Doctors' Debts Are Clear; What About the Subsidies?

Today's NYT story "New Doctors Awash in Debt" paints a grim picture for physicians. It graphs ever-increasing educational costs and salaries that fail to keep pace--at least in terms of percent-increase per year. But there are a few parts of the graph that need to be better explained. First, what exactly is the median compensation for specialists and primary care physicians (PCPs)? More importantly, what are the current subsidies that the federal government provides to medical education? Consider this passage from an article in the Chronicle of Higher Education by Katherine Mangan on an apparent physician shortage:

A larger number of graduating physicians also does not guarantee that the physician work force will be appropriately distributed among specialties. In the future, the nation is likely to need more geriatricians and primary-care physicians, for instance, but may need a smaller proportion of surgeons or other specialists. . . . Jonathan P. Weiner, a professor of health policy and management at the Johns Hopkins University[, says that] [t]axpayers end up paying $500,000 to $1-million to train each new doctor through programs such as Medicare and subsidies to state medical schools. . . .

Admittedly, Weiner's estimate is for new doctor education, not present programs. But it highlights a dimension of current health policy debates that few are discussing presently: what is the stake of taxpayers in the current system? As I explain at the end of this post, the challenge for health reformers may be getting pols to recognize the public's already enormous investment in health care--and mustering the courage to use that leverage to improve care.