I'm a physician (internist and nephrologist). I have been practicing medicine for almost 20 years now (in Europe mostly). Here's what I have been thinking about lately. If you read the Medscape Survey for physicians' compensations for the US, you can draw some interesting consequences:
The average physician had a salary of 262k in the US in 2023. It looks like a nice sum of money, however, you get a completely different picture if you consider the details.
1. medical school is 3 years of college and 5 years of medschool in the US. So if you are lucky and start at 18, you finish at 26.
3. Then you have residency. Residency in the US means you work 100 hour work weeks and earn 30k a year for 6-8 years. So this adds another 8 years to you basically losing money, which means you start actually earning anything at the age of 34.
4. So you are 34, most likely your 200k student loan is now MUCH more because of high rates (6-14% right now) AND you have been working your ass off for 16 years (8 years of the hardest universities then 100 hour work weeks for another 8 years with next to no pay), you have no sex life, no private life, you are either never married or already divorced (this is my case, actually). Now you start making money. You make 262k. Except this is before taxes. Since most states in the US have a progressive taxation system, and you are a high earner, most likely you lose at least half of this to federal, state and local taxes, insurance fees, legal fees, board membership fees, training costs, etc. Let's say you keep 130k. That is a little over 10 k a month.
5. However, you still most likely have your student loan debt, which most likely increased VASTLY since you left med school, since you were making 30k a year for 8 years AND rates are now 6-14%. If rates remain this high, I don't think its an exaggeration to suggest that your average trained doctor after finishing residency will look at a 500k debt pile by the time they start working as a trained doctor. I mean, at 10%, a 200k debt is increases by 20k in the first year, 22k in the second, and so forth, after 8 years, with a geometrical sequence you are looking at 389k on your student loan alone, supposing you didn't take out a loan for something else, like getting a car, helping with your living expenses, medical training fees, etc. etc. You obviously have to start paying this back. If you want to pay back 500k over a 10-year period, given that only your rates on this are about 10%, you will have to contribute AT LEAST 100k a year to pay it back in 10 years. So you pay 50k on the 10% rate and another 50k to decrease the principal, now you paid it back in 10 years. Well, also you only have something like 30k left to live on, but hey, you are now used to this lifestyle from your 8-year residency, so Status idem, as we say in Latin.
6. Hooray, you are now out of debt in 10 years. You are 44, still no sex life, still no private life, no wife, no kids, but now you get to keep your whole 10k salary a month for yourself. Except you are burnt out, haven't had a partner in 20 years, biologically you are 60-70 years old because of the 26 years of non-stop work and struggle, you don't have a house, you don't have a car. Good luck starting your life!
You see everyone I ever talked to kept telling me if I want to make it big, I should go to the USA. Well, given the consequences from the above calculation, I think I'll stick to my locum business in Switzerland.
If I were a US citizen, I would DEFINITELY expect my medical bills to rise STEEPLY in the near future...
Student lending reform idea: all institutions accepting third party payers post the % of graduates that are able to fund their loans with work relevant to their degree and that % can be used as a major selling point to potential students. Then they, the university, gets transferred the loan from the taxpayer at face value for any discrepancy beneath their claimed %. So if they say that 60% of their nurses get nursing jobs that can be used to service their debt but only 50% of a class gets hired as nurses, then the government or third party payer can take the loan off their book and transfer it to the (often richly endowed) school.
So many frustrating things about the cost of college.
1. The federal government giving 18 year olds with zero collateral basically a blank check. So you add basically endless demand.
2. The universities are not ran like a business they are ran like a government agency - spending endless money and complaining that they do not have enough funding. So what do they do - jack up the price of tuition while sitting on billion dollar endowments.
3. The universities are competing against each other for student blank checks - so what do they do is improve the amenities to look like a sandals resort. I had lunch yesterday with someone who just sent his son to U of Texas. As a freshman he is living in a high rise - 4 bed / 2 bath apartment with a living room for 4 kids. Upstairs on the roof they have a pool set up that rivaled a Ritz Carlton. He showed me a picture of their studio room where the kids can film their Tik Tok and YouTube videos.
What happened in living in a shit dorm - sharing a bathroom with 60 other ppl. Have a dining hall that was a cafeteria line. These kids are living like they make $250K +..........not dirt poor.
Part of the college experience for me is to learn how poor people live and make sure I busted my butt to get a degree and a job.
4. Is college even worth it? The kids are better off not going to school taking $250K and investing it until they are 65. Getting a job in the trades or sales - where college is not needing. Get real life experience which is 10X's more important that being indoctrinated for 4 years. College should be for those who want to be a doctor - other than that, most careers could be trained in a 1-2 year trade school process. Focus on your career - stop spending 100K on 2 years of Gen Ed's.........you can go to the library and read for free if you want to broaden your education.
The government should be completely removed from the student loan business. Financing for college should be provided by the schools. The large universities can do a bond issue each year that matches the student loan demand for that school year. Smaller schools can work with banks that will handle the loans that will be backed by the schools. Other non-federal government entities can get into the business but, there are no guarantees, the lender assumes all risk.
This will of course force a major change on higher education as low ROI, to the student, degrees will now be a risky loan. This takeover of student loans by the government is really just to feed $ into an enormously overpriced tuition structure to fund what is basically hard left institutions pushing an indoctrination agenda.
It strikes me that given the universities need to take some credit (blame?) for these students' outcomes as they are the purveyors of increasingly useless degrees while simultaneously gathering substantial endowments and adding useless administrative personnel. Perhaps we can simply tax the endowments on a pro rata basis while requiring those schools to reduce the administrator/student ratio substantially, thus reducing their cost bases and allowing for reduced tuitions overall. meanwhile, the students see their debts reduced because the schools themselves pick up part of the tab, making it more affordable for the remainder to be repaid by the student who signed the contract
When I went to Cal Poly SLO in the late 70s/early 80s tuition was $65 a quarter and a room in a house was $100 a month. Last I heard tuition there was $12,000 a year and a room in a house was $1,000-1,500. And that's a subsidized state university. Why more of California's high taxes they collect aren't being used to help lower tuition I don't know but that's one place to start on this mess.
(On the current student debt--the government has thrown money at two completely stupid Mideast wars, sloppy pandemic payouts, etc. and lacks the balls to correctly assess for Social Security and Medicare (or for that matter institute a universal healthcare system which would be cheaper for everyone) so why not throw another trillion at student loans forgiveness --the federal deficit is unpayable already and eventually all going into default or high inflation to get resolved anyway. I mean why are we excluding student education, probably the best use of money in comparison, from the free for all? *Some sarcasm included*).
In my lifetime, the COSTS of going to college, any college, have skyrocketed. But colleges are not holding this debt, banks are. And soon it will be taxpayers on the hook. Colleges raised their prices and told students 'you need this degree to make a good living." Colleges are the big winners.
15800 for a year, for 6 years. This costs you 94800 for the whole programme. Also, if you work in the summer, or take a semester off every now and then to do some work, you can probably even earn your own student fees while you study.
Oh, did I mention that the US does NOT allow foreign specialists to practice in the US? You could be the best Hungarian trained doctor in the world, however, you don't get a board membership, you can't practice.
I think it's time for the US to implement some REAL competition in its healthcare system...
"As managed, this system cannot continue as a loan program. It will not end well."
everything that is going on in the World today......IMHO ....none of it is going to end well.......whether it be Debt......whether it be War........or any the number of other things that you can come up with.........everything looks to have a group of numerous time bombs surrounding it........and when those Bombs do go off.........we all know......it is not rocket science........nothing is going to end well.........................
The educational industrial complex is completing its mission: making an obedient citizenry and getting people into debt. There are better options for young people than to go to college today.
When I sent my daughter to college in 2015, I paid for the first semester without using student loans. It was tough going but we did it. I then did some research, I went to the New York Fed's website and looked a their chart on student loans. After 2007-2008 they exploded upwards. Like a hockey stick. It was a bubble, plain and simple. So I took out government loans for the rest of her education. I have made my payments since we had to start again, and I won't complain. But the Fed and Dept of Education all know what it is. It's a big bubble that has to be dealt with at some point.
Here in US pandemic era student loan repayment pauses are no longer in effect. I could handle my ~ $400/mo. repayments. However, my income is modest enough that I asked for and was granted a further reduction in my payments. It's reviewed each year. My payment didn't stop, but it reduced to $8/mo. Sure, I'll pay interest, but at ~7%, that's well under the "real" (not the BS official) inflation rate.
Total government control of education leads to bad outcomes: 1) communist indoctrination, 2) elevated costs and 3) bad major choices due to "free" money. It's gotten so bad I'm not even sure college is worth it anymore, except that you need that piece of paper to get a job. High costs have to be funded with student debt, which starts the graduate on a path of debt slavery and allows the state to decide who is entitled to "relief," which buys more votes. Student loan debt forgiveness is nothing more than taxpayer theft leading to more borrowing and ultimately inflation. Truly a twisted system.
Tim pool has the right idea. The students chose to get the student loans so that should be paid back. What should be gotten rid off is the interest rates tagged on top so abolish the interest rates for student loans though watch the loans increase in price to make up for that loss.
I agree in principle. Problem: Many loans were granted to people who have no business setting foot on a college or university campus. Turns out that there are just so many Diversity and Inclusion Director positions (or equivalent) available. That Transgender Lesbian Gerbil Studies MA just isn't highly marketable. In a saner world (no government loans and no coercion upon private lenders) loans would be granted based upon a prospective student' s academic abilities and thus future career prospects.
I'm a physician (internist and nephrologist). I have been practicing medicine for almost 20 years now (in Europe mostly). Here's what I have been thinking about lately. If you read the Medscape Survey for physicians' compensations for the US, you can draw some interesting consequences:
https://www.webmd.com/corporate/press/20230413/medscapephysicians-compensationreport
The average physician had a salary of 262k in the US in 2023. It looks like a nice sum of money, however, you get a completely different picture if you consider the details.
1. medical school is 3 years of college and 5 years of medschool in the US. So if you are lucky and start at 18, you finish at 26.
2. The average collage graduate from med schools has a debt of 200k when they start their career: https://www.forbes.com/advisor/student-loans/average-medical-school-debt/
3. Then you have residency. Residency in the US means you work 100 hour work weeks and earn 30k a year for 6-8 years. So this adds another 8 years to you basically losing money, which means you start actually earning anything at the age of 34.
4. So you are 34, most likely your 200k student loan is now MUCH more because of high rates (6-14% right now) AND you have been working your ass off for 16 years (8 years of the hardest universities then 100 hour work weeks for another 8 years with next to no pay), you have no sex life, no private life, you are either never married or already divorced (this is my case, actually). Now you start making money. You make 262k. Except this is before taxes. Since most states in the US have a progressive taxation system, and you are a high earner, most likely you lose at least half of this to federal, state and local taxes, insurance fees, legal fees, board membership fees, training costs, etc. Let's say you keep 130k. That is a little over 10 k a month.
5. However, you still most likely have your student loan debt, which most likely increased VASTLY since you left med school, since you were making 30k a year for 8 years AND rates are now 6-14%. If rates remain this high, I don't think its an exaggeration to suggest that your average trained doctor after finishing residency will look at a 500k debt pile by the time they start working as a trained doctor. I mean, at 10%, a 200k debt is increases by 20k in the first year, 22k in the second, and so forth, after 8 years, with a geometrical sequence you are looking at 389k on your student loan alone, supposing you didn't take out a loan for something else, like getting a car, helping with your living expenses, medical training fees, etc. etc. You obviously have to start paying this back. If you want to pay back 500k over a 10-year period, given that only your rates on this are about 10%, you will have to contribute AT LEAST 100k a year to pay it back in 10 years. So you pay 50k on the 10% rate and another 50k to decrease the principal, now you paid it back in 10 years. Well, also you only have something like 30k left to live on, but hey, you are now used to this lifestyle from your 8-year residency, so Status idem, as we say in Latin.
6. Hooray, you are now out of debt in 10 years. You are 44, still no sex life, still no private life, no wife, no kids, but now you get to keep your whole 10k salary a month for yourself. Except you are burnt out, haven't had a partner in 20 years, biologically you are 60-70 years old because of the 26 years of non-stop work and struggle, you don't have a house, you don't have a car. Good luck starting your life!
Is anyone wondering why we see reports like this?
https://www.prnewswire.com/news-releases/medscape-physician-burnout-and-depression-report-burnout-worsening-depression-increasing-301732504.html
You see everyone I ever talked to kept telling me if I want to make it big, I should go to the USA. Well, given the consequences from the above calculation, I think I'll stick to my locum business in Switzerland.
If I were a US citizen, I would DEFINITELY expect my medical bills to rise STEEPLY in the near future...
Student lending reform idea: all institutions accepting third party payers post the % of graduates that are able to fund their loans with work relevant to their degree and that % can be used as a major selling point to potential students. Then they, the university, gets transferred the loan from the taxpayer at face value for any discrepancy beneath their claimed %. So if they say that 60% of their nurses get nursing jobs that can be used to service their debt but only 50% of a class gets hired as nurses, then the government or third party payer can take the loan off their book and transfer it to the (often richly endowed) school.
So many frustrating things about the cost of college.
1. The federal government giving 18 year olds with zero collateral basically a blank check. So you add basically endless demand.
2. The universities are not ran like a business they are ran like a government agency - spending endless money and complaining that they do not have enough funding. So what do they do - jack up the price of tuition while sitting on billion dollar endowments.
3. The universities are competing against each other for student blank checks - so what do they do is improve the amenities to look like a sandals resort. I had lunch yesterday with someone who just sent his son to U of Texas. As a freshman he is living in a high rise - 4 bed / 2 bath apartment with a living room for 4 kids. Upstairs on the roof they have a pool set up that rivaled a Ritz Carlton. He showed me a picture of their studio room where the kids can film their Tik Tok and YouTube videos.
What happened in living in a shit dorm - sharing a bathroom with 60 other ppl. Have a dining hall that was a cafeteria line. These kids are living like they make $250K +..........not dirt poor.
Part of the college experience for me is to learn how poor people live and make sure I busted my butt to get a degree and a job.
4. Is college even worth it? The kids are better off not going to school taking $250K and investing it until they are 65. Getting a job in the trades or sales - where college is not needing. Get real life experience which is 10X's more important that being indoctrinated for 4 years. College should be for those who want to be a doctor - other than that, most careers could be trained in a 1-2 year trade school process. Focus on your career - stop spending 100K on 2 years of Gen Ed's.........you can go to the library and read for free if you want to broaden your education.
The government should be completely removed from the student loan business. Financing for college should be provided by the schools. The large universities can do a bond issue each year that matches the student loan demand for that school year. Smaller schools can work with banks that will handle the loans that will be backed by the schools. Other non-federal government entities can get into the business but, there are no guarantees, the lender assumes all risk.
This will of course force a major change on higher education as low ROI, to the student, degrees will now be a risky loan. This takeover of student loans by the government is really just to feed $ into an enormously overpriced tuition structure to fund what is basically hard left institutions pushing an indoctrination agenda.
College is a racket. Plain and simple.
It strikes me that given the universities need to take some credit (blame?) for these students' outcomes as they are the purveyors of increasingly useless degrees while simultaneously gathering substantial endowments and adding useless administrative personnel. Perhaps we can simply tax the endowments on a pro rata basis while requiring those schools to reduce the administrator/student ratio substantially, thus reducing their cost bases and allowing for reduced tuitions overall. meanwhile, the students see their debts reduced because the schools themselves pick up part of the tab, making it more affordable for the remainder to be repaid by the student who signed the contract
When I went to Cal Poly SLO in the late 70s/early 80s tuition was $65 a quarter and a room in a house was $100 a month. Last I heard tuition there was $12,000 a year and a room in a house was $1,000-1,500. And that's a subsidized state university. Why more of California's high taxes they collect aren't being used to help lower tuition I don't know but that's one place to start on this mess.
(On the current student debt--the government has thrown money at two completely stupid Mideast wars, sloppy pandemic payouts, etc. and lacks the balls to correctly assess for Social Security and Medicare (or for that matter institute a universal healthcare system which would be cheaper for everyone) so why not throw another trillion at student loans forgiveness --the federal deficit is unpayable already and eventually all going into default or high inflation to get resolved anyway. I mean why are we excluding student education, probably the best use of money in comparison, from the free for all? *Some sarcasm included*).
In my lifetime, the COSTS of going to college, any college, have skyrocketed. But colleges are not holding this debt, banks are. And soon it will be taxpayers on the hook. Colleges raised their prices and told students 'you need this degree to make a good living." Colleges are the big winners.
And to give you an idea how to solve this calamity: Here are the fees for medical university education from my home town, Szeged:
https://www.med.u-szeged.hu/fs/fees-and-costs/tuition-fees-for
15800 for a year, for 6 years. This costs you 94800 for the whole programme. Also, if you work in the summer, or take a semester off every now and then to do some work, you can probably even earn your own student fees while you study.
Oh, did I mention that the US does NOT allow foreign specialists to practice in the US? You could be the best Hungarian trained doctor in the world, however, you don't get a board membership, you can't practice.
I think it's time for the US to implement some REAL competition in its healthcare system...
"As managed, this system cannot continue as a loan program. It will not end well."
everything that is going on in the World today......IMHO ....none of it is going to end well.......whether it be Debt......whether it be War........or any the number of other things that you can come up with.........everything looks to have a group of numerous time bombs surrounding it........and when those Bombs do go off.........we all know......it is not rocket science........nothing is going to end well.........................
You win the internet, at least @ 6:15 EST.
The educational industrial complex is completing its mission: making an obedient citizenry and getting people into debt. There are better options for young people than to go to college today.
https://securesingle.substack.com/p/12-reasons-why-young-people-should
When I sent my daughter to college in 2015, I paid for the first semester without using student loans. It was tough going but we did it. I then did some research, I went to the New York Fed's website and looked a their chart on student loans. After 2007-2008 they exploded upwards. Like a hockey stick. It was a bubble, plain and simple. So I took out government loans for the rest of her education. I have made my payments since we had to start again, and I won't complain. But the Fed and Dept of Education all know what it is. It's a big bubble that has to be dealt with at some point.
Here in US pandemic era student loan repayment pauses are no longer in effect. I could handle my ~ $400/mo. repayments. However, my income is modest enough that I asked for and was granted a further reduction in my payments. It's reviewed each year. My payment didn't stop, but it reduced to $8/mo. Sure, I'll pay interest, but at ~7%, that's well under the "real" (not the BS official) inflation rate.
Total government control of education leads to bad outcomes: 1) communist indoctrination, 2) elevated costs and 3) bad major choices due to "free" money. It's gotten so bad I'm not even sure college is worth it anymore, except that you need that piece of paper to get a job. High costs have to be funded with student debt, which starts the graduate on a path of debt slavery and allows the state to decide who is entitled to "relief," which buys more votes. Student loan debt forgiveness is nothing more than taxpayer theft leading to more borrowing and ultimately inflation. Truly a twisted system.
Tim pool has the right idea. The students chose to get the student loans so that should be paid back. What should be gotten rid off is the interest rates tagged on top so abolish the interest rates for student loans though watch the loans increase in price to make up for that loss.
I agree in principle. Problem: Many loans were granted to people who have no business setting foot on a college or university campus. Turns out that there are just so many Diversity and Inclusion Director positions (or equivalent) available. That Transgender Lesbian Gerbil Studies MA just isn't highly marketable. In a saner world (no government loans and no coercion upon private lenders) loans would be granted based upon a prospective student' s academic abilities and thus future career prospects.