Just Don’t Default by Pat Conrad MD

Being a deadbeat is bad.  Before you complain about the rest of this piece, go back and read the introductory sentence.  Got it?  I have had to pay back student loans, and so have most of you.  They are expensive, and hurt to pay off.  And as far as I’m concerned, it gives me license to run off any argument about “but doctors make too much!”

There are a lot of hardworking folks starting out with student loans, and a huge spectrum of personal circumstances that affect their ability to repay them.  My undergraduate degree is in history, so I have exactly zero sympathy for a liberal arts major who can’t get a six-figure job two years out of college.  But there are a lot of people accruing student debt for technical training in the health care field, including ” registered nurses, Certified Nursing Assistants, pharmacists and opticians.”   A local TV station is reporting that up to 12 states have the legislative authority to suspend the licenses for health care workers with unpaid student loans.  Worse still, they found that the state of Florida – which regulates every job not involving asking whether you want fries with that order – is the only one actively pursuing this, and that “the state’s Board of Health suspended more than 900 health care licenses … in the just the past two years alone.”

I get it, some of these may just be deadbeats, slackers, or lay-abouts.  But as the article notes, some are in tough circumstances, in recent life upheavals, or simply having a tough time starting a career on the lower side of the wage scale.  “The state can garnish up to 100 percent of wages before a health care worker’s license can be reinstated … And under Florida law, once the state suspends a license for student loan default, the only way to get it back is to pay a fine equal to 10 percent of the balance, plus state investigation costs.”  Like the debtors prisons of colonial days, the punishment for default seems to be forbidding the guilty from making any income at all.  I suppose the next step might be to lease some old British prison ships and anchor them in Tampa Bay until we find a new Australia to settle.  In the interim, these defaulters now without a way to pursue the field for which they went into debt will be burdens on the state and no good to anyone.  Does this make sense?  “’You take their license, you take their way of working, how are you going to get your lump sum?’” said registered nurse Andrea Chandler. “’How are you going to get your payment? You’re already not getting your payment.’”  Well, yeah.

A couple weeks ago, I pointed out the value of paranoia when it comes to the federal government telling states what to do with respect to medical licenses.  The connection in this story is that “federal student loan companies spent years lobbying states to adopt laws to punish those who default on student loans by taking away their professional licenses.”  It strikes me that federal student loan companies – which nearly all medical students are required to deal with – would all the more easily be able to lobby the federal government to pressure states over defaulting doctors.  Yes, we get a grace period extending through residency for a period into private practice.  But as this industry continues to decline and squeeze physicians financially, what happens if a job loss, illness, divorce, or some other disruption happens to a doctor five years out of residency?  Could the rules be changed so that the finance company via Uncle Sam could pressure the state of Florida to lien on a defaulting doc?  What if a new cardiologist was fired for low Press-Ganey takes, and missed 3 months of payments while relocating?  Could a finance company complaint allow the state to force him to instead provide primary care in an underserved area until some debt was worked off, on pain of license suspension?  One more strand in the web…

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  1 comment for “Just Don’t Default by Pat Conrad MD

  1. Steve O'
    March 10, 2019 at 12:22 am

    Why bother? In a country rapidly splitting apart into some sort of African dictatorship with no medical care for the vast majority, and the best care for the crooked leadership?

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