Med students weigh in on health reform

Medical student Nicklaus Atria at work at the University of Miami Pediatric Mobile Clinic

TEXT OF STORY

Kai Ryssdal: There's word today that the Senate Finance Committee's going to vote on its health-care bill on Tuesday. That's clearly not going to be the end of the health-care debate but to paraphrase Winston Churchill, it could be the end of the beginning. A point of departure for yet more negotiations. Whatever the final bill does looks like, it's going to affect today's doctors quite a bit. Tomorrow's, too. As part of our continuing series, The Cure: Remaking Health Care in America, Joel Rose asked medical students what they think of all the proposals floating around.


JOEL ROSE: With her clipboard and long white coat, Manasa Ayyala could be auditioning for the cast of "Grey's Anatomy" as she examines her instructor's scalp in a classroom at Temple University School of Medicine in Philadelphia.

MANASA Ayyala: So now I'm going to palpate your skull, apparently. OK, so...

Ayyala is starting her second year of medical school. She plans to go into primary care. She recently talked about her choice with her own doctor. Now he thinks she's the one who should have her head examined.

Ayyala:
I've always wanted to go into primary care, and just hearing that from my own physician -- don't go into primary care -- is really disheartening.

Primary care doctors earn a lot less than specialists like radiologists and cardiologists. That's a big reason they're in such short supply. The country will need 40,000 new primary care doctors by 2020. President Obama says he'd like to close that income gap. But whether he will is one of many uncertainties about the health-care overhaul.

ISMAR Dizdarevic: We're being asked to make a decision on what we want to do, what kind of career path we want to take, without really knowing where it's heading.

Ismar Dizdarevic is a third-year medical student across town at Thomas Jefferson University. He's wanted to be a doctor since he came to the U.S. with his parents during the Bosnian civil war.

Dizdarevic: I'd really like to be able to work with a refugee population myself. But at this point, it's kinda unrealistic that I'm going to be able to do that.

Unrealistic because Dizdarevic will graduate with more than $200,000 of student loan debt. So he's training to be an orthopedic surgeon. The White House wants to create more programs that forgive loans for primary care doctors. And the administration would like to boost their Medicare reimbursements. But that boost comes at the expense of specialists.

Gary Weissman isn't worried. He's a third-year medical student at Jefferson.

GARY Weissman: And I think in most other countries that specialists don't make nearly as much as they do in the United States. So I think it would be a more equitable system. There aren't any poor doctors anywhere.

There's another big question that divides medical students, and that's whether the health-care overhaul will include a government-run insurance plan, the so-called public option.

GREG Corcoran: It doesn't seem like they're considering much how this reform is going to affect doctors.

Greg Corcoran is a second-year medical student at Jefferson. He's planning to go into a specialty, though he hasn't decided which one. Corcoran opposes the public plan. His reasons may sound familiar.

Corcoran: They're trying to model if after Medicare. But I just think anything left up to the government is guaranteed to have some inefficiencies.

Corcoran also thinks a public plan would lead to lower salaries for doctors. But there are lots of medical students who support the idea, including Beth Hart, a second-year student at Temple.

BETH Hart: Cause that's the only chance of real reform happening. Everything else is just tweaking, and whatever. It's not reform.

Not all medical students have such strong opinions about the health-care overhaul. In fact, lots of the ones I talked to have no opinion at all. They're busy enough just trying to make it through their classes.

In Philadelphia, I'm Joel Rose for Marketplace.

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