it isn't a matter of being able to pay the loans back, it's a matter of opportunity cost (she is a doctor so will be able to pay the debt back, but if she had a better understanding of finance when she took the loans she would have done some things differently). If you really want to start a company for example, having a lot of debt rules that out. So maybe if you want to keep optionality to start a company, you go to a cheaper public college instead of taking a loan to go to a private one, or you decide to work instead of grad school, or you just save more. If you don't understand the opportunity costs of debt, it's hard to make those choices