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The Debt and the Cash Flow of Residents: II. And Now for the Future: The End of HEAL?

Thomas L. Walden Jr, PhD
JAMA. 1990;264(10):1249-1250. doi:10.1001/jama.1990.03450100039013.
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To the Editor.—  The Health Education Assistance Loan (HEAL), an important source of financial assistance for medical students, has been targeted for elimination by its insurer, the federal government. This action, proposed in the 1991 budget because of the 8.2% default rate and the physician surplus, would be disastrous for medical students. More important, the proposed elimination is based solely on financial concerns and ignores the health care needs of the American people.The rising cost of medical education since abolition of per capita payments in 1974 and of the National Health Service Corps in 1981 has forced more students to rely on HEAL. Of the $642.5 million allocated to medical students for scholarships and aid during the 1987-1988 school year, 13% was generated through the HEAL program.1The average 1988 graduate from a private medical school had a debt of $48 068. At my school, Georgetown University, where


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