One of the consistent healthcare problems facing the state is the ever-present private sector/public sector divide: in addition to the high costs of receiving health education in a variety of areas (most notably nurses), they are often lured away by the private sector (or other states) that are able to pay them more money.
In turn, college faculty in these fields must often be offered more money to stay and teach others, which creates more of a financial drain on the state itself.
A number of possible solutions for this problem exist: the implementation of loan forgiveness for programs for these fields, expanding nursing education programs, the reduction of excess paperwork for healthcare professionals, and expanding the scope of practice for existing healthcare professionals. While many of these solutions are viable in their own way, it is the implementation of loan forgiveness programs that will be most beneficial to the state over time.
The initial cost of forgiving the loans is still cheaper than having to continually raise paychecks to entice healthcare professionals to stay, and the terms of service attached to loan forgiveness—particularly regarding how many years they must work at a specific location/state to obtain it—ensures that even if they were to leave for another state (or for the private sector), the state would still benefit from years of their expertise. In this case of retaining healthcare faculty, this means years of training the “next generation” so that the cycle can continue.
Current political climate in New York
With its status as such a controversial issue, anything related to healthcare costing the state additional money is going to be scrutinized that much more diligently by citizens. Because of this, one of the more obvious solutions—the expansion of the nursing program itself by opening more slots for nursing candidates—is something of a slippery slope.
The expansion of the program would require an expansion of the faculty who, as already noted, are difficult to retain due to the more lucrative offers they receive from other states and institutions. Even if an expansion of the program could be achieved with a minimal increase in healthcare faculty, it doesn’t really address the problem itself: increasing the number of future nurses might simply increase the number of future nurses who offer themselves to the highest bidder.
Meanwhile, taxpayers will be increasingly paranoid regarding whether this money of theirs is actually benefiting them, or more evidence of a governmental (albeit state governmental) act of throwing money into the health problem without getting results.
The reduction of excess paperwork for healthcare officials is another idea that looks good on paper (no pun intended) but could be politically disastrous.
While the existing healthcare professionals see excess paperwork like other veterans of other professions do—as a waste of their time—the public sees the excessive paperwork as a series of safeguards against malpractice.
If something is out of sort with their care and the doctor doesn’t catch on, then there’s a possible chance that the other professionals who will encounter it in its journey through the filing system might.
Economically, too, the issue can be controversial: as citizens complain about the cost of doctor’s visits and the cost of healthcare being taken from their tax money, even the appearance (however minor) that their care is being given less scrutiny and attention is one that will set the attack dogs of conservative radio on the state of New York in no time.
One solution that would be ideal (aside from the court of public perception) is the idea of “widening the scope” for healthcare professionals. This idea is fairly straightforward: it would allow more professionals to do more tasks, such as allowing dental hygienists to do more things that only dentists can currently do, freeing up the pool of talent to exercise that talent in areas where it is more needed.
This idea is another one that would be crucified by political opponents, because it gives the appearance that one is getting less high-quality care from less highly-trained people for the same costs.
Like the previous idea, this is tied into an economic dimension as well: since people are still paying the same amount they did previously, then receiving anything less than the same level of service (even when, in reality, they were receiving too much—it doesn’t take a twenty-year dental veteran to perform a routine screening) would be politically suicidal.
In a worst-case scenario, this might actually increase the number of healthcare professionals leaving for more lucrative opportunities elsewhere, as they will get the idea that they are no longer needed when more and more of their routine tasks are being given to various assistants.
The ideal solution
As you can see, part of the reason that the loan forgiveness for healthcare professionals is the ideal solution is because it is not a politically controversial issue.
While there may still be conservative grumbling regarding where the money for loan forgiveness comes from, this has the political effect of making healthcare professionals more relatable to the general public: everyone hates owing the government money, and if the issue is spun as it should be—namely, that this will allow the state to offer a higher level of quality healthcare from a larger pool of healthcare professionals than they have previously had—then public approval should be quite high.
After all, of the proposed solutions, this is the only one that does not give the appearance of the public receiving less quality of care than they previously had received.