25 years old and deep in debt

[Ideologue]

From the article:

Today, her debt exceeds her salary by a factor of five — much higher than the recommended twice-starting-salary ratio. She signed up for income-based repayment, a government program available to federal student loan recipients. (A newer program with slightly more generous terms, called Pay As You Earn, or PAYE, is available to more recent graduates.) Both income-based repayment and PAYE allow graduates to lead relatively normal lives by paying back a modest percentage of their income based on a formula. After a fixed amount of time, from 10 to 25 years, the balance of the debt is discharged.

That's the good news. The bad news is that the interest on the debt keeps growing and taxes must be paid on the amount discharged, as if it is a gift. Dr. Schafer sends $400 a month to Sallie Mae, a sum that will rise. But what kind of tax bill awaits her? Asked to run the numbers, GL Advisor, a financial services company that specializes in student loans, calculated that Dr. Schafer's debt is likely to exceed $650,000 when her tax bill lands 25 years after the start of the loan, which means she will owe the Internal Revenue Service roughly $200,000. That will happen while she is still deep in her career, perhaps around the time she wants to send some children to college.

That's really a nice racket your government runs with the higher education institutions.

That's also a deeply inaccurate summary.  For all IBR's (and its evolved program, PAYE's) faults, the insolvency provisions of the IRC should protect people from being completely destroyed in discharge.

Plenty of need for veterinarians in the medical research arena;  but taking care of the facilities where researchers decapitate a dozen rabbits every day to see how fast they blink afterwards isn't why most go to vet school.

Indeed.  I've looked into vet school off and on, and the problem does in part (though not entirely) appear to be a reluctance to take jobs at R+D facilities and at giant factory farms.  At the same time, in either case this is a lot like asking Hawkeye Pierce to go work at Auschwitz.

[CountDeMoney]

Plenty of need for veterinarians in the medical research arena;  but taking care of the facilities where researchers decapitate a dozen rabbits every day to see how fast they blink afterwards isn't why most go to vet school.

Indeed.  I've looked into vet school off and on, and the problem does in part (though not entirely) appear to be a reluctance to take jobs at R+D facilities and at giant factory farms.  At the same time, in either case this is a lot like asking Hawkeye Pierce to go work at Auschwitz.

Yeah, I've seen the research facilities.  Medical guillotines that would make Robespierre spooge.  Ever wonder how they figure out what happens to lab rats when they smoke 500 cigarettes a day?  And I'm not even going to describe what the monkey centrifugal chair does.  You can figure that one out.

The collapse in the economy didn't help, either.  Remember all those magazine cover stories just a few years ago, how Americans were spending more money on their pets than ever before?  That's when these kids started going into vet school.  With the disappearance of disposable income, sending Spot to the vets tends to drop a bit on the List of Things To Do. 

[Ideologue]

Owing to work, I'm actually pretty familiar with pharmaceutical preclinical studies.  Why can't we just use homeless people or all those excess Chinese males?  The science would be sounder too.

[DGuller]

She was probably too stupid to get into a real vet school in the US.  IIRC Caribbean medical-type schools are traditionally for rich, yet dim students.  I guess if you go to one of them, but are not rich, you truly are a moron.

My cousin went to a Caribbean medical school, and his family is not particularly rich.

[Malthus]

She was probably too stupid to get into a real vet school in the US.  IIRC Caribbean medical-type schools are traditionally for rich, yet dim students.  I guess if you go to one of them, but are not rich, you truly are a moron.

My cousin went to a Caribbean medical school, and his family is not particularly rich.

Well, is he a moron? 

[Maximus]

High Debt and Falling Demand Trap New Veterinarians

'The problem is a boom in supply (that is, vets) and a decline in demand (namely, veterinary services). Class sizes have been rising at nearly every school, in some cases by as much as 20 percent in recent years. And the cost of vet school has far outpaced the rate of inflation. It has risen to a median of $63,000 a year for out-of-state tuition, fees and living expenses, according to the Association of American Veterinary Medical Colleges, up 35 percent in the last decade.

This would seem less alarming if vets made more money. But starting salaries have sunk by about 13 percent during the same 10-year period, in inflation-adjusted terms, to $45,575 a year'

There's a huge shortage of large-animal vets in many parts of the country.

[HVC]

Ya, but then you have to shove your hand into their asses, while city vets get to play with kitties.

[Tonitrus]

Ya, but then you have to shove your hand into their asses, while city vets get to play with kitties.

Not to mention living in desolate wastelands like Wyoming or the Dakotas.

[Neil]

Girls become vets to take care of puppies and kitties, not to deal with livestock or to massacre various testlab animals.

[DGuller]

She was probably too stupid to get into a real vet school in the US.  IIRC Caribbean medical-type schools are traditionally for rich, yet dim students.  I guess if you go to one of them, but are not rich, you truly are a moron.

My cousin went to a Caribbean medical school, and his family is not particularly rich.

Well, is he a moron? 

He's my cousin, and I love him.

[crazy canuck]

If you change your system to a single payor system that fundamentally changes the cost structure because the single payor now has all the clout it needs when dealing with the amount it is willing to pay health care providers.

That's true, but it's only a part of the equation. It just squeezes the providers. It doesn't change the cost of medical equipment, or the cost of a medical education. Or the number of doctors that can be trained and enter the market in a year.

Since the single payor also purchases most of the equipment it has the similar cost controls on that as well - including the ability to get better deals from manufacturers of the equipment.  Drug costs are also contained since the single payor can negotiate directly with big pharma to get big discounts.  The cost of medical education is heavily subsidized as well so that takes care of the problem with doctors needing to earn large amounts just to pay off their large loans.

You are right about the number of doctors though.  In recent years this province has steadily increased the number of seats in medical school through direct funding the the Universities to try to increase the number of doctors that are necessary.  But that remains an issue.

[fhdz]

Sure, governments across Canada are having great success in enforcing cost discipline.  Oh wait, they're not.

The only way health care costs in a general sense are going to go down over time is if the long life expectancy trend reverses sharply for some reason. The rising cost of health care is a function of our productivity.

[Fate]

I don't agree with that. We're probably going to have a decrease in the average lifespan because of the increase in prevalence of obesity/hypertension/diabetes, yet health care costs over that same time are going to rise. People are just going to be sick for longer periods of time. We have the ability to keep them alive, but not cure them.

[Fate]

Socializing is probably the wrong word for it.

If you change your system to a single payor system that fundamentally changes the cost structure because the single payor now has all the clout it needs when dealing with the amount it is willing to pay health care providers.

It is fundamentally different from the kind of cost discipline private health insurance companies engage in which is to deny coverage rather than deal with the cost of the service.

BB's point is well taken that health care is expensive no matter what system you use. But at the very least a single payor system has the benefit of having some actual cost discipline along with the very great benefit that everyone has access to basic health care.

Sure, governments across Canada are having great success in enforcing cost discipline.  Oh wait, they're not.

Here's a chart showing Canadian health care spending:

Meh. How's that compared to other OECD countries? Your population increased by 1.5 fold over 1975-2011, while health care spending in 1997 dollars increased 3 fold over that same time period. That seems pretty good given how far technology has come since 1975.

[fhdz]

I don't agree with that. We're probably going to have a decrease in the average lifespan because of the increase in prevalence of obesity/hypertension/diabetes, yet health care costs over that same time are going to rise. People are just going to be sick for longer periods of time. We have the ability to keep them alive, but not cure them.

Exactly.