I think the problem is not that they didn't recognize this fact, but that they intentionally ignored it in order to maintain an artificial scarcity of physicians, thereby ensuring higher wages.

That there are thousands of graduated doctors that can't get residencies because they went to school in the Caribbean, needs to be resolved. Get them in residencies and we will be on an accelerated resolution path.

The way to do this is a modest hospital tax.

That way the funding is scaled to the size of the industry without reevaluating it year to year.

We already do this sort of thing via Medicare. It's simply underfunded. It seems it would be more effective to expanded and properly manage the existing tax than start a new one. In theory, this would scale well based on population.

Taxing hospital revenues aligns the tax with what you want it to reduce.

I suppose it would end up in healthcare organizations working to have care classified as non-hospital to avoid the tax.

How would it reduce staffing shortages? Hospitals wouldn't care if they pass it on to patients. It would be cheaper to continue to understaff since they'd pay the tax either way.

Even many domestic doctors have had difficulty getting residencies due to the funding structure.

Did it say that in the article? I didn't see it. Is there evidence of that?

This is a case where the act itself is evidence of the intent.

I know how insulting this is, but asking this question implies either the one asking shouldn't participate in discussions of any kind, or is involved in the corruption

It’s pretty obvious why the doctor’s guild would prevent more medical school spots from being available.

> It’s pretty obvious why ...

That's never evidence and a well-labeled gateway to our own fallacy. There's a reason serious examination of an issue requires factual evidence in any field, from medicine to law to science, etc.

IME, in areas I lack expertise, the truth is usually intuitive but an unexpected intuition. The only solution, the only source of truth, is evidence.

Do I need to say this on HN? Sadly, it seems like it.

This is how every guild in history has operated. Every profession when it controls the supply of its own members seeks to limit it. The AMA can only furnish the weakest of excuses for this practice. They say it has to do with federal funding for residency programs. But there's no reason for residency programs to need federal funding at all. They generate more value for hospitals than they cost to run.

There's a reason evidence, not fact-free theories, is required.

But now I see the name of your throwaway account. It's sad that you can't talk to other people respectfully.

:'(

It would be interesting to predict a surplus of software engineers and sharply raise the requirements for applicants to engineering departments.

At least the prediction of surplus of VCs in all other countries except US seems to be working well.

/s

I would hope they’d be smart enough to not write it down if they did.

It didn’t no, but that’s the effect, and why it was so slow to change: the existing members benefited.

It's an hypothesis that's worth exploring because of the apparent effect you point out, which is I think is fact. Based on this discussion, I suspect nobody here knows any evidence.

The very sad and dangerous issue is, they don't seem to care or grasp the fallibility of their subjective judgment. Some even turn to ridicule as an argument, which of course is irrelevant and obstructs the search for truth.

Without truth, we are doomed. We only spin our wheels, sometimes excitedly, sometimes frantically, sometimes confidently - but it's all a waste of time and labor. We go nowhere; we gain nothing; we are in the same place tomorrow as today (or we may go backward). We don't even know what problems there are or how to solve them.

(The claim that existing members benefit also needs evidence: Existing members express feeling very overworked, which doesn't corroborate the claim, and most analyses I see say the the money is going to the insurance companies and the hospital owners and managment.)

Is there another reason why having a surplus of doctors a problem?

Isn't "the existing doctors would be displeased" reason enough?

Why doctors would be displeased? They could offload some ungodly load to their peers, while enjoying less desperate patients. BTW patients significantly outnumber doctors, and they would probably be pleased, no?

/s

No?

Well, that's pretty much what the current protectionism is doing.

That’s unfortunately true. “The purpose of a system is what it does.”

There are many possible reasons. Do you want to seriously explore them?

> "In retrospect, we should have recognized that as the US population increases the number of US medical graduates should increase" is an all-timer.

Meanwhile, there's no cap on law admissions, leading to malignant narcissists who couldn't make it in the humanities doubling down on chasing losses and feeling entitled to grift the vulerable at the barrel of a gun because they made they are too ornery to get good tips if they work customer service and can't figure out a terminal prompt to save their life.

Interesting that while US population increased over the last century, at least the percentage of agricultural workers actually sharply decreased.

Somehow productivity among medical professionals - also taking into account increased demand - didn't increase fast enough to get to similar decreases of doctors per capita.

A more efficient plow can increase agricultural yields and a machine that can automatically core apples will remove the need for people to core the apples -- is there an equivalent for medical diagnostics?

Better tests and more access to diagnostic tools helps medical productivity to some degree, although unnecessary testing pushes the other way. And sometimes better diagnostics leads to more interventions which may mean more labor (and sometimes better outcomes too)

When it works, imaging (x-ray, CT, MRI, etc.) is ridiculously effective.

There's also stuff like figuring out that bacterial infections are a big contributing factor in ulcers. Once doctors believed it was true, interventions got a lot more effective.