Clearly there are multiple factors in play, and it is simplistic of me to pin all the failings of the USSR on central planning. (Which is the essence if my root

Clearly there are multiple factors in play, and it is simplistic of me to pin all the failings of the USSR on central planning. (Which is the essence if my root post, planning is hard and only one small part of the political environment.) Clearly geographical, climate, and population dynamics (Not to mention war damage) of the US , USSR and Japan post WW2 are enormously varied. >> the government stopped subsidizing medical schools That's part of it, yes. The other part and perhaps more damaging part, is the moratorium on creation of new schools, and the measures to actively reduce the ability of hospitals to offer residency positions. Given a finite money supply the feds have to pick winners and losers for receiving money. However introducing policy, beyond money, has more impact on outcomes. The libertarians would argue that the policies caused the shortage, not the lack of money. (As evidenced by the US citizens training outside the country.)