6 ms·

It's weird how there's a scarcity of all the important things--physicians and medical specialists, houses, cars, etc. Why can't is supply not increasing to meet

It's weird how there's a scarcity of all the important things--physicians and medical specialists, houses, cars, etc. Why can't is supply not increasing to meet demand? It seems like our modern economy has lost focus on the basics. It seems like a scam more than anything.

polygamous_bat 3y ago
The age of value creation has passed us by, now is the age of value capturing. If you're creating value, you're a loser to those who specialized in capturing the value you produce.
hardtke 3y ago
The supply of doctors in the US is primarily limited by the number of residency slots. Unlike many countries, foreign medical graduates can't practice here without doing a residency. I think the number of residency slots is kept low by the federal government (which funds them) and also by physician organization lobbying.
- maxerickson 3y ago
  There aren't rules against entities other than the federal government funding a slot.
- fallingknife 3y ago
  Why does the federal government need to fund residency slots? They generate tons of billings and get paid next to nothing. Should be very profitable.
  - HDThoreaun 3y ago
    they're not. As far as I understand every single one loses money before accounting for federal subsidies. Many are actually closing.
- diogenescynic 3y ago
  Exactly, just like the number of homes is artificially limited by zoning, permitting, etc. It's all artificial scarcity and it's for life's essentially--which is why I said it's a scam because it seems intentional.
bboygravity 3y ago
This is a clear consequence of devaluation of currencies (inflation). It's documented to have happened at least as early as with the romans. The exact same things happened that we're seeing now: people made less babies, rich got richer, the middleclass turned into poor(er), most people stopped being productive and switched to rent seeking (owning land and properties became the goal instead of actually making things or delivering services) and so on.
crooked-v 3y ago
> houses This particular one is a self-inflicted problem in most major US metro areas, by way of medium density housing being explicitly or implicitly banned for decades.
8f2ab37a-ed6c 3y ago
Are not all of these caused by some form of gatekeeping or artificial restriction? Of course some of that is benign and intentional, such as only letting people practice medicine after they've been thoroughly trained and certified, but are we perhaps restricting access to the things you list too much?
- diogenescynic 3y ago
  Exactly. Most of the things I listed are artificially scarce--they are intentionally restricting new supply. These are not issues in other countries. That's why I called it a scam.
groby_b 3y ago
Inelastic supply is a well-known phenomenon. The usual reasons are "it's hard to add supply" or "suppliers are working at full capacity" The medical field has both. Suppliers are working at capacity - there's a limited amount of residency spots[1] Increasing supply is also incredibly hard, because it has a decade+ of lead time. Neither one of those "our modern economy" can fix. The latter requires loosening training requirements. That's why we have Nurse Practitioners, which folks are loudly complaining about a few threads above. The number of residents is capped because new residents cost money. Hospitals used to make up for that by relying on Medicare, but that funding hasn't been increased. And so the economy works exactly as designed, the expensive good of "residency slots" is only offered to a limited amount, where it makes financial sense. It doesn't matter that additional doctors would make sense, the hospitals can't make money of more residency spots. Existing doctors don't complain, because it drives their salaries up. All of this very much makes the eloquent point that our modern economy is not the right tool for education or medical services. It can't work, given the forces around it. And so it goes. [1] https://www.medicaleconomics.com/view/match-day-2023-a-reminder-of-the-real-cause-of-the-physician-shortage-not-enough-residency-positions https://www.medicaleconomics.com/view/match-day-2023-a-remin...
local_person 3y ago
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polygamous_bat 3y ago

The age of value creation has passed us by, now is the age of value capturing. If you're creating value, you're a loser to those who specialized in capturing the value you produce.

hardtke 3y ago

The supply of doctors in the US is primarily limited by the number of residency slots. Unlike many countries, foreign medical graduates can't practice here without doing a residency. I think the number of residency slots is kept low by the federal government (which funds them) and also by physician organization lobbying.

maxerickson 3y ago
There aren't rules against entities other than the federal government funding a slot.
fallingknife 3y ago
Why does the federal government need to fund residency slots? They generate tons of billings and get paid next to nothing. Should be very profitable.
- HDThoreaun 3y ago
  they're not. As far as I understand every single one loses money before accounting for federal subsidies. Many are actually closing.
diogenescynic 3y ago
Exactly, just like the number of homes is artificially limited by zoning, permitting, etc. It's all artificial scarcity and it's for life's essentially--which is why I said it's a scam because it seems intentional.

bboygravity 3y ago

This is a clear consequence of devaluation of currencies (inflation). It's documented to have happened at least as early as with the romans. The exact same things happened that we're seeing now: people made less babies, rich got richer, the middleclass turned into poor(er), most people stopped being productive and switched to rent seeking (owning land and properties became the goal instead of actually making things or delivering services) and so on.

crooked-v 3y ago

> houses This particular one is a self-inflicted problem in most major US metro areas, by way of medium density housing being explicitly or implicitly banned for decades.

8f2ab37a-ed6c 3y ago

Are not all of these caused by some form of gatekeeping or artificial restriction? Of course some of that is benign and intentional, such as only letting people practice medicine after they've been thoroughly trained and certified, but are we perhaps restricting access to the things you list too much?

diogenescynic 3y ago
Exactly. Most of the things I listed are artificially scarce--they are intentionally restricting new supply. These are not issues in other countries. That's why I called it a scam.

groby_b 3y ago

Inelastic supply is a well-known phenomenon. The usual reasons are "it's hard to add supply" or "suppliers are working at full capacity" The medical field has both. Suppliers are working at capacity - there's a limited amount of residency spots[1] Increasing supply is also incredibly hard, because it has a decade+ of lead time. Neither one of those "our modern economy" can fix. The latter requires loosening training requirements. That's why we have Nurse Practitioners, which folks are loudly complaining about a few threads above. The number of residents is capped because new residents cost money. Hospitals used to make up for that by relying on Medicare, but that funding hasn't been increased. And so the economy works exactly as designed, the expensive good of "residency slots" is only offered to a limited amount, where it makes financial sense. It doesn't matter that additional doctors would make sense, the hospitals can't make money of more residency spots. Existing doctors don't complain, because it drives their salaries up. All of this very much makes the eloquent point that our modern economy is not the right tool for education or medical services. It can't work, given the forces around it. And so it goes. [1] https://www.medicaleconomics.com/view/match-day-2023-a-reminder-of-the-real-cause-of-the-physician-shortage-not-enough-residency-positions https://www.medicaleconomics.com/view/match-day-2023-a-remin...

local_person 3y ago

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