Loan repayment and medical school debt: what about me?

Loan repayment and medical school debt: what about me?

This transcript has been edited for clarity.

Hi. I am Art Caplan. I direct the Division of Medical Ethics at New York University’s Grossman School of Medicine.

Many of you know that President Biden created a loan forgiveness program, forgiving up to $10,000 on federal student loans, including graduate and undergraduate. The Department of Education is supposed to provide up to $20,000 in debt forgiveness to Pell Grant recipients who have loans held by the Department of Education. Borrowers can get this relief if their income is below $125,000 for an individual or $250,000 for married couples.

A lot of people looked at this and said, “Hey, wait a minute. I paid off my loans. I didn’t get any refunds. That’s not fair.”

One group struggling with massive debt is made up of people who are still carrying their medical school loans, who often still have huge debts, and either because of income limits or because they don’t qualify because this debt has been accumulated for a long time, they say: “And me? You don’t want to relieve me?”

This is a subject close to my heart because I am in a medical school, NYU, which has decided for the two medical schools it operates – our main campus, NYU in Manhattan and NYU Langone on Long Island – that we’re going to go tuition-free. We’ve been doing it for a few years.

We did this because I think all of the administrators and professors understood the enormous burden that debt places on people who both defer their undergraduate debt and then have medical school debt. It really leads to some very difficult situations – which we have great empathy for – in terms of what specialty you’re going to go into, whether you have to moonlight and how you’re going to handle a huge debt load.

A lot of people don’t have sympathy in the audience. They say doctors make a lot of money and have a good life, so we’re not going to alleviate their debt. The reality is that whoever you are besides Bill Gates or Elon Musk, having hundreds of thousands of dollars in debt is not an easy task to live with and manage.

Yet when we created free tuition at NYU for our medical school, many people paid high tuition in the past. Some of them said to us: “And me? We decided not to try anything in retrospect. The plan was to accumulate enough money so that we could manage tuition free of charge in the future. We didn’t really have it in our portfolio to help people who had already paid their debts or were struggling with debts at NYU. Is it right? No, that’s probably not fair, but it’s an improvement.

That’s what I want people to think about, who say, “What about my medical school debt? What about my undergraduate debt and medical school? I think we should be grateful when efforts are made to reduce the very expensive student loans that people take out. It’s good to give that edge and push it forward.

Does this mean that no one should receive anything unless everyone with any school debt is covered? I do not think so. I don’t think that’s fair either.

It’s possible that we could continue to agitate politically and say, let’s go after some health debt. Let’s move on to some of the things that still cause people to work more than they would or choose specialties they really don’t want to be in because they have to pay off that debt.

That doesn’t mean the last word has been said on debt relief policy or, for that matter, the price of going to medical school in the first place and trying to see if it can be reduced.

I don’t think it’s fair to say, “If I can’t benefit from it, given the huge burden I carry, then I’m not going to try to relieve others.” I think we are providing debt relief as much as we can. The nation can afford it. Moving forward is a good thing. It’s wrong to create these gigantic debts in the first place.

What are we going to do with the past? We may decide that we need some kind of forgiveness or reparations for loans that have been accrued for others who are backsliding. I would not hold the future and our children hostage to what was probably a very poor and unethical practice of placing doctors and other people in huge debt in the past.

I’m Art Caplan from the Division of Medical Ethics at New York University Grossman School of Medicine. Thank you for watching.

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