This article is based on reading (some) government reports, not on actual experience reports from medical schools, funding (which has increase), etc. Still, it

This article is based on reading (some) government reports, not on actual experience reports from medical schools, funding (which has increase), etc. Still, it's an important issue and set of data. It's not unreasonable given the training investment to err on the side of avoiding wasted education, and fill gaps with less-trained people. The physician/patient ratio is not a good measure of service availability. Some would say US doctors are more productive. The alternative is not more doctors, but more "advanced practice" providers - Nurse Practitioners and Physician Assistants (or Associates). Their numbers have increased dramatically, and they have taken over anything routine and many ancillary functions of complex cases. PA schools in particular have proliferated, and produced an over-supply of PA's, who depend entirely on having a supervising physician. NP's by contrast benefit from the long history of unionization in nursing, have taken over management in many cases, and restrict the supply at the school level. Overall they top out at what doctors start at, even with decades of experience. It's good for young professionals, but there's not a lot of headroom. As for dependence on foreign schools, the US has more foreign graduates in every field, and most have been hired into hospital systems as a way of combating medical practice groups. The independent medical practice groups almost completely died out, as hospital systems refused to contract out to practices, and instead hired doctors as employees so they could control costs. Recently with private equity targeting specific local monopolies, you're getting specialty practices in radiology, anesthesiology, cardiology (mostly stenting) and now even GI, where the same private equity firm coordinates everyone in a geographical area (and pursues a number of dark-billing practices). There may be small internal practice in the hospital for poor people to get middling care, but the good doctors go into the practice groups. Access to care comes down to logistics (terrible IT) and PCP's being used to reduce care. They hate it, which is why those who can avoid primary care. The other side of supply is loss. Doctors are leaving the profession at a high rate because they're not really doing medicine (and they can afford to leave). They need better systems and adjuncts and more sensitive administration.