No they haven't and that's the point. People who came before us had way less in loans and their interest rates were reasonable too. People who graduated a decade or so ago paid less than than half what we are paying and they were able to consolidate at reasonable rates, around 2% or so.
Calling us out for numbers pulled out of thin air then citing 2% as the interest rate? They had drastically higher interest rates then we have.
http://www.finaid.org/loans/historicalrates.phtml shows how during the 90s only 1 year (1993-94) did Stafford loans have a
lower interest rate than today's fixed amount. During 2000-2010, the variable rate for Stafford loans was lower on average, but averaged 4.3% rather than 6.8% - not 2%.
They also didn't have the interest compounding during medical school and could defer payments in residency if I recall correctly. I believe this was changed three years ago but I could be wrong about that, don't have time to check. Our current interest rate is 6% and will go up. (this is for the first 40k you borrow and you are almost certain to borrow grad plus loans which have a higher fee and interest rate associated with it). Interest is compounded as soon as you accept the loan (with a hefty fee taken out).
They did have interest compounding, hence the in-school rate which
was different than the fixed rate we have now. They were given forebearance, just like we are - payments are deferred, but the interest is still accrued on the total. The only feasible difference is that older physicians didn't have to take out as large PLUS loans, because if they did, they had even higher interest rates than the 8.5% we have now (on average 8.58% during the 90s and lower, but not as drastic as you are suggesting, 5.83% average from 2000-2010). Sure you could consolidate these loans, but consolidation just means that you're taking all of your loans and making it into 1 amount with an interest rate equal to the weighted average of the individual loans' interest rates.
Tuition is probably around 35k for state schools and 50k for private schools and increases by ridiculous percentages yearly. These things are all relatively recent phenomena.
Take a look at this graph:
http://avillage.web.virginia.edu/iaas/instreports/studat/dd/fees.htm#medicine
People were concerned about affording medical school over a decade ago even when things were "easier" as you say. This thread is from 2002:
http://forums.studentdoctor.net/threads/can-i-pay-for-med-school-and-survive.52672/ and has a wonderful
post about how to reduce your expenditures. And another thread from 2003:
http://forums.studentdoctor.net/threads/how-do-you-pay-for-medical-school.110644/. As you so astutely pointed out, tuition rates are skyrocketing, but medical professionals' compensation is also increasing. While physicians' salaries are not holding pace with inflation rates and the consumer price index, AND is far surpassed by the increase in tuition rates, physicians from over a decade ago qualified as the top 5% of earners. Ultimately the huge up front costs just knock physicians from upper class to middle-upper class (200k annual earnings is currently the 94th percentile of earners).
And despite all questioning of the nmbers, programs like IBR and PAYE can be taken advantage of if needed and are actually better alternatives for the lower earning physicians who cannot afford traditional loan repayment. Although frankly I'd rather live poor and pay everything off in the first decade rather than continuing to pay for 2.5 decades.
The fact remains that unweildy amounts of debt can be handled in a systematic fashion to ensure paying it off in a relatively short amount of time (10 years). ITT@chenzt has shown that an average current-day physician making 200k/yr can live comfortably (50-60k) until all the loans are repayed.
You also forgot to propose an alternative to being proactive and forthcoming with your expectations. If the proposed method of repayment (10 years for repayment at 200k/yr salary) seems unreasonable, what alternative is there? or are you saying outright that it can't be done?