In response to a heavily editorialized propaganda piece disguised as news from the BBC: https://www.bbc.com/news/articles/cnv56q82vnro
If you listened to any number of neoliberal status-quoist politicians from the Western world, from America or Canada, to the UK or Australia, all with failing healthcare systems plagued by urban-rural supply inequalities, staggering wait times, and spiralling costs that the government can barely manage to keep in line, the solution seems simple: increase privatization, throw more money at the raging trash fire, and the problems will be ameliorated.
As with countless other societal blights that lazy politicians have presided over while embers turned to forest fires, there seems to be a logical gap between basic macroeconomics and the policy prescriptions of those who conveniently take significant sums of money from the perpetrators off to fund their “campaign expenses” such as $25,000 Armani suits and $120,000 Patek Philippe watches. We all have to make a living after all.
The most basic elementary school lessons on supply and demand would teach us that when the price is too high, increase supply to bring costs down. That the same would not be true for things like doctors, or domestically produced medical equipment has been assumed by all to be a fact, with poorly articulated explanations.
One, internal protectionist regulation from OPEC-like cartel organizations like the AMA capping the number of annual graduating seats to prevent this exact situation (an oversupply of doctors that heaven forbid would reduce healthcare costs) is a major factor, although this could be easily legislated out of practice, especially because in even the most privatized countries like the United States, medical education is still primarily subsidized by the government despite all of the benefits being received by private individuals who then primarily go into private practice.
Another is that physicians are precious human capital, and can not simply be churned out. If this is true, then why are vast numbers of American physicians only coming into the clinics once a month to sign off supervision documents for Physician’s Assistants (PA) or Nurse Practitioners (NP) who do their job for them? Why is it that in some states, one can see a PA within hours or days, but to see an MD one must wait months to years? If MD-graduate physicians are by and large not the ones practicing medicine, and have been replaced by a subclass of lesser paid substitute service providers that perform the same task, but not without passing their cut to their “supervisors” who only appear to sign documents, then the human capital we have invested in has become too precious to access for most of the population and ought to be revalued.
Perhaps an alternative situation is this: cut the length of medical school to conform to EU standards from 8 years of tertiary education to 6 years, create new centrally managed medical schools that set the number of graduating seats based on the anticipated national need, and not on preserving artificial scarcity, and mandate that all graduates of those schools accept public funding regime prices, and lastly and most importantly, ban the practice of physicians accepting fees for “supervising” the practice of other parahealth professionals, which is essentially legalized racketeering.
These changes follow the basic premises of market capitalism much more closely than does the monopolistic medieval-style guild self-regulation, paired with modern day professional serfdom for residents, PAs and nurses alike. The only reason this has persisted for so long without change is the sheer amount of money being exchanged between state, third-party insurance providers, hospital managers, paraprofessionals and then doctors, for which each step and middle-man along the way, a cut is collected, and then a portion passed to the politicians who allow the festering corpse of modern medicine to pretend to remain alive like Lenin in Red Square.
Only when doctors are plentiful and required to accept what national health boards determine are fair fee for service costs can the practice of medicine transform from a scarcity driven frenzy to a rational market in which the supply of physicians actually meets societal demand.