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Before everyone loses their minds that somehow this is the free market run amok, keep in mind that healthcare is one of the most regulated and government-involv

Before everyone loses their minds that somehow this is the free market run amok, keep in mind that healthcare is one of the most regulated and government-involved industries not only in the USA but on earth. For example, you can't even construct a new healthcare facility in most states unless a group of bureaucrats agrees there is a "need" for one https://www.investopedia.com/terms/c/certificate-of-need.asp https://www.investopedia.com/terms/c/certificate-of-need.asp Here is an entrepreneurial doctor trying to add MRI machines to his practice, stymied by the glorious government of North Carolina https://www.vox.com/policy-and-politics/2018/7/31/17629526/mri-cost-certificate-of-need-north-carolina-lawsuit https://www.vox.com/policy-and-politics/2018/7/31/17629526/m...

ethbr0 5y ago
To be fair, "I've just been in a car accident and require immediate stabilization followed by airlift to a Level I trauma center" is a process most of us don't think about. There's nothing that says a Level I trauma center needs to exist... except planning (largely by states) to try and ensure it does. And a lot of ensuring availability means balancing profitability against access to the market. A VC firm financing a facility across the street, until it loses interest and both implode financially, is of no good to anyone.
- seibelj 5y ago
  My point is that before people go crazy about a judge not letting people quit, a judge also won’t let you work in this industry simply because you want to. It’s a highly regulated, government-interfered business so nurses being disallowed from jumping to another hospital is not surprising in the context of all the ways the market is managed.
  - lotsofpulp 5y ago
    Requiring person A to have qualifications to sell something to person B is not comparable to stopping person A from selling something B.
    - ethbr0 5y ago
      Parent isn't speaking about just qualifications, but the extent to which the government also controls supply of healthcare professions in the US, largely via its residency funding, and requirements to complete a residency program to practice (to simplify the system to a sentence). https://www.nationalreview.com/2021/10/america-cant-fix-its-doctor-shortage-without-fixing-federal-financing/ https://www.nationalreview.com/2021/10/america-cant-fix-its-... So it's generally accurate to say "You cannot be a physician in the United States without the federal government's permission." (At minimum, indirectly via position funding) And since we generally require a credentialed physician at some point for most care, that trickles down the entire system.
- novok 5y ago
  I think there is a bit of a difference between "we have to make sure a level 1 trauma center exists" and "we will restrict people building more level 1 trauma centers indepedently", which is what I think the parent comment was implying.
  - ethbr0 5y ago
    Those two things are intrinsically related though.

ethbr0 5y ago

To be fair, "I've just been in a car accident and require immediate stabilization followed by airlift to a Level I trauma center" is a process most of us don't think about. There's nothing that says a Level I trauma center needs to exist... except planning (largely by states) to try and ensure it does. And a lot of ensuring availability means balancing profitability against access to the market. A VC firm financing a facility across the street, until it loses interest and both implode financially, is of no good to anyone.

seibelj 5y ago
My point is that before people go crazy about a judge not letting people quit, a judge also won’t let you work in this industry simply because you want to. It’s a highly regulated, government-interfered business so nurses being disallowed from jumping to another hospital is not surprising in the context of all the ways the market is managed.
- lotsofpulp 5y ago
  Requiring person A to have qualifications to sell something to person B is not comparable to stopping person A from selling something B.
  - ethbr0 5y ago
    Parent isn't speaking about just qualifications, but the extent to which the government also controls supply of healthcare professions in the US, largely via its residency funding, and requirements to complete a residency program to practice (to simplify the system to a sentence). https://www.nationalreview.com/2021/10/america-cant-fix-its-doctor-shortage-without-fixing-federal-financing/ https://www.nationalreview.com/2021/10/america-cant-fix-its-... So it's generally accurate to say "You cannot be a physician in the United States without the federal government's permission." (At minimum, indirectly via position funding) And since we generally require a credentialed physician at some point for most care, that trickles down the entire system.
novok 5y ago
I think there is a bit of a difference between "we have to make sure a level 1 trauma center exists" and "we will restrict people building more level 1 trauma centers indepedently", which is what I think the parent comment was implying.
- ethbr0 5y ago
  Those two things are intrinsically related though.