> The AMA is a trade guild that restricts the supply of doctors.

Technically the supply of doctors is throttled by residency programs, the numbers of which are determined by an incredibly weird dance between Congress and hospitals.

Your point stands, but just noting that simple monopolistic graft would be far more rational than how this actually works.

It’s not that “incredibly weird.” Medicare doesn’t reimburse for residents unless a teaching physician is also present. Because that dramatically limits hospitals’ incentives to train physicians, Medicare pays hospitals a certain amount to support training residents. To limit how much is paid under that program, the number of residents Medicare will pay for is capped.

It’s not irrational, but an example of how a series of government interventions, each seemingly rational on its own and aimed at reducing costs, can end up creating a systematic problem.

You're skipping past the congressional funding negotiations that set up those rules, and the motivations of hospitals to create the conditions supporting either funded or unfunded slots.

Sure, we can slice off portions of this process and explain the decisions of individuals, but there are so many players with motivations independent of the outcome it's not a clean line.