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Tuition alone at private medical schools is ~$40,000/yr, with some schools much higher than that. So, $160,000 for tuition alone for four years of medical school. Fees, living expenses etc. during that time add easily another $80,000 - $100,000 over the four years, and it's very difficult to work or earn much during that period because of the demands of the training. This, after four years of undergraduate university training that could easily have cost $100,000 or more. With interest on loans, etc., it is very easy to owe 100s of thousands of dollars when you graduate from medical school, at say 26-30 years of age if you take the quick route.

So, then you start residency training, during which you often work 80+ hours per week (used to be worse) and make a starting salary in the $35,000 - $45,000 range, and your loans are coming due. The shortest residencies are 3 years, and many go on for five years. Then, if you sub-specialize, you do a fellowship, also for relatively low pay for an additional three to seven years. After that you can go out and start practicing.

If you go private you will be the low man/woman on the totem pole and thus make significantly less than others in the group, and often be saddled with extra holiday and weekend call. The bottom line is that it's not going to make sense to people to go through that if at the end of the day the government decides what you can earn, and if you can earn as much or more doing other things that require less years of training and time commitment.

I'm in complete agreement with your assessment. That's another issue that does not get brought up enough is this whole debate: the projected shortfalls of both doctors and nurses. Common sense would dictate that if you are going to add millions of people to the roles of the insured rationing of health care is a given.

The ignorance of our community organizer and chief in this, and most matters is breathtaking. In one breath he's telling us that Wall St. will play a less dominant role in America's life and that traders should now become engineers and computer programmers while in the next breath he's pontificating the value of universal health care. Where are these additional doctors and nurses going to come from? Thin air? And as you've stated, where is the incentive to become a doctor, with all of the expense in time and treasure involved, only to be told what you can make and what patients you'll be required to administer to? These questions do not have easy answers as he will soon find out.