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You're at the Bedside, Make a Diagnosis, Give Us Your Ideas
House of Representatives - September 21, 2005

The following are prepared remarks that McDermott spoke from at the "Undergraduate Medical Education Summit." held in the Rayburn House Office building.

Thank you for asking us to share some thoughts as you open this summit on financing undergraduate medical education.

Throughout his distinguished career, Fitzhugh Mullan has provided the kind of thought-provoking leadership in research and practice that has improved the lives of people and the profession you aspire to join.

"Summit" means the highest point, the top of a mountain, and I think it is the right word to describe the challenge you face. Each and every one of you will face a mountain of debt on the road to a career in medicine.

I believe it is time to ask the question: Is there another way?

Let me ask for a show of hands. How many of you have ever played the game "Monopoly?" You all know in Monopoly, one or two lucky players pick up a "Get Out of Jail Free" card. Well, I have something just as good, maybe even better. A member of my staff staff is going to pass out a card. It's about the same size as a monopoly card. Wrong color but that's okay.

As you look at the card, you may think it is merely my business card, but I want you to think of it as something else. This is a "Get Out of Medical School Debt Free Card." The back is blank because you have to fill it in. Write down your ideas and give the cards to Dr. Mullan before the summit is over. He'll get them to me.

I believe there is at least one solution, so let me tell you my idea: A one-for-one trade. One year of medical school free and clear for every year of public health service you commit to immediately following graduation. You get all or part of your medical school paid for; America gets a steady stream of talented doctors working where the need is great-- and greatly underserved today, places like the inner city, native reservations and rural America.

Does this idea interest anyone here?

When I graduated medical school, and it wasn't all that long ago, my medical education debt was $500 dollars.With few exceptions, each of you will owe something like $150-350,000 dollars by the time you become doctors.

It's hard to comprehend a mountain of debt that high. But it's not hard to understand the consequences. How do you work for next-to-nothing in an inner city clinic when you're staring down a significant house payment, without the house? How do you bring your medical skills to rural America when you can't earn enough to chip away at the debt and eat at the same time?

The system today--- and its mountain of debt--- forces young doctors to make choices based on debt service, not community service. We've got to change that. I believe we can change that. If you don't like my idea, give me another one.

I believe we need to undergo a philosophical change in our nation and it should begin by addressing where you are--- undergraduates preparing for medical school. We don't adequately fund higher education. We hear lofty rhetoric from the White House, but the President does not walk the talk. We're short on funding and long on promises.

Here are my ideas. We need to allow students to consolidate their undergraduate loans and we need to increase the use and availability of the federal direct loan program. What are your ideas? Tell me. Write them down.

Does anyone in this room doubt that America faces a health care crisis? In my judgment, there is a health care crisis, but we are not facing it. Instead, we're using band aids. The Republican majority talks about medical malpractice reform as if this will solve all of our problems. The truth is, in the real world, medical malpractice amounts to a small fraction of the problem and solution.

America needs real reform and America needs the passion, commitment and talent of future doctors like you. There are others who ought to be in this room today but aren't, because they can't accept a debt burden that is a mountain higher than Everest. We've got to change that

The health care system in America today is like a patient on life support. The outcome could go either way.

You're not on the sidelines. You're at the bedside. Make a diagnosis. Give us your ideas.

I expect to get all these cards back in a few days-- with ideas. I'll speak about them on the floor of the house and share them with Representative Price. You may well hold the solution. I'll give you the forum; don't sit back and stay silent.