In the 1980s, colleges and universities began to lobby for unlimited student loans, arguing that a college education meant higher lifetime earnings. Congress agreed, but schools quickly began charging tuitions and fees that were clearly exploitative - 700% increases are just the average. Before unlimited student loans, you could pay tuition at a public college with money you made working a summer job, now it is a mountain of debt.
The federal government recently proposed debt caps for fields where schools have deceived young people into believing the high costs are worth it. The belief is if you end the bottomless pit of funding schools will curb their excesses and limit tuition hikes. To see what impact that might have, scholars looked at 9,570 respondents and found that over 50% who left said they left the field due to pay. The median student loan balance is over $66,000 while nearly a third carry debt of over $100,000.(1)
That's above the proposed federal loan cap for graduate degrees but in the new paper, rather than arguing that schools need to stop lapping the rate of inflation with tuition hikes, the scholars argue that the status quo needs to continue or health care will be ruined.
That is in defiance of all economics throughout world history. The field already experiences 50% turnover due to high cost. Nurses can't afford to be in it because they care about helping people, they have to chase money due to high debt. And just like with hospitals, the predators are not "for-profit" schools, the greediest cost increases have been colleges and universities. The authors argue that 'debt relief' for those who work in poorer hospitals is the answer - ironically they want to treat the symptom rather than the disease.
Unlimited student loan debt created "credentialism" - to advance in their careers, nurses will be competing with those who have Ph.D.s so they also need Ph.D.s. The authors insisting that a student loan cap will mean less nursing is in defiance of the reality that it will only limit graduate degrees. Pregnant women and children will not suffer due to fewer graduate degrees in nursing, any more than films will suffer if actors need a Ph.D. in theater. Being actors means becoming better actors and practical work improves nurses. It also makes nurses happier, because treating people is why they went into the field, not money.
What America needs are compassionate people who want to be in nursing, and won't be buried in debt to do so. That means government must do the logical thing, what the authors of the recent paper argue against, and place funding caps on debt. Then schools will have to exist within realistic means, and hospitals and clinics can focus on why they went into health care, rather than regretting it.
Citation: Christopher R Friese, Lara Khadr, Deanna J Marriott, Barbara R Medvec, Marita G Titler, Nurses Carry Substantial Student Loans: Health Care Workforce Implications, Health Affairs Scholar, 2026;, qxag019, https://academic.oup.com/healthaffairsscholar/advance-article/doi/10.1093/haschl/qxag019/8436264
NOTE:
(1) It is not lack of funding for hospitals, healthcare cost increases have even dwarfed university tuition hikes, and for the same reason. Government tinkering. Despite what media may claim, the problem isn't for-profit hospitals. Non-profits have become so adept at raking in $60 billion just in government funding that even political allies like New York City mayor Zohran Mamdani and Vermont Senator Bernie Sanders criticize the non-profit hospital grift. Like with universities, they advertise non-stop to make sure popularity stays home and costs are not a factor. And if you run a successful one like NYU Langone you get paid $23,000,000 per year.
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