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What is Loan Forgiveness?
- Loan Forgiveness is when a student's loan debt can be "forgiven" (or discharged) by the Federal Government.
- For example, the National Health Service Corps Loan Repayment Program recruits health professionals to provide primary health services in areas that lack adequate medical care. In return, the Federal Government offers loan forgiveness.
- Increases in medical school tuition and high levels of graduating student indebtedness are a growing problem.
- Over 86% of medical school graduates carry educational debt.
- The median debt burden for graduates of public medical institutions has risen to over $119,000 while that for private school graduates has increased to nearly $150,000.
- Medical education debt was 4.5 times as high in 2003 as it was in 1984, growing well beyond the consumer price index.
- Over the past twenty years, median medical school tuition and fees have increased by 165% in private schools and by 312% in public schools.
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Why is Loan Forgiveness so important for geriatrics health care providers?
- Our nation's aging population is growing rapidly.
- By 2030, when the last of the baby boomers reaches the age of 65, the U.S. population aged 65 and older will exceed 70 million - approximately twice the number in 2000.
- The complex problems associated with aging will require a supply of health care providers with special training in geriatrics.
- There is already a shortage of geriatricians.
- As of April 2007, there were only 7,128 board certified geriatricians in the US - one geriatrician for every 2,546 Americans 75 or older. Due to the projected increase in the number of older Americans, this ratio is expected to drop to one geriatrician for every 4,254 older Americans in 2030.
- One reason for the geriatrician shortage is due to financial disincentives.
- The median salary for a geriatrician in private practice in 2005 was $162,977. Geriatricians' compensation is significantly lower than that of most other medical and surgical specialists.
- Low Medicare reimbursement discourages physicians-in-training from entering the field.
- The Government should provide incentives for physicians to enter the field of geriatric medicine.
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What are states doing to support Loan Forgiveness?
As of yet, the federal government has failed to pass any type of Loan Forgiveness legislation to help ameliorate the current shortage of geriatrics health care providers. However, the states below are doing the following:
South Carolina
South Carolina is currently the only state that has a loan forgiveness program that works in recruiting geriatricians. The program provides educational debt forgiveness for geriatricians agreeing to practice in the State of South Carolina for five years. Qualified applicants who are selected for the loan forgiveness program may receive educational debt repayment of up to $35,000 per year of fellowship training.
Oklahoma
In February 2007, Representative Ryan Kiesel (D) introduced a bill that would create the Oklahoma Geriatric Medical Loan Repayment Program. The program would provide educational loan repayment assistance for up to five physicians each year who have completed a fellowship training program in geriatrics, including geropsychiatry. Each loan recipient would be eligible for $25,000 in annual assistance for up to five years. In exchange, the doctors receiving financial assistance from the state would agree to provide medical care in high-need areas of Oklahoma.
California
On February 22, 2008, Assembly Member Patty Berg introduced a bill, the California Geriatric and Gerontology Workforce Expansion Bill of 2008 (AB 2543), that would attempt to fill the growing workforce gaps in geriatric services by establishing a loan assistance program across a variety of disciplines. As part of the program each recipient of loan assistance would have to commit to a minimum of three years of service in a geriatric care setting. The loan assistance amounts will vary by profession, and be available to eligible beneficiaries for up to three years. Those eligible include physicians, osteopathic physicians, dentists, psychologists, registered nurses, and social workers. Anything between $7,500 and $45,000 per year of training would be forgiven.
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What is the status of Loan Forgiveness legislation for geriatrics health care providers at the Federal level?
Caring for an Aging America Act of 2008
Introduced March 4th, 2008 by Senator Barbara Boxer (D-CA), the purpose of this bill is to attract and retain trained health care professional and direct care workers dedicated to providing quality care to the growing population of older Americans by providing loan forgiveness and career advancement opportunities. This legislation establishes the Geriatric and Gerontology Loan Repayment Program for physicians, physician assistants, advance practice nurses, psychologists and social workers who complete specialty training in geriatrics or gerontology and who agree to provide full-time clinical practice and service to older adults for a minimum of two years. The bill also expands eligibility for the Nursing Education Loan Repayment Program (NELRP) to include registered nurses who complete specialty training in geriatrics or gerontology and who choose to provide nursing services to older adults in home and community-based or facility-based long-term care settings. The bill will also establish a health and long-term care workforce advisory panel for an aging America.
Geriatricians Loan Forgiveness Act of 2007 (HR 2502)
Introduced May 24th, 2007 by Representatives Rosa L. DeLauro (D-CT), Ike Skelton (D-MO) and Bobby L. Rush (D-IL), this legislation will provide incentives to doctors and psychiatrists interested in pursuing additional training in geriatrics. Specifically, the measure would extend the National Health Service Corps Loan Repayment Program to geriatric training, forgiving $35,000 of educational debt incurred by medical students for each year of advanced training in geriatric medicine or psychiatry.
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What is the Society's position on Loan Forgiveness?
The American Geriatrics Society (AGS) strongly endorses efforts in support of Loan Forgiveness programs for geriatrics health care providers. The current shortage of geriatrics health care providers will only worsen as America's 77 million baby boomers age. A career focused on caring for older adults can be particularly financially unattractive for physicians with increasingly large medical school loan debts. A loan forgiveness program will provide the incentives needed to bring more providers into the field of geriatrics. Specifically, AGS endorses Senator Boxer's Caring for an Aging America Act of 2008.
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