One Big Beautiful Bill Will Fuel Doctor Shortage, New York Times Imagines

Plus, Governor Healey Teases on Mass. Millionaire Tax Repeal

“Limits on Loans Could Intensify Doctor Shortfall,” is the headline of a front-page New York Times news article. If this is the best they can come up with to try to derail the passage of the One Big Beautiful Bill, the legislation must not be that bad, because the Times article is ridiculous.

“The bill, which passed in the House last month and carries the president’s support, would cap direct federal unsubsidized loans at $150,000,” the Times reports, fretting that the limit will fuel a physician shortage.

What the Times leaves out is that over the past decade, between 51,000 and 63,000 students a year have applied for the 20,000 to 23,000 spots a year available in American medical schools. Even if the number of applicants declines by half, the constraining factor in physician availability in the U.S. is not number of people who want to become doctors, it’s the limited number of seats in accredited medical schools. That number is limited largely because the existing medical schools have an accreditation process that makes it extremely difficult verging on impossible to open a new medical school. An additional factor is that residency slots for graduating M.D.’s are likewise limited by a combination of regulatory and cartel-type factors, and no medical school wants a reputation for graduating students who do not match for residency.

The Times does mention that private loans might be an option for would-be doctors, but worries that those loans would not be eligible for “public service loan forgiveness.”

There are lots of numbers in the Times article about medical school costs and indebtedness:

Four years of medical education costs $286,454 at a public school, on average, and $390,848 at a private one, according to the Association of American Medical Colleges. Medical school graduates leave with an average debt of $212,341, the association found.

The price of a four-year program in osteopathic medicine is $297,881 at a public school, on average, and $371,403 at a private school, according to the American Association of Colleges of Osteopathic Medicine. The average indebtedness of their graduates is $259,196.

There are zero numbers in the Times article about how much money doctors earn, which might have been useful to include to provide some context for the debt. The Bureau of Labor Statistics has mean (average) annual wages for physicians and surgeons in May 2024 and they run from $450,810 for pediatric surgeons to $222,340 for “pediatricians, general.” It says, “Wages for physicians and surgeons are among the highest of all occupations, with a median wage equal to or greater than $239,200 per year.”

Increasingly, medical school is free. NYU Grossman School of Medicine at NYU Langone Health is tuition-free regardless of merit or financial need. Albert Einstein College of Medicine is tuition-free thanks to a gift from Ruth Gottesman. Johns Hopkins medical school is tuition-free for students from families earning under $300,000 a year thanks to a $1 billion gift from Bloomberg Philanthropies.

Maybe at the margin a cap on direct federal student loans will mean that the bottom-of-the-barrel medical schools will have to reach further into the applicant pool to fill their classes, or that the graduates will be more likely to seek out higher-paying specialties in higher-paying places. But plenty of rural medicine and lower-paying specialties are already being served by foreign-trained physicians.

It’s a good illustration of how low the bar is for getting a bad-news outcome prediction about a Trump policy onto the front page of the New York Times. Yesterday we wrote here about Treasury Secretary Bessent calling CNBC and the Washington Post out about their warnings that tax season would be a disaster because of DOGE cuts to the IRS. In fact, tax receipts were up. There’s no accountability for journalists and editors who make these false catastrophic predictions. If anything, there are rewards, because the negative predictions generate traffic, which is more easily trackable and measurable than accuracy is.

Healey Teases on Mass. Millionaire Tax Repeal: Earlier this week the governor of Massachusetts, Democrat Maura Healey, signaled she’d be open to a repeal of the state’s “millionaire’s tax,” which went into effect in 2023.