5 ms·

Supply and demand 101 continues to work.

ChuckMcM 1y ago
So funny that. Weirdly even if you build nothing but market rate housing, housing gets more affordable. :-)
koolba 1y ago
Someone should try this with medicine. Instead of subsidizing insurance (demand side), let’s spend the money to bring doctors to the USA from all over the world and have them work in free clinics (supply side).
- adgjlsfhk1 1y ago
  we also could just stop having the federal government limit the number of residency slots so we could have enough doctors trained in the US.
  - yablak 1y ago
    And by not limit you mean fund. And I agree.
  - ZYbCRq22HbJ2y7 1y ago
    https://www.beckershospitalreview.com/quality/hospital-physician-relationships/residency-programs-4-things-to-know/ https://www.beckershospitalreview.com/quality/hospital-physi... https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/
  - jmye 1y ago
    Not just residency. Fix the cost (and capacity) of the education system as a whole, especially for mid-levels. There’s no reason this country should have such a chronic NP shortage, and you don’t need MD/DOs for most of the healthcare gaps we have. You also make rural care viable when you don’t have folks who need to pay off astronomical loans.
    - kgwgk 1y ago
      > you don’t need MD/DOs for most of the healthcare gaps we have Or maybe you do! It’s for your own good. https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten https://www.ama-assn.org/practice-management/scope-practice/...
    - mindslight 1y ago
      How are NPs not just the trend of enshittification? Most doctors already aren't very engaged in the tiny 15 minute slices of appointments, and now we're supposed to be happy that they'll be even less educated? The most straightforward way to address the doctor shortage is to make it so doctors are spending most of their time on healthcare, rather than appeasing "insurance" company bureaucrats with onerous paperwork.
      - jmye 1y ago
        What a weird comment. What do you think you need an MD for, in your primary care visit, that an NP can’t do? What do you actually know about their education? What do you actually know about licensing? How much time, in a day, do you think doctors are spending on “insurance”, and what specific experience leads you to believe that? (Because the actual answer is “near zero for literally any provider who isn’t completely independent, and almost none of them are, anymore”.) Or was this just a way to memetically add “enshittification” to a conversation it doesn’t even slightly apply to, but you think that’s currently trendy?
        FireBeyond 1y ago
        You can be an NP in as few as 4-5 years out of high school with some courses. That’s to me the definition of not knowing what you don’t know. I’m a critical care paramedic who has corrected many NPs on fairly fundamental learning. I’ve found that nurses with significant field experience do very well, but there are plenty of courses who will “zero to hero” you fresh out of high school. Meanwhile, PAs go through a program near as rigorous as medical school and have to have physician supervision while NPs are not subject to oversight.
  - kgwgk 1y ago
    Good luck getting the federal government to stop doing what the unio..., I mean, what the American Medical Association and representatives of the nation's medical schools ask for. https://web.archive.org/web/20200501175120/https://www.baltimoresun.com/news/bs-xpm-1997-03-01-1997060012-story.html https://web.archive.org/web/20200501175120/https://www.balti...
- madars 1y ago
  You don't even need to import foreign doctors: just increase the number of residency slots.
- ZYbCRq22HbJ2y7 1y ago
  We already do that? I mean, minus the free clinic thing.
- hangonhn 1y ago
  You basically can’t or it won't have the same effects because medicine doesn’t really follow the same dynamics as most other markets: the supplier (doctor) has an information asymmetry and thus makes most of the decisions, while the buyer (patient) is not usually the payer (insurance) so aren’t really incentivized to save. Kenneth Arrow famously analyzed the healthcare market and made the above insight: https://assets.aeaweb.org/asset-server/files/9442.pdf https://assets.aeaweb.org/asset-server/files/9442.pdf I know he was a Nobel Laureate but not sure if this is the work that won him the Nobel. Updated: I should qualify my statement by pointing out this is for the US healthcare system.
  - JumpCrisscross 1y ago
    > the supplier (doctor) has an information asymmetry and thus makes most of the decisions, while the buyer (patient) is not usually the payer (insurance) so aren’t really incentivized to save Counterfactual: patients in India routinely shop around for second opinions and negotiate fees.
    - hangonhn 1y ago
      Completely fair point. I should have prefaced my statement with US based healthcare system is structured this way. I don't know how the dynamics are in other countries -- though I do suspect it's similar in term of information asymmetry. I imagine doctors everywhere have some pretty advanced and specialized knowledge. I don't know enough about India to know how they overcome this issue or if they do or not.
  - elictronic 1y ago
    He said free clinics.
    - hangonhn 1y ago
      But then you're just shifting the cost somewhere else. The doctors aren't working for free. Someone is paying them. It's just not the patients in the case of free clinics. In addition, doctors aren't the only cost centers in health care either. Even if they're free, which is sort of already the case or fairly inexpensive for the insured in the US, the overall cost of healthcare will still be high. Plus if you want completely free clinics (everything from doctors to medicine, etc), then you're not talking about a market solution to the issue, which is completely fair too. No one said you have to use a free market solution for this problem. My point is that we can't expect a free market to solve this issue. It isn't as simple as supply and demand.

So funny that. Weirdly even if you build nothing but market rate housing, housing gets more affordable. :-)

Someone should try this with medicine. Instead of subsidizing insurance (demand side), let’s spend the money to bring doctors to the USA from all over the world and have them work in free clinics (supply side).

adgjlsfhk1 1y ago
we also could just stop having the federal government limit the number of residency slots so we could have enough doctors trained in the US.
- yablak 1y ago
  And by not limit you mean fund. And I agree.
- ZYbCRq22HbJ2y7 1y ago
  https://www.beckershospitalreview.com/quality/hospital-physician-relationships/residency-programs-4-things-to-know/ https://www.beckershospitalreview.com/quality/hospital-physi... https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/
- jmye 1y ago
  Not just residency. Fix the cost (and capacity) of the education system as a whole, especially for mid-levels. There’s no reason this country should have such a chronic NP shortage, and you don’t need MD/DOs for most of the healthcare gaps we have. You also make rural care viable when you don’t have folks who need to pay off astronomical loans.
  - kgwgk 1y ago
    > you don’t need MD/DOs for most of the healthcare gaps we have Or maybe you do! It’s for your own good. https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten https://www.ama-assn.org/practice-management/scope-practice/...
  - mindslight 1y ago
    How are NPs not just the trend of enshittification? Most doctors already aren't very engaged in the tiny 15 minute slices of appointments, and now we're supposed to be happy that they'll be even less educated? The most straightforward way to address the doctor shortage is to make it so doctors are spending most of their time on healthcare, rather than appeasing "insurance" company bureaucrats with onerous paperwork.
    - jmye 1y ago
      What a weird comment. What do you think you need an MD for, in your primary care visit, that an NP can’t do? What do you actually know about their education? What do you actually know about licensing? How much time, in a day, do you think doctors are spending on “insurance”, and what specific experience leads you to believe that? (Because the actual answer is “near zero for literally any provider who isn’t completely independent, and almost none of them are, anymore”.) Or was this just a way to memetically add “enshittification” to a conversation it doesn’t even slightly apply to, but you think that’s currently trendy?
      - FireBeyond 1y ago
        You can be an NP in as few as 4-5 years out of high school with some courses. That’s to me the definition of not knowing what you don’t know. I’m a critical care paramedic who has corrected many NPs on fairly fundamental learning. I’ve found that nurses with significant field experience do very well, but there are plenty of courses who will “zero to hero” you fresh out of high school. Meanwhile, PAs go through a program near as rigorous as medical school and have to have physician supervision while NPs are not subject to oversight.
- kgwgk 1y ago
  Good luck getting the federal government to stop doing what the unio..., I mean, what the American Medical Association and representatives of the nation's medical schools ask for. https://web.archive.org/web/20200501175120/https://www.baltimoresun.com/news/bs-xpm-1997-03-01-1997060012-story.html https://web.archive.org/web/20200501175120/https://www.balti...
madars 1y ago
You don't even need to import foreign doctors: just increase the number of residency slots.
ZYbCRq22HbJ2y7 1y ago
We already do that? I mean, minus the free clinic thing.
hangonhn 1y ago
You basically can’t or it won't have the same effects because medicine doesn’t really follow the same dynamics as most other markets: the supplier (doctor) has an information asymmetry and thus makes most of the decisions, while the buyer (patient) is not usually the payer (insurance) so aren’t really incentivized to save. Kenneth Arrow famously analyzed the healthcare market and made the above insight: https://assets.aeaweb.org/asset-server/files/9442.pdf https://assets.aeaweb.org/asset-server/files/9442.pdf I know he was a Nobel Laureate but not sure if this is the work that won him the Nobel. Updated: I should qualify my statement by pointing out this is for the US healthcare system.
- JumpCrisscross 1y ago
  > the supplier (doctor) has an information asymmetry and thus makes most of the decisions, while the buyer (patient) is not usually the payer (insurance) so aren’t really incentivized to save Counterfactual: patients in India routinely shop around for second opinions and negotiate fees.
  - hangonhn 1y ago
    Completely fair point. I should have prefaced my statement with US based healthcare system is structured this way. I don't know how the dynamics are in other countries -- though I do suspect it's similar in term of information asymmetry. I imagine doctors everywhere have some pretty advanced and specialized knowledge. I don't know enough about India to know how they overcome this issue or if they do or not.
- elictronic 1y ago
  He said free clinics.
  - hangonhn 1y ago
    But then you're just shifting the cost somewhere else. The doctors aren't working for free. Someone is paying them. It's just not the patients in the case of free clinics. In addition, doctors aren't the only cost centers in health care either. Even if they're free, which is sort of already the case or fairly inexpensive for the insured in the US, the overall cost of healthcare will still be high. Plus if you want completely free clinics (everything from doctors to medicine, etc), then you're not talking about a market solution to the issue, which is completely fair too. No one said you have to use a free market solution for this problem. My point is that we can't expect a free market to solve this issue. It isn't as simple as supply and demand.