4 ms·

"Medical schools/the AMA are artificially limiting the number of students and residents for their own ends (keeping wages and scarcity high) so they need to cha

"Medical schools/the AMA are artificially limiting the number of students and residents for their own ends (keeping wages and scarcity high) so they need to charge a lot." That is the peril of this type of analysis. Clinician cost is only 20% of total healthcare spend. Your premise is flawed so your conclusion is invalid.

oarabbus_ 7y ago
His premise is not flawed; yours is. Looking only at clinican costs is akin to saying that a sandwich should only cost $1.50 because that's the cost of the ingredients. Doctor wages tie into personal health insurance, medical malpractice insurance costs, hospital system insurance costs, and more. Even if you were correct on the cost bit (you aren't), you're completely ignoring that artificially constraining the SUPPLY of doctors causes massive cumulative ripple effects adding up to significant costs across the system. The AMA is absolutely a cartel restricting supply and artificially keeping wages high. Have you taken a look at any other health care system in the world?
- throwaway5752 7y ago
  You just proved my point, you know that right? It's the healthcare delivery and the markups along the way. If you paid doctors $0 tomorrow, healthcare costs would go down by 20%, at best, and probably less. Your analogy is perfect, actually. The problem in sandwich cost is rent, utilities, administrative expenses, marketing, an acceptable return on investment to the owners, etc, etc. The actual good being sold, a sandwich, probably costs 10% of what you pay retail. Your repeated use of the phrase "cartel" is not impressive or convincing to me. In every other field: civil engineers, lawyers, real estate agents, accountants, teachers, police, and countless others have licensure, education, and training requirements. And thanks for you concern, but I am familiar with many other global heath systems. I notice you ignore LNPs and PAs in your analysis.
  - oarabbus_ 7y ago
    On the contrary, you proved mine. I worked in medical devices and hospitals for a significant portion of my career, and I really don't care that you aren't impressed by the term "cartel", that's your prerogative to turn a blind eye to the facts. It's a combination of inflated salaries plus numerical shortage of doctors (the two are related) causing the root issues here. You claim to be familiar with other health systems; care to explain why in every other developed nation where doctors are not so overpaid, health care costs are reasonable? NPs and PAs are not allowed to perform a significant number of medical procedures; I see you ignore that, conveniently, and bringing it up isn't much other than a red herring. The "cartel" term has been used both colloquially and in academic literature for quite some time: https://www.jstor.org/stable/2352286?seq=1#page_scan_tab_contents https://www.jstor.org/stable/2352286?seq=1#page_scan_tab_con... Here are some other reading links. http://www.jparksmd.com/blog/a-massively-overpaid-cartel http://www.jparksmd.com/blog/a-massively-overpaid-cartel https://wallstreetpit.com/5769-medical-cartel-md-salaries-high/ https://wallstreetpit.com/5769-medical-cartel-md-salaries-hi... https://www.forbes.com/sites/timworstall/2017/06/04/milton-friedman-told-us-the-answer-decades-ago-now-itll-probably-be-ibms-watson/#363863b61bce https://www.forbes.com/sites/timworstall/2017/06/04/milton-f... https://fee.org/articles/the-medical-cartel-is-keeping-health-care-costs-high/ https://fee.org/articles/the-medical-cartel-is-keeping-healt...
    - deleted 7y ago
      [deleted]
    - throwaway5752 7y ago
      For the record I want to say that the second link you pasted - http://www.jparksmd.com/blog/a-massively-overpaid-cartel http://www.jparksmd.com/blog/a-massively-overpaid-cartel -actually argues against even more effectively than I was able to.
      - oarabbus_ 7y ago
        I'm very glad you pointed that out; I mean, jparks makes the same claim you make - that salaries aren't the problem - and doesn't address the artificial restriction of doctors at all. In other words, he fails to refute the "AMA isn't a cartel" claim. If you prevent the AMA from artificially restricting doctor supply, the overall cost of health care drops significantly, and the health of the population increases considerably. As a consequence of the overwhelmingly positive benefit of lifting the artificial supply of MD (or DO), doctor salaries will naturally drop, as necessitated by economics.

oarabbus_ 7y ago

His premise is not flawed; yours is. Looking only at clinican costs is akin to saying that a sandwich should only cost $1.50 because that's the cost of the ingredients. Doctor wages tie into personal health insurance, medical malpractice insurance costs, hospital system insurance costs, and more. Even if you were correct on the cost bit (you aren't), you're completely ignoring that artificially constraining the SUPPLY of doctors causes massive cumulative ripple effects adding up to significant costs across the system. The AMA is absolutely a cartel restricting supply and artificially keeping wages high. Have you taken a look at any other health care system in the world?

throwaway5752 7y ago
You just proved my point, you know that right? It's the healthcare delivery and the markups along the way. If you paid doctors $0 tomorrow, healthcare costs would go down by 20%, at best, and probably less. Your analogy is perfect, actually. The problem in sandwich cost is rent, utilities, administrative expenses, marketing, an acceptable return on investment to the owners, etc, etc. The actual good being sold, a sandwich, probably costs 10% of what you pay retail. Your repeated use of the phrase "cartel" is not impressive or convincing to me. In every other field: civil engineers, lawyers, real estate agents, accountants, teachers, police, and countless others have licensure, education, and training requirements. And thanks for you concern, but I am familiar with many other global heath systems. I notice you ignore LNPs and PAs in your analysis.
- oarabbus_ 7y ago
  On the contrary, you proved mine. I worked in medical devices and hospitals for a significant portion of my career, and I really don't care that you aren't impressed by the term "cartel", that's your prerogative to turn a blind eye to the facts. It's a combination of inflated salaries plus numerical shortage of doctors (the two are related) causing the root issues here. You claim to be familiar with other health systems; care to explain why in every other developed nation where doctors are not so overpaid, health care costs are reasonable? NPs and PAs are not allowed to perform a significant number of medical procedures; I see you ignore that, conveniently, and bringing it up isn't much other than a red herring. The "cartel" term has been used both colloquially and in academic literature for quite some time: https://www.jstor.org/stable/2352286?seq=1#page_scan_tab_contents https://www.jstor.org/stable/2352286?seq=1#page_scan_tab_con... Here are some other reading links. http://www.jparksmd.com/blog/a-massively-overpaid-cartel http://www.jparksmd.com/blog/a-massively-overpaid-cartel https://wallstreetpit.com/5769-medical-cartel-md-salaries-high/ https://wallstreetpit.com/5769-medical-cartel-md-salaries-hi... https://www.forbes.com/sites/timworstall/2017/06/04/milton-friedman-told-us-the-answer-decades-ago-now-itll-probably-be-ibms-watson/#363863b61bce https://www.forbes.com/sites/timworstall/2017/06/04/milton-f... https://fee.org/articles/the-medical-cartel-is-keeping-health-care-costs-high/ https://fee.org/articles/the-medical-cartel-is-keeping-healt...
  - deleted 7y ago
    [deleted]
  - throwaway5752 7y ago
    For the record I want to say that the second link you pasted - http://www.jparksmd.com/blog/a-massively-overpaid-cartel http://www.jparksmd.com/blog/a-massively-overpaid-cartel -actually argues against even more effectively than I was able to.
    - oarabbus_ 7y ago
      I'm very glad you pointed that out; I mean, jparks makes the same claim you make - that salaries aren't the problem - and doesn't address the artificial restriction of doctors at all. In other words, he fails to refute the "AMA isn't a cartel" claim. If you prevent the AMA from artificially restricting doctor supply, the overall cost of health care drops significantly, and the health of the population increases considerably. As a consequence of the overwhelmingly positive benefit of lifting the artificial supply of MD (or DO), doctor salaries will naturally drop, as necessitated by economics.