Rounds Online

It would appear that the serious issue of medical education debt is finally beginning to get some attention.  A couple of new initiatives are attempting to direct some young physicians into primary care in under served areas.  It is a very small start but it is a start.  The Washington Post picked up on one of the new programs.  Here is their article.

A Boost for Those Burdened by Student Loan Debt

The Washington Post

By Joe Davidson

BALTIMORE Americans invest heavily in the future of the nation by providing loans to help put students through college. Yet the burden of that debt for many former students is so great that it interferes with investments they would like to make in a home, a family or even a good time now and then.  This is especially true for the public-spirited who are burdened by heavy debt. No one expects to get rich doing good, but getting paid enough to pay back Uncle Sam would be nice.

Now there are a couple of new programs that could make those debts much lighter. One of them is specifically designed to encourage young people to serve the public by working for federal, state or local governments, nonprofits or other public service employers.

Under the Public Service Loan Forgiveness Program, the Obama administration announced yesterday, people with student loans can have their debts erased after 10 years of public service. Let’s say Dr. Feelgood graduates from medical school with a mountain of student loan debt. Her heart, and a little angel on one shoulder, tell her to work in a clinic serving a low-income community on tribal lands, but that little devil on her other shoulder says to become a plastic surgeon in Beverly Hills. And the little devil is holding her empty pocketbook as evidence to back his case.

If the doctor follows her heart and makes 120 payments — one a month for 10 years — on her student loan, Uncle Sam will tell her to forget the rest of the money she owes.   That’s great, but for those 10 years she still will have huge monthly payments that could prevent her from buying a house or discourage her from starting a family.  That’s where the Income-Based Repayment plan comes in.   Starting yesterday, Dr. Feelgood’s monthly federal loan payments would be capped at an amount determined by her income and family size. (continue reading…)

A recent gallup poll showed that 73% of  Americans would trust physicians to recomend the right thing for reforming the U.S. Healthcare System.  On the other hand, 66% wouldn’t trust the Republicans and 58% wouldn’t trust the Democrats.  Even the president only registered 58%  on the Trust O Meter.

On Healthcare, Americans Trust Physicians Over Politicians

by Lydia Saad               

PRINCETON, NJ — Nearly three-quarters of Americans (73%) say they are confident in doctors to recommend the right thing for reforming the U.S. healthcare system. That is significantly higher than the public confidence extended to President Barack Obama, as well as to six other entities that will be weighing in during the emerging healthcare reform debate. Full Story Here

Those of you who follow my blog know that I am no big fan of current healthcare reform legislation. I am unconvinced that the government can effectively manage anything as complex as the delivery and funding of healthcare (for that matter I am unconvinced that the government can manage anything effectively). But I am very concerned with the recent disruptions at town hall meetings where politicians have appeared to answer questions about their position on healthcare reform.

Now, I have not been at a town hall meeting that has been disrupted. I have been at meetings in our suburban Chicago community and I have made it a point to make myself heard. But I was not shouted down and the meeting was quite tranquil (and poorly attended). I can only judge other meetings by what is being reported in the press (always a risky policy). But all Americans should be concerned when unruly mobs gather and shout down public discourse. If you are upset and concerned with a politician’s position you have many options in a democracy:
• Write a letter registering your position. A representative wants to know where his or her constituents stand. Emails work equally well.
• If you have the means and feel strongly enough, visit your congressman…either in Washington or in his local office when he visits.
• Attend a town hall meeting and voice your opinion or ask your questions…in a civil and orderly manner. Respect the right of others to do likewise.
• If you feel that it will gain support for your position you can demonstrate with signs and slogans outside the meeting, or outside the congressman’s office or outside the White House if you think it will do any good. But demonstrate in a civil manner. Don’t trod on the rights of others who don’t share your views.

There is no justification for organized mob action designed to squash public discourse. And there is no excuse for individual behavior that attempts the same. Now I know all about the 1st Amendment. But a democracy cannot endure if mob rule is the order of the day. Issues should not be determined by the loudest or the most aggressive opinion put forth.

I was particularly disappointed in the weak stand taken by Senate Republican Leader Mitch McConnell on one of the weekend talk shows. His comments were unworthy in my view.

“”Look, I don’t think either side ought to be trying to engage in disrupting meetings, either the Democratic side or the Republican side. But “to demonize citizens who are — you know, who are energetic about this — strikes me as demonstrating a kind of weakness in your position,” McConnell said. “In other words, you want to… change the subject…..

“Attacking citizens in our country for expressing their opinions about an issue of this magnitude may indicate some weakness in their position on the merits,” McConnell said. “This is an enormously important subject. Of course American citizens are concerned about it. And many of them are upset about it.”

No one is suggesting that American’s should be demonized for expressing their opinions Senator. The issue is storm trooper behavior, intimidation and physical confrontation. You know what is going on and you should be as outraged and concerned as every other American who believes in free and open debate.