2 ms·

This may be partially true, but my anecdotal evidence points elsewhere. I live in a very poor city in the US, and most of the private hospitals here run a surp

This may be partially true, but my anecdotal evidence points elsewhere. I live in a very poor city in the US, and most of the private hospitals here run a surplus. The problem (like in tech) is finding adequate talent. Doctors and nurse practitioners (the people that are licensed to actually provide medical care) are in extremely short supply. The money problem is at the University level. Medical programs are so rigorous and expensive, that schools cannot expand and graduate enough students to meet the demand. Hospitals and clinics are expanding, but medical schools are not. So the students that do graduate and move on to residency are overworked due to lack of adequate staff for the facility (rather than lack of money). Residents are extremely cheap compared to boarded physicians and nurse practitioners. I know personally if the hospitals I work for could hire more residents, they would in a snap, but the local University won't fund the programs. The only solutions are to either get more money into schools to graduate more practitioners, or hope that new technology and innovation can somehow alleviate the burden of work on the existing care providers.

msabalau 10y ago
Or we could open medical credentialing to foreign talent. But that would mean that our trade policy would have disadvantage elites rather simply leaving the working class open to global competition while protecting doctors, lawyers, and content conglomerates.
- eru 10y ago
  That could be part of a solution. Another one is to be very careful about how much training to require for which function. Eg lots of routine work in hospitals could be done by people with less training than a full doctor. Some places around the world are moving in that direction.
ambicapter 10y ago
Maybe we should look into teaching techniques and technologies that would make learning more effective somehow.
wolfgke 10y ago
> The only solutions are to either get more money into schools to graduate more practitioners, or hope that new technology and innovation can somehow alleviate the burden of work on the existing care providers. Why can't hospitals simply say to highschool graduates: We will "sponsor" your medical study, i.e. you won't have to take any debt for medical school education, but afterwards you will have to work, say, 10 years for us (with a priori defined salaries)?
- eterpstra 10y ago
  This does occur in some states. Some students get loans repaid if they contract to work in rural areas for 5 years. I think this is still a symptom of too few graduates. The acceptance rate of US medical schools fluctuates around 20%, so there is no shortage of applicants. There is a shortage of available slots (both in school, and residency positions). According to an old NIH study, a student's tuition only covers about 60% of the cost of a four year med-school education. Universities are also required to pay a portion of the salaries for residents in affiliate hospitals. So lots of money going out of schools, but not much coming in.

msabalau 10y ago

Or we could open medical credentialing to foreign talent. But that would mean that our trade policy would have disadvantage elites rather simply leaving the working class open to global competition while protecting doctors, lawyers, and content conglomerates.

eru 10y ago
That could be part of a solution. Another one is to be very careful about how much training to require for which function. Eg lots of routine work in hospitals could be done by people with less training than a full doctor. Some places around the world are moving in that direction.

ambicapter 10y ago

Maybe we should look into teaching techniques and technologies that would make learning more effective somehow.

wolfgke 10y ago

> The only solutions are to either get more money into schools to graduate more practitioners, or hope that new technology and innovation can somehow alleviate the burden of work on the existing care providers. Why can't hospitals simply say to highschool graduates: We will "sponsor" your medical study, i.e. you won't have to take any debt for medical school education, but afterwards you will have to work, say, 10 years for us (with a priori defined salaries)?

eterpstra 10y ago
This does occur in some states. Some students get loans repaid if they contract to work in rural areas for 5 years. I think this is still a symptom of too few graduates. The acceptance rate of US medical schools fluctuates around 20%, so there is no shortage of applicants. There is a shortage of available slots (both in school, and residency positions). According to an old NIH study, a student's tuition only covers about 60% of the cost of a four year med-school education. Universities are also required to pay a portion of the salaries for residents in affiliate hospitals. So lots of money going out of schools, but not much coming in.