COMMENTARY

Cancel Student Debt for COVID-19's Frontline Medical Workers

Kunal Sindhu, MD; Nicholas Gavin, MD, MBA, MS; Courtney Vose, DNP, MBA, RN; Alden Bush, MS, MPH

Disclosures

September 03, 2020

On June 22, 1944, President Roosevelt signed the Servicemen's Readjustment Act — better known as the GI Bill — into law. Among its benefits, the legislation offered World War II veterans tuition assistance and cost-of-living expenses to continue educational or vocational training. In his signing statement, Roosevelt explained, "They have been compelled to make greater economic sacrifice and every other kind of sacrifice than the rest of us, and are entitled to definite action to help take care of their special problems."

In other words, by putting their lives on the line to protect the country, veterans were owed a special debt of gratitude from American taxpayers. America is once again facing an existential crisis, in the form of the deadliest pandemic in a century. Once again, the country owes a special debt of gratitude. And once again, that debt can be paid by assisting with the cost of educational training.

Although all Americans have been affected, frontline healthcare workers have been uniquely risking their health on a near-daily basis. The doctors, emergency medical services workers, nurses, pharmacists, respiratory therapists, and others directly administering care to patients with COVID-19, as well as the laboratory technicians and researchers dedicating themselves to coronavirus-related work, "have been compelled to make greater sacrifice," as Roosevelt described. That is why we are calling for the government to forgive the student debt of healthcare workers on the COVID front lines.

As is well known, in addition to spurring a public health catastrophe, COVID-19 has triggered a devastating economic crisis. Those in healthcare have not been immune. In April alone, nearly 1.5 million healthcare jobs were lost. Even now, months after the pandemic began, the financial health of many hospitals and medical practices remains uncertain.

This is especially troubling for American healthcare workers, who depend on stable employment to pay back the massive amounts of debt they accumulate during their pre-professional and professional schooling. The median student debt for graduate nursing students stands between $40,000 and $54,999. Nearly three quarters of American medical students graduate with a median student debt of $200,000, and 85% of pharmacy students graduate with a median student debt of $170,000.

These debt burdens weigh on the American healthcare workers currently tasked with stemming the tide of COVID-19. Studies have linked student debt to burnout, psychological distress, and a decreased quality of life. A large survey of medical students in 2014 found that student debt "appears to influence the way that students approach major life choices like when to start a family, when to buy a home, and what specialty to choose." Another study found similar limitations for new nursing graduates that directly impact their futures.

To be clear, frontline healthcare workers are not soldiers, and the COVID-19 pandemic is not a war. However, at a time when many intensive care units and hospitals around the country are overwhelmed, these individuals are making tremendous sacrifices to care for their fellow Americans. They are working grueling extended-hour shifts — some without sufficient personal protective equipment and are experiencing significant psychological distress. Although they are at high risk of being exposed to the virus, they continue to show up every day, ready to work. They have been setting aside their fears in service of communities, and a country, that they deeply love.

Forgiving the student debts of these workers would eliminate a source of perpetual insecurity and stress. It would make a life-changing difference in the quality of their lives. It would also help them do their jobs better. And it would serve as an expression of gratitude for the unique sacrifices that America's frontline healthcare workers have made since the pandemic began, in the same way the GI Bill did more than 70 years ago. It is the right and moral thing for the country to do.

Although it shouldn't be the driving factor to do so, canceling the student debt of frontline healthcare workers is also likely to benefit the American economy. In 2018, the Levy Economics Institute of Bard College projected that eliminating all student debt would increase gross domestic product, boost job growth, lower the unemployment rate, and improve state budget finances. The cost would be modestly higher federal deficits and inflation. A smaller, targeted program aimed specifically at frontline healthcare workers would potentially deliver some of these economic benefits at a fraction of the cost.

The excessive costs of education in the healthcare professions and the processes by which students fund their schooling have long needed desperate reform. Healthcare workers should not be graduating with tens or hundreds of thousands of dollars in student debt. Long-term, comprehensive fixes are still years away at best and should absolutely remain a priority. But right now, America should focus on immediately compensating our frontline healthcare workers for their efforts.

On May 5, Representative Carolyn Maloney (D-NY) introduced the Student Loan Forgiveness for Frontline Health Workers Act in the House of Representatives. This legislation would direct the Secretary of Education to forgive the federal student loans of frontline healthcare workers by "[assuming] the obligation to repay" or "[canceling] the outstanding balance of interest and principal due." Crucially, forgiven student debts "shall not be included in the gross income of the borrower" and would thus not be considered taxable income.

At a press conference on the day of the bill's release, Representative Maloney stated, "Healthcare workers are worrying about their own health and how it will affect their families. They should not have to worry about their financial security after the crisis has passed. That is a burden that we can lift right now." She is right.

As the House and Senate leadership consider restarting negotiations with the White House on another coronavirus relief bill, there has never been a better time to forgive the student debt of America's frontline healthcare workers. Our political leaders should not miss this opportunity to acknowledge their tremendous sacrifices, and the medical community should raise its voice in support of this much needed relief.

Kunal Sindhu, MD, is a resident physician in New York City. Nicholas Gavin, MD, MBA, MS, is an assistant professor in the Department of Emergency Medicine at Columbia University. Courtney Vose, DNP, MBA, RN, is vice president and chief nursing officer at NewYork-Presbyterian/Columbia University Irving Medical Center. Alden Bush, MS, MPH, is a doctoral nursing student and university senator at Columbia University School of Nursing. The views expressed in this article are those of the authors only and do not necessarily reflect the views of their institutions.

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