10x cheaper, and longer life expectancy.

It's shocking how little this is talked about... This is so obviously the root of the problem. People like to blame the free market but there is no free market in medicine. Corporatism is to blame for artificially restricting the supply of doctors and artificially restricting who is allowed to render medical services, both of which benefit the corporate members, the doctors. Of course, those anti-competitive measures are always sold under the guise of protecting the population.

https://www.ama-assn.org/press-center/press-releases/ama-fun...

Fighting residency expansion: http://www.usatoday.com/news/health/2005-03-02-doctor-shorta...

Fighting expansion of care to other types of practicioners: https://www.ama-assn.org/practice-management/scope-practice/...

Why would you believe the AMA's line on this? Do you think the professional association that represents all doctors, one of the highest paid and influential professions in the country, has no power to control the amount of residencies are funded by the government? They have no reason to increase the number of doctors, absolutely none. They benefit in every way from having constrained supply.

By the way, that expansion of 15000 residency positions barely puts a dent in the number of doctors we are lacking[2]. But yeah, a press release from 3 years ago really absolves them of guilt for sure.

[1]: http://www.cnn.com/HEALTH/9708/24/doctor.glut/ [2]: https://www.washingtonian.com/2020/04/13/were-short-on-healt....

Most other private sector professions don't require nearly as much postgraduate training before being allowed to work. Prospective lawyers usually take the bar exam less than a year after graduating from law school. Medicine is simply more complex.

What would you propose as an alternative to the status quo? The AMA has proposed a number of improvements, but perhaps there are alternatives?

https://savegme.org/

Also blaming "corporatism" is basically just a meme at this point, because it is just used by libertarians when someone criticizes capitalism. Its the same when communists say "true communism has never been tried".

In case of life or death emergencies, your insurance or ambulance driver would send you to a reasonably priced doctor, and doctors that charge unreasonable prices would go out of business. But my guess is that life or death emergencies do not account for most doctor visits.

> Also blaming "corporatism" is basically just a meme at this point, because it is just used by libertarians when someone criticizes capitalism. Its the same when communists say "true communism has never been tried".

Well, I don't feel like arguing about semantics. Feel free to call the problem I described however you like.

Again, what incentive would there be to lower prices? New doctors could just be bought out and the prices jacked up. There are a lot of industries where there is little barrier to entry (for example tech), where the big companies just buy anyone trying to "get in on their territory".

Also, why would the "unreasonable prices" (what would that even look like?) doctors go out of business? They could just provide some kind of "luxury deluxe" ("no poor people here") state of the art care for people who can afford it.

[0] https://www.healthcare.gov/health-care-law-protections/docto....

Emergency services are only like 5% of costs, anyway [367]:

> The percentage of U.S. health spending attributable to the ED has increased from 3.9% (CI, 3.9%-3.9%) in 2006 to 5.0% (CI, 5.0%-5.0%) in 2016.

So the other 95% is more flexible. I know when looking at birthing costs they could vary wildly but it didn't really matter because who cares, they're all in-network anyway.

[367] https://journals.plos.org/plosone/article?id=10.1371/journal...

There is no cost problem in "tech". In fact, many services are literally free of charge. Despite Google having a near-monopoly on search, it is unable to charge users for it. Demand for software developers has grown massively in the past decades and yet, wages have only slightly gone up.

Anyways, I didn't mean to start a debate on the merits of free enterprise. I was hoping that we could at least agree that artificial limiting the supply of doctors causes medicine to be more costly, regardless of the economic system.

But Google can charge their "actual" users, i.e. advertisers quite a bit, and it is much harder to do any advertising without also advertising on Google Platforms, such as Search, Maps, Youtube, Adwords, etc. The wages may have only slightly gone up, but the profits definitely have gone up quite a bit, which shows that amount of workers and their pay has little to do with how much money can be made (which I believe is perfectly fine, because tech is not a place where I think free markets create a detriment to society).

I don't want to start a debate on free enterprise in general, just to show that free enterprise is not a once size fits all solution. My argument was just that the supply of doctors has very little to do with the price of medicine, because the market forces that determine price and can lead to lower prices in some markets do not work correctly in this market.

The statement is a reaction to blaming free market economics when the reality is a scenario of the opaque third party payer system in a highly regulated environment. Consumer gets no price transparency, state regulatory boards made up of current market suppliers control market entry - say what you want about it’s appropriateness but the US medical industry hardly resembles a free market.

“Corporatism” may be a ham-handed way to call this out, but it’s not helping society to lay the medical industry’s problems at the feet of capitalism. This problem of cronyism in markets (especially) exists in communist economies as well. It’s throwing out the baby with the bath water.

Most first world countries have a solution for this already. It is baffling that the US does not.

Even second and third world countries have implemented this solution.

https://www.fraserinstitute.org/studies/waiting-your-turn-wa...

All healthcare systems impose some sort of rationing. Canada rations care by imposing long queues for non-emergency cases, with significant variations between provinces. Affluent Canadians frequently travel to the US as medical tourists and pay for treatment out of pocket in order to skip the lines.

There are also major differences in MRI scanners. A 3.0T unit can produce higher resolution images than a 1.5T unit, and this makes a difference in patient care quality. Countries like Chile are more likely to have the cheaper units.

https://doi.org/10.1097/rli.0000000000000801

There should be flying ambulances, like international flights taking emergency patients to where they can be treated economically instead of getting signature after signature squeezed out of them, one per hour starting inside the ambulance.

This is exacerbated in the US itself, where only the top 10% have access to expensive and timely medical treatment.

I would argue that, at the very least, Canada does offer medical treatment to everyone.

The Fraser institute is a libertarian think tank so even if their data is right I don’t trust their conclusion. So what if 3% of people are waiting on a procedure? This needs to be apples to apples compared to other countries, per capita healthcare spending, life expectancy before drawing conclusions

I just happened to have this RAND corporation ranking of "most expensive insulin in the world" from 2018 handy; America is first, Chile is second.

https://worldpopulationreview.com/country-rankings/cost-of-i...

But I don't know, did you try the municipal pharmacy in Recoleta? Way cheaper.

[1] Note for admins: this is not the same as calling someone a shill on the forum, I went and gave my account and signed an affidavit in the complaints and suggestions book, with the help of the guard who also witnessed the shill, and backed by a third witness who conversed with the shill like I did. I told them by all means use this in court, I'll vouch on the witness stand, and I'm doing this with the same moral authority and motivation of being a hero according to Roman Law, in a very similar set of conditions that led to my actions and consequent recognition as a hero by the victims in the spur of the moment, ten years ago.

That, BTW, is a consequence of the system responsible for selecting and influencing those in power and not any particular individual, so voting in someone new won't change anything. And that goes for much more than just health care.

The only real solution is to completely abolish privatized healthcare. No more discrimination between the poor and the rich when it comes to something as critical as that. When everyone has to row the same boat, then the rich will finally have a good reason to make sure the poor don't drown.

EDIT: I don't remember Chile having that much cheaper healthcare, either. I lived there for 14 years and it was just as much of a constant drain on my salary as it is here in the US. And those who couldn't afford good insurance were pretty much screwed, just like here in the US. And the real costs were buried deep and obscured by insurance waffle, just like here in the US.

Yeah. Because rescue workers, fire fighters, EMT's, nurses, etc., etc. don't count. (As if the ways in which America's medical establishment treats those people didn't make that obvious enough. And the alpha sociopath in the room always deserves 100% of the credit for anything good happening...right?)

My impression is that other countries (ones not poisoned by the AMA) don't have this particular problem nearly so much.