Why Medical School Should Be Free

In an opinion piece in the New York Times this weekend, two prominent physicians explained why they believe medical school needs to be tuition free, and offered up a proposal on how to pay for it.

The physicians, Peter B. Bach, MD, director of the Center for Health Policy and Outcomes at Memorial Sloan-Kettering Cancer Center, and Robert Kocher, MD, a special assistant to President Obama on healthcare and economic policy from 2009 to 2010, and a guest scholar at the Brookings Institution, said the need to make medical school free is driven by the looming shortage of primary care physicians.

The doctors argue in the Times piece:

“Huge medical school debts — doctors now graduate owing more than $155,000 on average, and 86 percent have some debt — are why so many doctors shun primary care in favor of highly paid specialties, where there are incentives to give expensive treatments and order expensive tests, an important driver of rising health care costs.

“Making medical school free would relieve doctors of the burden of student debt and gradually shift the work force away from specialties and toward primary care. It would also attract college graduates who are discouraged from going to medical school by the costly tuition.”

The authors estimate it would cost $2.5 billion per year to make medical school free, or about one-thousandth of what the U.S. spends on healthcare annually. They believe that those costs can be offset by charging doctors for specialty training.

The authors detail how their proposal would pay for itself:

“Under our plan, medical school tuition, which averages $38,000 per year, would be waived. Doctors choosing training in primary care, whether they plan to go on later to specialize or not, would continue to receive the stipends they receive today. But those who want to get specialty training would have to forgo much or all of their stipends, $50,000 on average. Because there are nearly as many doctors enrolled in specialty training in the United States (about 66,000) as there are students in United States medical schools (about 67,000), the forgone stipends would cover all the tuition costs.“

The doctors note that there are hurdles to their plan, including the fact that some hospitals that provide training are not associated with medical schools, so there would need to be some way to redistribute specialty training fees and government subsidies. They also raise the possibility that medical schools might begin raising tuition rates artificially high once students are no longer paying the bills.

What do you think? Should medical school be free? Would you be willing to be charged more for training in order to make free medical school a reality?