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Your previous post leads in with: > Ever wonder why the cost of healthcare is so ridiculously expensive in this country? The major point that I make is that p

Your previous post leads in with: > Ever wonder why the cost of healthcare is so ridiculously expensive in this country? The major point that I make is that physician salary is under 10% of US healthcare expenditure, so that's not why healthcare is so ridiculously expensive here, and driving it to 0 would likely make little overall impact. You haven't made the case that a constrained supply of physicians is the reason why there is a large amount of healthcare regulation in the US. Much of that regulation is to the consternation of physicians as much as it is to those who want to innovate in healthcare. Finally, part of the reason that 16 of the top 30 jobs are different subspecialties of physician is that those jobs have existed for quite some time and are cleanly delineated into subspecialty. If you were to break out different roles in investment banks and hedge funds similarly, you'd probably not see physicians in the top 30 list.

joelx 10y ago
I agree completely with you that the large amount of healthcare regulation is the ultimate culprit for the extreme high prices Americans pay. My argument is that the root cause of all of the regulation is not the best interest of the patients, but what is the best interest of the doctors. Doctor backed trade organizations push for more and more obfuscation of the actual price a consumer pays in order to be able to charge more. They don't allow pricing or quality to be openly shared in the marketplace, and they don't allow new entrants to compete. Healthcare is ripe for disruption, but entrepreneurs are prevented from doing so by archaic laws that harm patient care and increase prices. These regulations are vigorously defended by doctor backed trade organizations.. it's in their best interests to keep their cash cow.
- northern_lights 10y ago
  The regulations only look like they're in favor of the doctors to those completely unfamiliar with the field. But who keeps the money from that $8000/night hospital stay? It certainly isn't the internal medicine doc making $200k/year (admittedly a great salary, but not at all out of line with the requirements of the job). I'm an advocate for less regulation in the healthcare industry, but it's not as simple as just throwing away all barriers and allowing the free market to solve everything. Nurse practitioners and physician assistants are new entrants in the healthcare marketplace, and they are absolutely a "disruptive force" in the healthcare market, in the original Clayton Christensen-sense of the term. In fact, these professions were even called out as such in The Innovator's Dilemma. So your argument that new entrants to the market will somehow magically make prices lower doesn't hold much water (and for those who think that these entities should be freed from the regulations which require them to be supervised by a physician...that's like advocating for a large bridge to be designed and signed off by a civil engineer 2 years out of undergrad). As for Certificate of Need laws, which limit the amount of hospitals and sophisticated equipment that can exist in any given area...certainly most doctors I know don't love these laws. It's the hospital associations (made up of many, many people other than doctors) which continually fight to keep them on the books.

joelx 10y ago

I agree completely with you that the large amount of healthcare regulation is the ultimate culprit for the extreme high prices Americans pay. My argument is that the root cause of all of the regulation is not the best interest of the patients, but what is the best interest of the doctors. Doctor backed trade organizations push for more and more obfuscation of the actual price a consumer pays in order to be able to charge more. They don't allow pricing or quality to be openly shared in the marketplace, and they don't allow new entrants to compete. Healthcare is ripe for disruption, but entrepreneurs are prevented from doing so by archaic laws that harm patient care and increase prices. These regulations are vigorously defended by doctor backed trade organizations.. it's in their best interests to keep their cash cow.

northern_lights 10y ago
The regulations only look like they're in favor of the doctors to those completely unfamiliar with the field. But who keeps the money from that $8000/night hospital stay? It certainly isn't the internal medicine doc making $200k/year (admittedly a great salary, but not at all out of line with the requirements of the job). I'm an advocate for less regulation in the healthcare industry, but it's not as simple as just throwing away all barriers and allowing the free market to solve everything. Nurse practitioners and physician assistants are new entrants in the healthcare marketplace, and they are absolutely a "disruptive force" in the healthcare market, in the original Clayton Christensen-sense of the term. In fact, these professions were even called out as such in The Innovator's Dilemma. So your argument that new entrants to the market will somehow magically make prices lower doesn't hold much water (and for those who think that these entities should be freed from the regulations which require them to be supervised by a physician...that's like advocating for a large bridge to be designed and signed off by a civil engineer 2 years out of undergrad). As for Certificate of Need laws, which limit the amount of hospitals and sophisticated equipment that can exist in any given area...certainly most doctors I know don't love these laws. It's the hospital associations (made up of many, many people other than doctors) which continually fight to keep them on the books.