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I believe the American Medical Association (AMA) lobbying congress to shut down medical schools and artificially limit residencies and thus the supply of doctor
by chimi 7y ago
I believe the American Medical Association (AMA) lobbying congress to shut down medical schools and artificially limit residencies and thus the supply of doctors is a much bigger factor.
A lot of people who are capable and motivated to be doctors for good reasons are shut out because doctors don't want there to be more doctors who will serve to limit their wage growth.
- journalctl 7y agoDo you have sources for this? I see this claim a lot on HN.
- chimi 7y agohttps://www.washingtonexaminer.com/thanks-to-doctors-there-arent-enough-doctors https://www.washingtonexaminer.com/thanks-to-doctors-there-a... I also like this 45 minute lecture Milton Friedman gave to physicians telling them how they were making healthcare worse due to this type of lobbying by their representatives. https://www.youtube.com/watch?v=rWlk9HreE7U https://www.youtube.com/watch?v=rWlk9HreE7U
- yourbandsucks 7y agoShouldn't Milton Friedman be complimenting them for pursuing their narrow interests and having faith that it will contribute to the optimal free market outcome? When someone doesn't even buy their own brand..
- chimi 7y agoHe stays quite true to his brand in the video when he chastises them with a list of the many things they have done to destroy the free market in healthcare.
- yourbandsucks 7y agoWhat a fragile free market. You're telling me that the free market requires willing selflessness of players to function? That sounds more like the ghost of Christmas than the invisible hand to me..
- flyingfences 7y agoNo, a free market expects selfish players to function. The adjective "free", however, means an absence of a government that can be lobbied to restrict the market.
- yourbandsucks 7y agoDid you just predicate your argument on the absence of government?
- flyingfences 7y agoThat's the definition of "free market" - free from government interference. You can't call something a "fragile free market" if the market is not free.
- refurb 7y agoWhen the system becomes so unworkable that the govt steps in and starts creating unfavorable rules for doctors, they were actually working against their own best interests.
- yourbandsucks 7y agoSo self interest isn't infallible, is what you're saying? There are coordination problems and externalities? Next you'll be telling me that money isn't speech and maybe we shouldn't let establishment players capture the government.
- coolgeek 7y agoYour source is an opinion article in an outlet deemed right-biased and of mixed factual reporting. https://mediabiasfactcheck.com/washington-examiner/ https://mediabiasfactcheck.com/washington-examiner/ "In the early 1900s, the AMA lobbied lawmakers to shut down many medical schools." That's over 100 years ago. No information is provided as to which schools, or what the AMA's reasoning was behind their decision. Likewise, lobbying to reduce residencies occurred over 20 years ago. The actual reductions were implemented by a Republican Congress and the Clinton administration. "At the time, they argued there was an impending 'glut' of physicians. It is more likely they were, again, trying to protect their high wages." Needless to say, that latter assertion is not in any way supported by documentation.
- vo2maxer 7y agoWhy go through the costly process of training a physician, when in most healthcare a midlevel practitioner would provide appropriate evaluation and treatment? Also it seems that not all stakeholders in medicine are into restricting physician training[1]. (I come into the discussion with a physician’s perspective.) [1] https://www.modernhealthcare.com/article/20140730/NEWS/307309954/iom-report-on-medical-education-questions-doc-shortage-fears https://www.modernhealthcare.com/article/20140730/NEWS/30730...
- chimi 7y agoWe should go through the process of training more physicians, because every day in the USA many people are harmed, up to death, due to there not being enough physicians. We need more midlevels too, I agree, though midlevels are not allowed to do everything doctors can do and are required to have many things approved by a doctor as well. So to increase midlevels would naturally require an increase in physicians. I come to this from the perspective of someone being harmed by the way it is right now and I don't like being harmed.
- vo2maxer 7y agoI don’t mean to underestimate what you’re going through and those in similar situations, but consider the significant harm being done by unnecessary procedures and medications which add no value to a patient’s life. A lot of it is being done by a glut of avaricious physicians in metropolitan areas, particularly those with large elderly populations. Witness end-of-life care with its outrageous in-hospital costs, which again adds little to the quality of someone’s life. This is one of the great scandals in U.S. healthcare. Edit: For whatever reason, I was downvoted on this comment. I’m truly curious to know why. Is it too alarmist? Is it betrayal of my colleagues from someone in the trenches of our inefficient healthcare? Am I just restating the well known? Is it believable? Here is an article which should stimulate continuing discussion[1]. As far as I know, this hasn’t changed. I’m not sure how increasing the amount of medical school graduates and residency spots will deal with the issue described. [1] https://www.propublica.org/article/unnecessary-medical-care-is-more-common-than-you-think https://www.propublica.org/article/unnecessary-medical-care-...
- aantix 7y agoYou need wage growth. It’s half million dollars in schooling and deferred wages.
- bradleyjg 7y agoApplications to medical schools suggest the contrary.