WASHINGTON (Reuters) - One measure of the troubled state of U.S. health care is the hordes of idealistic young people lining up to fix it.
A generation ago, college kids interested in health would have become doctors or nurses. Some might have picked hospital administration as a career.
Now, with health reform in the headlines and countless families having their own health crises, students are pouring into health policy classes in economics, political science, history, and public health departments. Many plan on making health policy their career.
Aaron Chang, a senior at the University of North Carolina at Chapel Hill, tried one subject and then another before he heard a lecture on health policy by professor Jon Oberlander. Chang signed up for a course with him, worked as an intern on health in the state legislature, and now recommends 600-page tomes on health policy to his friends -- who go and read them.
"I tell some of my friends that are a few years younger then me, if they are interested in politics and what is going on -- take policy courses. Health policy is something that affects us and it's going to affect us in the long run," said Chang, who hopes to attend law school.
"If you offer a seminar or class on health policy or politics, you'll fill it up. We can't meet the demand," said Oberlander, echoing a view heard on campuses across the country.
Students are drawn by the political debate over how to cover 47 million uninsured Americans, the challenge of containing runaway costs, and the growing awareness that quality of care is often tragically uneven.
"There are fascinating economic issues, fascinating politics, fascinating cultural and social issues," said David Cutler, an economist who helped set up a popular new interdisciplinary health studies program at Harvard.
The spike of interest is partly cyclical; the United States is embarking on another debate about health in the 2008 presidential campaign. A student entering college now was scarcely out of kindergarten when the last attempt to overhaul U.S. health care under President Bill Clinton -- and then-first lady, now-presidential contender Hillary Clinton -- fell apart.
The growing recognition of the quality gaps also motivates students. "More people within their own families experience the kind of life-altering events that make health hugely salient to them," said Mark Schlesinger, a health expert at Yale.
The surge in interest extends beyond political debate over cost and coverage. Public health programs in epidemiology, global health and environmental health are expanding as rich and poor countries alike face health risks ranging from bird flu and AIDS to bioterror and climate change.
Students also see health, which makes up about a sixth of the U.S. economy, as a business career.
"Pharmaceutical companies, hospitals, physician group practices -- they all need people to run their businesses. There are a lot of jobs out there," said Dennis Shea, who teaches health policy at Pennsylvania State University.
Idealism is also a motivator.
"If you are a 17- or 18-year-old interested in domestic social policy, you're going to study health care. It's the exciting area of social policy," said Sherry Glied, a policy expert at Columbia's Mailman School of Public Health. Glied and experts at other top schools said they also see more aspiring doctors studying policy alongside chemistry and anatomy.
Lindsay Kennedy Brown entered Johns Hopkins University in Baltimore knowing she wanted to go on to medical school but like scores of other Hopkins premeds she ended up specializing in public health.
"I still want to be a practicing physician but I want to incorporate public health research in my career," Kennedy Brown said. She spent last summer working with a Seattle surgeon developing breast cancer screening programs for poor countries; one of her classes this year will require a final paper analyzing presidential candidates' health platforms.
Outside of specialized public health schools, health economics is booming, as are health law and health business programs. Political science and history departments offer courses on health politics, and medical sociology is also expanding on many campuses.
"Anyone teaching any course about health care gets a ton of students," said Harvard's Cutler. "There are just so many political and social dimensions."