many American doctors? They can’t afford the education!
Pay it forward. This program is self sustaining, requires no government funding, and preserves a couple of professions in America. We generate the best medical professionals in the world. Let’s not lose it. Press one for English.