NYU Makes Tuition Free for All Medical Students • Hacker News Board

Re: NYU Makes Tuition Free for All Medical Students

#101

Post by dnomad » Thu, Aug 16, 2018, 5:45 PM UTC

chimeracoder wrote: post #12

retbull wrote: post #2

I hope this helps to decrease the costs of medical care in the US to some extent as it removes one pressure for doctors to earn extra money charging for things that might not need to be needed. edit: Just so I am clear I know that there are lots of other influences on healthcare costs and doctor debt isn't the only pressure they face. Doctors do have some influence on cost (if not large) and if pressure on them is re…

> I hope this helps to decrease the costs of medical care in the US to some extent as it removes one pressure for doctors to earn extra money charging for things that might not need to be needed. Physician earnings account for about 7% of total spending on healthcare. Of that 7%, the fraction due to student debt specifically is significant from the physician's perspective, but negligible from a systemic picture. This…

That's a very strange way to consider salaries. 7% of the healthcare output is extraordinary. By any measure US doctors are obscenely overpaid for what is ultimately not very creative or challenging work. On average US doctors earn 2-5x more than doctors in other developed countries [1] -- while delivering significantly worse healthcare outcomes. Some estimates put this "excess income" at an extra $100 billion a year but I've seen estimates of a quarter trillion a year that gets sucked up by doctors -- again, for delivering worse care.

The priestly incomes that these NYU graduates will go on to earn is precisely why NYU can offer free tuition. Attracting the best medical talent, even if you pay for all their training (call it half a million dollars a pop), can probably still be profitable if this talent can be leveraged by NYU's network of private care facilities.

[1] https://www.politico.com/agenda/story/2017/10/25/doctors-sal...

Re: NYU Makes Tuition Free for All Medical Students

#102

Post by naveen99 » Thu, Aug 16, 2018, 5:46 PM UTC

scarface74 wrote: post #60

pcurve wrote: post #33

Earlier quoted context omitted.

By creating a giant endowment that can be used to generate cash. In this case, $600 million lump sum.

While I’m glad that billionaires are donating, why should colleges be dependent on the largess of private benefactors to ensure that our healthcare system is sustainable?

we want the most capable doctors. This will help keep more of top candidates from choosing other careers.

Re: NYU Makes Tuition Free for All Medical Students

#103

Post by koala_man » Thu, Aug 16, 2018, 5:46 PM UTC

caymanjim wrote: post #94

btian wrote: post #82

Earlier quoted context omitted.

What are you worried about?

Indeed. Some of these universities (Stanford, Harvard) are so filthy rich that they could provide free tuition for everyone and still watch their endowments grow from investment returns alone. Not to mention the enormous gifts they receive from successful alumni. Harvard has received hundreds of millions from the likes of Bill Gates and Mark Zuckerberg.

And to think that this was Stanford's original mission.

Re: NYU Makes Tuition Free for All Medical Students

#104

Post by nwienert » Thu, Aug 16, 2018, 5:51 PM UTC

x2f10 wrote: post #97

Idea: What if tuition was initially free for all students and universities collected a percentage of the graduate's pay for a fixed number of years?

Question: Why would you want to obscure the real cost of college even further?

Re: NYU Makes Tuition Free for All Medical Students

#105

Post by extralego » Thu, Aug 16, 2018, 5:52 PM UTC

pandler wrote: post #76

aabajian wrote: post #4

This is amazing. I graduated from medical school two years ago with $300,000 in debt. I'm a software developer on the side and would love to stop residency to try a healthcare startup and/or pursue a research, but the risk is too great - I need the attending salary to pay off the debt.

I’ve started thinking of the obligation to stick in industry to pay off my loans as an analog to having an organization like the US military pay for my degree. I have a few friends in the military studying at university for free. Their payment for those degrees essentially consists of X number years of obligatory post-degree military service, in addition to whatever military obligations during their study. [1] It’s a…

Sounds like smart thinking to me. I do similar rationalizing myself, and I wouldn’t worry too much what others think.

These things are tough to reconcile but we are all wrestling with them, and we have to keep our heads healthy to contend.

The only mistake I’d warn against is letting this influence your judgement of others, or your prescription for future generations. They are counting on us and we are counting on them. The point about the military speaks to the reality that you are not alone, but the bottom line is we have been dealt an injustice. We must not pass this nonsense on to those depending on us to make it right. We’ve got to stand together against the agregious opportunism undermining the livelihoods of Americans.

If nothing else, I don’t want to bare this weight through my middle age and still have the kids speaking of me in the way they speak of baby-boomers today. This isn’t to say the baby-boomers are to blame, but it is tough to feel sorry for them given the opportunities they had.

I’d much rather get the praise the Great Generation gets. Let’s work for it.

Love yourself, and all the moreso by loving others as well.

Re: NYU Makes Tuition Free for All Medical Students

#106

Post by jcoffland » Thu, Aug 16, 2018, 5:52 PM UTC

GoodOldNe wrote: post #28

gachavez wrote: post #17

Earlier quoted context omitted.

Fellow MD student here. I feel your pain. I've planning to just do PGY-1, work as a GP at urgent care night/weekends and do software dev full time.

You're going to work as a "GP" with at most one third of the training of almost every other doctor in practice? Seems like you're shorting your future patients a bit. My advice as someone who sees a lot of patients who were incompetently managed at urgent care is to avoid going this route. You're setting yourself and your patients up to fail with potentially devastating consequences.

This is not surprising. On my last two visits to late night urgent care I encountered complete incompetence. On the first occurrence, the Doctor did not know how to suture my hand. She put in four sutures when at least twice as many were needed and placed them way to close to the margin. She failed to even clean it properly. It ripped open again while I was sleeping. On the next, unrelated visit, the doctor was drunk. His face was all red and he reeked of alcohol.

Re: NYU Makes Tuition Free for All Medical Students

#107

Post by tootie » Thu, Aug 16, 2018, 5:56 PM UTC

x2f10 wrote: post #97

Idea: What if tuition was initially free for all students and universities collected a percentage of the graduate's pay for a fixed number of years?

Universities would probably stop offering humanities and push kids to professional courses.

Re: NYU Makes Tuition Free for All Medical Students

#108

Post by dunpeal » Thu, Aug 16, 2018, 5:57 PM UTC

sf_rob wrote: post #32

I'll probably be downvoted on a forum like this, but I worry about the most successful universities using their funds to subsidize those who would be fine without it. I was actually made aware of this by a wealthy Stanford alumni which has a fairly broad program for undergraduate tuition assistance. Graduates of mid/low tier universities seem more and more likely to have to compete with better credentialed people wit…

While "gaining admission to NYU medical school" is likely correlated with good socio-economic background (as do all accomplishment), the correlation is not 100%.

You can get into NYU from a poor socio-economic background, if you work hard and attain academic excellence.

And while all students will appreciate this discount, it will make more of a difference to those who are not "fine without it", i.e. those below the top richest and most privileged (for whom spending $200-300k on education is easily affordable).

Finally, this isn't exactly pure charity out of the kindness of NYU's heart. It's a response to medical candidates choosing other fields due to cost and debt issues:

https://www.wsj.com/articles/in-search-of-more-doctors-new-t...

These are the exact candidates this subsidy seeks to relieve.

Re: NYU Makes Tuition Free for All Medical Students

#109

Post by winslow » Thu, Aug 16, 2018, 5:57 PM UTC

x2f10 wrote: post #97

Idea: What if tuition was initially free for all students and universities collected a percentage of the graduate's pay for a fixed number of years?

That's the idea behind lambda school. Interesting podcast interview from Indie Hackers[1]. They only collect if your salary is above $55k if I recall correctly and there is a max amount that they take in total.

[1] https://www.indiehackers.com/podcast/046-austen-allred-of-la...

Re: NYU Makes Tuition Free for All Medical Students

#110

Post by analog31 » Thu, Aug 16, 2018, 5:57 PM UTC

acomar wrote: post #20

retbull wrote: post #2

I hope this helps to decrease the costs of medical care in the US to some extent as it removes one pressure for doctors to earn extra money charging for things that might not need to be needed. edit: Just so I am clear I know that there are lots of other influences on healthcare costs and doctor debt isn't the only pressure they face. Doctors do have some influence on cost (if not large) and if pressure on them is re…

Doctor's pay is not the driving factor behind increasing medical bills... administrative expenses at providers in insurance, opaque and arcane cost structures negotiated as deals between providers and insurance companies, and record profits at both insurance companies and providers point to a system that's cannibalizing itself. This will do nothing to costs even if implemented universally as it does nothing to addres…

As I understand it, salaries are only one of the many ways that doctors make money. Many "providers" are doctor-owned. Perhaps a more general statement would be that decreasing the cost of medical care will unavoidably decrease the income and/or wealth of doctors.

I don't see a problem with this, so long as doctors can earn a decent living. An idea I've thought about is that medical school is free, but doctors primarily earn their income by working for the government, for a salary. It might attract different people, who stand to benefit from that bargain.

What I've noticed about the debate is that everybody who is getting rich, is pointing the finger of blame at everybody else. Chances are, they're all gouging us.