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NYU Makes Tuition Free for All Medical Students

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Re: NYU Makes Tuition Free for All Medical Students

#141
post #89
post #20

Earlier quoted context omitted.

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…

I'm convinced that it's the cost structure, implemented by many-to-many negotiation between providers and insurers, that drives the uniquely high cost of the US health care system. (Unique as in twice as much per capita as the rest of the industrialized world.) Japan's system is structurally very similar to ours - employer-provided private insurance - with one key difference. In Japan, pricing for all medical goods/s…

> I'm convinced that it's the cost structure, implemented by many-to-many negotiation between providers and insurers, that drives the uniquely high cost of the US health care system. (Unique as in twice as much per capita as the rest of the industrialized world.) Japan's system is structurally very similar to ours - employer-provided private insurance - with one key difference. In Japan, pricing for all medical goods/services are set by a government agency, with an eye to keeping the industry functional/profitable while keeping costs under control. There are no "networks". Everyone knows what it's going to cost, everywhere.

In the US, Medicare pays for 40% of the market, and they set prices unilaterally. In addition to providers are legally required to charge private insurers more, Medicare has no mandate to keep the industry profitable, and in fact their reimbursement rates are about 7% lower than COGS. In other words, providers are (in the aggregate) losing money on Medicare patients on a per-patient basis, even before they account for overhead (building maintenance, staff wages, etc.).

Medicare knows this and admits as much - not just in their annual reports, but because they actually have a number of different stipend programs that provide extra money to providers who see a lot of Medicare patients, because otherwise they would literally go bankrupt and close their practices (ie, if they don't see enough privately-insured patients to be able to make up the gap, they will go out of business).

Medicare is, actually, the biggest beneficiary of price opacity in the American healthcare system today, but that opacity is not going anywhere.

Re: NYU Makes Tuition Free for All Medical Students

#142
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…

To be so privileged that the free med school is something you can do without is to be in an almost insignificant percentage of the population. Even for the upper middle class med school costs are huge.

Now less privileged people can see NYU med school as something to aspire to. I fail to see the problem here.

Re: NYU Makes Tuition Free for All Medical Students

#143
post #20

Earlier quoted context omitted.

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 primar…

> I don't see a problem with this, so long as doctors can earn a decent living.

There's an enormous opportunity to disrupt doctors. Doctors, particularly in the US, are grossly overpaid for the value they deliver. As I said below, there's an extra $100-$250 billion a year that gets sucked up by doctors. Frankly, the vast majority of what doctors end up doing -- collecting information, analyzing it, prescribing a course, repeat -- does not warrant the salaries doctors commandeer.

The industrialization of healthcare can't be done inside the existing system and the government certainly won't help which is what makes things tricky. But it's why you see Amazon, JP Morgan, Google and Uber starting their own healthcare companies and pushing into this industry more and more. [1] There's a great deal of money to be saved here while potentially improving outcomes. The current system, where a single doctor works obscene hours while spending 15 minutes with each patient, is just dumb.

[1] https://www.vox.com/technology/2018/3/6/17071750/amazon-heal...

Re: NYU Makes Tuition Free for All Medical Students

#144

Earlier quoted context omitted.

IDK. The same thought process led me to not being able to complete college due to financial reasons. Despite being emancipated, FAFSA still considers you a dependent until you're 24. I was told that only with documentation of leaving an abusive household would a dependency exception grant be applied. So according to FAFSA I was supposed to use all this money that I didn't have to pay for college. By 24 I had dropped…

> Just make college free. Sure, have some funding ideas?

Raise the income tax, create a VAT, kill the mortgage-interest tax deduction, add a Financial transaction tax, tax capital gains like normal income, stop subsidizing fossil fuel extraction, add a carbon tax, and lower the threshold for the inheritance tax and raise the percentage.

Re: NYU Makes Tuition Free for All Medical Students

#145
They need warm bodies (residents are cheap labor) to run the hospital (the money machine that gets thousands of dollars per xray, per drug, etc). A steady supply of med students who are already situated in NYC saves them the cost of recruiting residents from afar. And who knows how much money they save by cutting the bureaucracy to administer tuition, loans, Sally Mae compliance, etc.

Re: NYU Makes Tuition Free for All Medical Students

#146

Earlier quoted context omitted.

IDK. The same thought process led me to not being able to complete college due to financial reasons. Despite being emancipated, FAFSA still considers you a dependent until you're 24. I was told that only with documentation of leaving an abusive household would a dependency exception grant be applied. So according to FAFSA I was supposed to use all this money that I didn't have to pay for college. By 24 I had dropped…

> Just make college free. Sure, have some funding ideas?

Taxes

Re: NYU Makes Tuition Free for All Medical Students

#147
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…

> a wealthy Stanford alumni Grammar tip: In English, the word "alumnus" is typically declined as it would be in Latin. Especially amongst academics, I'd say. So if you're writing for that audience, the appropriate forms of "alumnus" are, I think, as follows [0]: "alumnus" - One male, or one person of unspecified sex. "alumna" - One female. "alumnae" - Multiple females. "alumni" - Multiple persons whose sex is all mal…

In my experience, most people simply use "alum" for the singular, "alums" for the plural. Dropping the n, even!

Re: NYU Makes Tuition Free for All Medical Students

#148

Earlier quoted context omitted.

IDK. The same thought process led me to not being able to complete college due to financial reasons. Despite being emancipated, FAFSA still considers you a dependent until you're 24. I was told that only with documentation of leaving an abusive household would a dependency exception grant be applied. So according to FAFSA I was supposed to use all this money that I didn't have to pay for college. By 24 I had dropped…

> Just make college free. Sure, have some funding ideas?

I liked the financial transaction tax proposed by Sanders. France, Belgium, and Singapore manage to have this without being known as financial wastelands were no exchanges exist.

Additionally fully nationalize the public schools, and work to remove the administrative bloat that has occurred. I know that the libertarian side here on HN is going to see this and say "more government -> less overhead? does not compute", but hear me out. Their pseudo private status has set up the incentives to de facto remove education from the core mission of universities. Chasing grant money, real estate capital, and investments might technically make them more money, but that flies in the face of what they should be doing, IMO.

Re: NYU Makes Tuition Free for All Medical Students

#149
post #76

Earlier quoted context omitted.

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…

ROTC (military scholarship[1]) pays tuition as you go, so there's no debt incurred. If the military allowed[2], you could study underwater tiddlywinks without any concern for unpayable loans. You're analogy works for academic programs that lead to careers that pay reasonably well. But, not for underwater tiddlywinks - no amount of time spent in that field will allow you to pay down the debt. 1 - They pay for four yea…

> You're analogy works for academic programs that lead to careers that pay reasonably well. But, not for underwater tiddlywinks - no amount of time spent in that field will allow you to pay down the debt.

Agreed, but that’s your onus to calculate the cost/benefit (whatever those benefits may be) of any pursuit, not just academic. It’s just especially important for studying in the US, given the insane cost of education.

Like you said, there’s a skew towards technical degrees, but I think about me and my peers at 18 and man we had no idea what we were doing and had little context for how such a big life decision would affect us down the road.

Re: NYU Makes Tuition Free for All Medical Students

#150
This is probably the other piece of the puzzle regarding the implementation of single payer healthcare.

Because who in their right mind wants to sacrifice 16 years of earning potential, take on 500K of debt only to become an MD with long work days and now prices that are fixed with no other form of negotiation leverage in sight.

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