For 33 years, Bill Sullivan has been the Executive Vice President of Dr. John Najarian’s Medical Research Foundation. The Institute for Basic and Applied Research in Surgery (IBARS) provides additional funding support to the Department of Surgery at the University of Minnesota with an emphasis on Solid Organ Transplantation, Surgical Oncology and Cardio-Vascular Surgery.
As with Dental School, most physicians graduating from Medical School have a total debt load of approximately $300,000.
Three “cataclysmic financial events” occur when many students graduate from Medical School. About one third marry another medical student, effectively doubling their tuition debt load. Next, Medical Students tend to buy homes they cannot realistically afford. And third, it is not at all uncommon for Medical Students to have a baby, effectively taking one of the wage earners out of the full-time practice of medicine.
Painfully, healthcare economists have calculated if a medical school couple assumes a “non-dischargeable” debt load of approximately $1 million dollars, over the course of a 42 year professional career, there is “great likelihood” they will not be able to retire their tuition obligation.
The average income of a Mpls./St. Paul Family Practitioner is $177,600, but new grads often earn less than $100,000/year in their first 3 years.*
This has resulted in the non-too-subtle self-segregation that is taking place between the ranks of the primary care physicians and the specialists. Recognizing the extraordinary costs involved, many students are gravitating to higher paying sub-specialty disciplines which, in turn, render the relative salary structure of the general practitioner to disproportionately fall behind.
THE 2012 AFFORDABLE CARE ACT (ACA)
Economists, political strategists, and business leaders have argued for years to expand the base of the insurance pyramid. Enrolling young, healthy candidates would help offset the exploding costs of health care costs today.
At the national level, this desired-for goal has not played out. In fact, young people remain reluctant to sign up for healthcare insurance. Even with a bitter pill of an annual Income Tax penalty assessed to those without healthcare insurance, many argue it is simply cheaper to “pay the penalty.” What the nation has witnessed over the past two years is a disproportionate enrollment among young and middle-aged participants whose needs for healthcare are defined by a host of chronic medical problems.
While some states have done an aggressive job of moving many off of the Medicaid roles by offering healthcare insurance subsidies, the sad fact remains that too often young people today suffer a disproportionate number of problems related to obesity, diabetes, early onset heart disease; all problems typically associated with an older population.
A TWO (OR THREE) TIERED SYSTEM
- The “financially advantaged” will always be able to receive care, most likely from a concierge physicians’ service. Painfully, 40% of physicians 55 years of age and older are opting out of Medicare participation and this number is growing. This is very bad news for aging Baby Boomers who are bound to need increased health care.
- The “financially disadvantaged” will receive care via Federal programs implemented at the State and Local levels.
- Sadly, the majority of Americans will fall into a system of quasi-rationing. Of course they will be treated, but there will be long lines of other patients ahead of them, “Justice delayed is justice denied!” and “Healthcare delayed is healthcare denied!”
* The mean income for a General Dentist in Mpls./St. Paul is $189,000. The range for means throughout Minnesota is $183,490 to $224,830. Source: U.S. Bureau of Labor Statistics, 2014 data.
Most incentives need to be adjusted each year taking into account factors like: