> Recently, her hospital’s dermatology program received more than 600 applications for four residency slots.
Perhaps if supply of dermatologists was not so strongly limited, prices and wait times would improve.
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Perhaps if supply of dermatologists was not so strongly limited, prices and wait times would improve.
Every time it comes up in the US, nationalized healthcare is demonized in some media. But it just feels like a facade perpetrated by the hospitals and insurance companies (and now private equity) who stand to lose the most. If it's good enough for veterans and retirees, why can't it be good enough for the rest of us? Maybe it's because when the government pays the bill, they don't just roll over and accept $EXORBITANT_FEE after $EXORBITANT_FEE - they negotiate and get some reasonable value.
From what I gather, Congress set the current low limit due to lobbying from the AMA something like 30 years ago. The AMA has since changed its tune and wants more slots to alleviate shortages in some regions and specialties, but the funding has not materialized.
What would they do if the government didn't fund any slots, just shrug and decide they didn't need doctors?
Note that I'm not opposed to the government funding lots more slots, I am objecting to the presumption that government funding is the only possible way to make a doctor.
But, the fact that hospitals don't fund their own seems to prove the underlying assumption - that offering a residency is a net loss to the hospital. If that weren't true, they'd fund the slots on their own.
It's bizarre that these discussions seem to start from the assumption that we got here intentionally by only making good decisions.
The lack of doctors allows hospitals to charge more money for access to the ones they have. And right now the government foots the bill for training new doctors.
If they funded new residency slots they'd simultaneously increase their expenses, and reduce long-term revenues. Even if the resident's work is profitable by itself - in the sense of generating more in billings than the costs in salary, benefits, and teaching time - it could be bad for the hospital in a decade or two.
If the government simply ended the practice of funding residencies then hospitals and the rest of the medical establishment would be forced to come up with a new approach. Until then they're content to ride the gravy train.
Regulation, left unchecked, favors constant indirect damage from shortage to more visible direct harms.
This is why it takes 3000 hours of training to cut someone's hair.