Michael Braun's Blog

Today, on Madison.com, and probably published in the Wisconsin State Journal, there’s a story about the pains of living far from a major hospital, specifically in the rural communities that dot northern Wisconsin. These communities are too small to support a for-profit medical practice and too removed to be attractive to many (if any) doctors. It would be a sacrifice to go and serve a rural community as a doctor, especially when many need to begin making a good salary so as to pay off their substantial school debts. So what’s to be done? It’s not fair to ask these people to move, especially as rural communities are vital to food production. It’s also not fair to ask them to pay excessive amounts for health care, such that a doctor could be lured to the area. It’s time for the government to step in with a program to help pay for medical education and help rural towns at the same time.

The program need not be complicated. Students admitted to medical school agree to serve a term in a rural community for a period of five years. Their placement is selected by the government based on need; the student is allowed to rank states, so as not to move them too far away from family or friends. In exchange, the student has their debt forgiven after the five years of service. The student could also be provided with incentives like a car (as rural doctors may be required to make home visits or provide other services), a housing stipend, or a flat-rate salary (with insurance payments going to the community or to the government). Interested communities must provide a community health center that meets certain requirements and may be asked to contribute to the doctor’s salary.

It’s hard to imagine that there would be many medical students completely opposed to this idea. It could even prove too popular, necessitating a more selective application process. Some students who participated in the program might even find that the rural life suits them well. Being a community doctor is likely to carry more cache than working in a big city in a large medical practice or hospital. And the cost of living would be much lower too. The program would likely be popular with communities as well. There may even be communities who would propose to enact the plan themselves, offering a partial or total payment of debts in exchange for service. And the government (state or federal; you’ll notice I haven’t been specific) may find that the program could work for other jobs that are in high demand. Overall, it seems like a win all around. Any bets on which political party would support the plan and which would arbitrarily try to block it?