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Comment by syntaxing | Hacker News Reader

In certain Asian countries, medical education is 100% covered but you must work at a public hospital for X years. I honestly think it’s very fair. If tax payers full funds your education, it should be mandatory to work in public services for X amount of years.

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This is common for teachers in many US states too -- spend X years teaching where we need you the most and we cover your degree.

In the US a teaching degree might be $50,000, and medical degree might be $500,000. I'm not sure I want my state government covering half a million in education costs for one person... I know that we need doctors but I'd want to see some ROI numbers to justify such a high expense.

The National Health Service Corps (NHSC) Scholarship Program and Indian Health Service Scholarship Program will pay for medical school in exchange for agreeing to work in underserved areas for several years. Some states have similar programs. I'm not sure how you would even begin to calculate ROI for that.

https://www.congress.gov/crs-product/R44970

It's complex and imperfect, but in this situation the most direct ROI would be the cost of recruiting a newly graduated doctor by increasing the salary until someone accepts compared to the cost of providing the scholarship.

There was an article posted on HN recently about the asymmetry in cost of providing an ambulance service vs the cost of the per-ride service. The cost of a medical degree, and the training on top of the degrees, may seem waaay too high but I am sure that when you need the service you want it to be there. I think if I break a leg, need an emergency surgery, etc I will be okay with $0.00001 of my taxes going into the pile needed for paying off those $500k loans.

At least in the US, the dudes who pick you up in the ambulance do not have medical degrees. They have various certifications that are far less than med-school levels of debt.

I think part of this is the organization of the training. Cuba trains doctors for likely much less than $500k USD. Also, the training we give to a US solider is very expensive but we have "productionized" the process. The people who provide the training are employed by the military, the training is standardized, etc. Maybe a similar approach could work for other skills. Remember, our military trains surgical assistants and nuclear engineers! These are expensive degrees but they manage to do it.

One of the teachers I know had to pay for 7 years past their forgiveness date of 10 years teaching because of the student loan shenanagains in the early 202's and then the shutdowns. Luckily finally she got the loan closed ans is still waiting on the 10% back for paying over.

That is essentially how it works in the US as well thanks to public service loan forgiveness for physicians.

Yep, that's common in many countries for doctors. Not much for anything else(maybe teachers too) and how much X is good enough is debatable.

Certainly common resources are very vulnerable to incorrect pricing and profiteering.

In the past there are many cases where local populations were deprived from their vital needs because some king/queen/sultan/khan etc needed that more.

There are programs that work this way in the US too. Most doctors arent interested because the pay cut you take working for the poor hospitals/military for a decade arent worth the paid off loan.

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