Cut out welfare (rewarding/paying teen girls to become baby’s mamas), make healthcare available to all at low cost – with or without insurance, legalize ganja, free all prisoners except those guilty of violent crimes, employ capital punishment for those guilty of violent crimes (thereafter close/shut-down all jails), scale down American military bases around the world (people, we are safe, why all the paranoia)? Channel the money that was previously going to un-needed military bases and wars around the world into EDUCATION. Have kids choose their majors by 10th grade high school. Start them on their majors and pursuing careers by the 11th grade. Emphasize science and math.

There. Mission complete.

fine. you choose to respond to factual critiques and contradictions of your superficial and incorrect claims about govt presence in today’s markets with doctrinal ad-hominem or patronizing comments like 42. which explains why my earlier comments were a more efficient use of my time.

to expand on comment 43, not particularly interested in speculating whether your motivation is more mankiw or malkin. but ok, you win. no point in arguing with a religious fundamentalist.

24 hours doesn’t make me feel much better, which a friend of mine was doing recently. It’s also a tremendous hazard for the doctor and unfair – why should there be that extensive a hazing process and why should the doctors be put at risk for malpractice? But more so, someone could die?

On the subject of transferring from US medical schools to schools in the Carribean, I personally know of 3 people from my medical school who did it. There were about 390-400 folks in my school at the time, so I’d say it’s around 1-5%. Interestingly, two of those three are successfully practicing physicians now.

RE: physician compensation – You are correct that teachers and police officers don’t practice their trades for the money. But, sadly, a lot of physicians do. You can’t compare the field of medicine to these other fields. Also, most teachers are fully accredited and ready to teach within 5-6 years of hs graduation. Excepting cases like Dr. Ambati, most docs take about 9-11 years after HS to start.

I would hate the idea of having a hip replacement, and the resident there has been working 36 hours straight. There are already regulations that guard against this – no resident can stay in the hospital for 30 hours straight. However, when I was in residency (pre-regulations), this was not uncommon. You’d be surprised how awake you are when you have a person on the table cut open in front of you, no matter how little sleep you got the night before. It’s quite an adrenaline rush.

Nicely put.

The US healthcare system is not ANYWHERE close to a free market system and I have not seen any proposals from those who are opposing the Obama changes that will make it into a free market system.

All this talk about “the market allocates resources efficiently”, etc makes no sense to me.

As Vinod pointed out, the US govt pays for almost half of health care costs. And in addition to this are all the laws that the govt makes, like enforcing IP rights, ensuring the quality of medicine, restricting the influx of doctors, etc, which makes it an very important stakeholder. To have such a big stakeholder, without an effective direct say in the matter means there is no accountability.

Pretending the govt does not influence the matter, only allows small and relatively small groups to control policy to benefit themselves to the detriment of society at large

P.S. Since a large part of the thread is on the AMA and doctors, here is an interesting chart on # of docs / 1000

http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people

and global salaries for GPs

http://www.worldsalaries.org/generalphysician.shtml

Free Markets at work?

Interesting, thoughtful research & analysis by Dean Baker but advocates, as well as adopters, of policies translated from research will always consider the multi-dimensional real-world context such as the practicality and timelines of policy implementation. (And this is why I muddied the waters here and here).

There are several reasons why primary care specialties are declining in popularity (a phenomenon that is a crisis in its own right)–and one of those reasons is the fact that these specialties pay less. For an average med school graduate who comes out with a $100,000 educational debt, the debt itself may play a crucial role in specialty-choices. Good luck to any society that tries to (drastically and rapidly) bring down the medical professionals’ pay. (Not a physician myself, so no conflict of interest here.)

It may be a good idea to see what is going on in the veterinary community. The average veterinary graduate is also said to come out with a $100,000 debt but the average pay for a new graduate is approximately $55,000 – 65,000 p.a. Some speculate that one of the reasons for the recent rise in gender imbalance (more women than men) in the field is the relative low pay. So any talk of decreased pay may come to nothing without a parallel decrease in tuition. There is also the tension that International Veterinary Graduates are in a position to accept jobs that pay less…Thankfully, so far, that is not one of the problems that International Medical Graduates face.

About state schools not accepting out-of-state applicants: I think the arguement is that tax payers have a right to decide whose medical education they are willing to subsidize. (Tuition only covers a portion of the true cost of medical education). And the reason the tax payers want to take a chance on one of their own, local “average” applicant and not the “super-brilliant” applicant from California is that they want to have some reasonable assurance that the medical graduate will actually serve the local community after graduating (someone with roots is more likely to stay or come back after a stint elsewhere than someone without roots is the belief).

This may or may not have been a good criticism in 1975 or maybe 1935. I don’t seem to know anyone like this at all and I would suspect that very few do. Even among radicals, there can be and often is a strong anti-state critique.

Mais a chaqu’un a son gout – things are quickly changing and the types of “ideal market” based economic arguments that your’e persenting are likely to continue to decrease in terms of favorability and the types of arguments that haven’t been made but will be soon will likely be there for you to respond to in coming decades. (on an aside, does anyone know a good social science equivalent of Thomas Kuhn’s Structure of Scientific Revolutions?)

That’s likely why most of the ‘responsible’ Republicans and Democrats are trying to salvage something far short of single payer health care – they know the issue’s not going away until the failures of the current system are actually addressed and are attempting to do so in the way that’s least disruptive to the current state of affairs.

I’ve found most of these people tend to be made of straw and the rest are nowhere near the levers of power.

sorta how I feel about folks who naively believe in the “fallible markets, infallible regulators” fallacy… no matter how much evidence / opinion, they just don’t seem to get it…

Well said.