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They need to deregulate the entire medical industry, so anyone can start a medical practice. Right now, doctors control the supply of new medical licenses, and
by MichaelBurge 10y ago
They need to deregulate the entire medical industry, so anyone can start a medical practice. Right now, doctors control the supply of new medical licenses, and they're incentivized to restrict the supply so their own wages go up. The official line is that they can ensure high-quality medical treatments this way, but that's just something they tell themselves to feel good about it.
One of the consequences is that doctors are beholden to large corporations who have teams of lawyers to handle legal issues and malpractice lawsuits. Since there are limited slots, some of them even work in foreign countries until they get experience to land a job in the US, which is a waste of talent.
If anyone could start a medical practice, a new syringe company could sell to smaller practices that haven't yet been mired in enterprise contracts.
Right now, in order to even build a hospital you have to submit "evidence of need" to the government to get approval. Imagine if every startup had to convince a bureaucrat that they were needed: fewer people would be interested in starting one.
It's probably worth considering moving medical negotiations from insurance companies and employers to the consumer. I don't know that it's very common to call up multiple doctors and find the one with the lowest price, because you're paying your insurance company to do the negotiation for you. Taxing employer-provided health insurance as income might remove the incentive for them to provide it at all. Together with deregulating the entire medical industry, it would make it possible to buy cheap treatment without insurance, which might be enough to make insurance less important.
- maxerickson 10y agoThere's an awful lot of middle ground between what we have now and "anyone can start a medical practice".
- MichaelBurge 10y agoIf I'm reading you right, you're worried about e.g. some crackpot calling himself a doctor who rubs moonstones on an infection to make the evil spirits go away. An unfortunate consequence of "anyone can start a medical practice" is that the crackpot would be allowed to operate, but the negative aspects could be mitigated by: * Somebody starting a "Yelp for doctors" * The government could give some approval stamp to doctors using all the existing restrictions, and you could always ask a doctor "Are you XYZ-approved?" It would be a very serious crime for a moonstone-carrying crackpot to lie about his governmental approval, and his status could be verified on a government website. People who solely use government-approved doctors would still benefit, since licensed doctors would still be competing against unlicensed doctors, so there'd be a limit to how much the government policy could distort the market. * People who repair your sidewalk or furnace often advertise "licensed, bonded, and insured". A furnace can burn your house down, which seems a similar risk to medical malpractice. You could ask your doctor if he's licensed by the government, has put his personal capital into a bond, and is insured.
- maxerickson 10y agoI'm not terribly worried about literal crackpots. I'm skeptical that "Yelp for doctors" will in practice be more efficient than up front regulation about who can provide certain services. I certainly think there are impediments that should be removed, just not all of them.
- flyingfences 10y agoYou're skeptical it is possible for something to be more efficient than the US Government?