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The problem is that it's not a free market either thanks to medical licensing laws, monopoly control over the accreditation of U.S. medical schools, etc. The su
by olalonde 2y ago
The problem is that it's not a free market either thanks to medical licensing laws, monopoly control over the accreditation of U.S. medical schools, etc. The supply of doctors was even once artificially limited as a matter of policy due to a fear that there would be a "surplus" of doctors (aka fear that doctor salaries would go down).
> The Graduate Medical Education National Advisory Committee convened by the Secretary of Health and Human Services (HHS) issued a report in 1980 warning that there would be a “surplus of 70,000 physicians by 1990” if steps were not taken to bring supply and demand into balance.
> This near freeze was enforced by the Association of American Medical Colleges (AAMC) and the American Medical Association (AMA), the two sponsors of the Liaison Committee on Medical Education, which is the sole accreditor of allopathic medical schools recognized by the U.S. Department of Education. The decision not to expand the number of slots in U.S. allopathic medical schools remained in place until 2005, when the AAMC and AMA changed their minds from declaring an impending doctor glut to warning of a looming doctor shortage.
https://www.heritage.org/education/report/why-dont-us-medical-schools-produce-more-doctors https://www.heritage.org/education/report/why-dont-us-medica...
- llamaimperative 2y agoThe doctor supply problem is orthogonal, at best, to the insurance problem. You can avoid the insurance problems with the same number of doctors or you can have the exact same insurance problems with 100x the number of doctors.
- golergka 2y agoThat's not how markets work. If there was a surplus of doctors, you would have a lot of private practices at low out of pocket prices and no need for insurance whatsoever.
- llamaimperative 2y agoWhich would in turn reduce the number of doctors that go into training, which would in turn raise prices back to where insurance is necessary. AFAICT, no health system on the planet, with or without controls on doctor supply, has achieved what you describe. If you have evidence that equilibrium can be found at "no need for insurance whatsoever," I'm interested to see it. It looks to me like equilibrium is nowhere near that.
- golergka 2y ago> Which would in turn reduce the number of doctors that go into training, which would in turn raise prices back to where insurance is necessary. Well, yes, one way or another, the market would reach in equilibrium. Like in physics or chemistry, you can't always exactly predict how exactly the equilibrium would be reached, but you can calculate where it is nevertheless. However, right now in US it is not in an equilibrium, because the supply of doctors is artificially limited. Therefore, the natural equilibrium between supply and demand lies to the side of more doctors and more affordable healthcare.
- llamaimperative 2y agoSure, I'm not denying the artificial supply constraints is a huge problem (I've complained about this on many instances on HN). I'm saying that it is orthogonal to the problem described in the article.
- golergka 2y agoYou don't think that the problem described in this article has anything to do with supply and demand for doctors and their services?
- llamaimperative 2y agoNo I have no reason to believe that having more doctors would induce insurers to keep their network directories up to date and to represent their network to consumers honestly. A more direct solution is to just fine them $10,000 every time a patient is told a doctor is in network and they are not.