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Comment by JamesBarney | Hacker News Reader

There are too many patients and not enough doctors. This isn't caused by capitalism, capitalism doesn't limit the # of doctors. Becoming socialist doesn't magically allow doctors to see patients for twice as long. If we had socialism more people could afford doctors(a good thing!) but it would make this specific problem worse, because there would be more patients. This is caused by the AMA lobbying to limit the supply of doctors in order to drive up salaries.

It's why we have this.

United States – $316,000 Germany – $183,000 United Kingdom – $138,000 France – $98,000 Italy – $70,000 Spain – $57,000 Brazil – $47,000 Mexico – $12,000

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The book M.D.: Doctors Talk About Themselves actually interviews someone who discusses this problem, and inadvertently illustrates a problem American policy ran into.

The interviewee says that the Reagan administration tried to drive down the cost of health care by increasing (as opposed to, say, lifting) the quota on production of doctors, with the idea in mind that more supply of doctors would drive down costs. And he goes on to say that the idea backfired by raising medical costs.

In the interviewee's mind, the problem is that doctors can "make their own work" -- with more doctors around, more medical care can be performed than was possible with fewer doctors, and so the cost of health care went up instead of down, making the policy a mistake. That is the beginning and end of his analysis.

No one asks whether the cost of particular treatments went up or down. If total national spending on health care went up, the policy is supposed to have been a failure.

> This is caused by the AMA lobbying to limit the supply of doctors in order to drive up salaries.

This. This is the problem - not the vague spectre of "capitalism" being waved around.

Since when do salaries have nothing to do with capitalism?

The Soviet Union had wages to, and far worse problems with shortages then capitalistic countries have ever had.

Yes, but not in general shortages of doctors. It's a totally different problem, so this isn't really a helpful way to look at it. After all, if there's a shortage of cabbages, it doesn't mean the remaining cabbages benefit and can lobby to keep it that way!

Cabbage farmers can, though.

Yes, but when that sort of thing happens in commodities it's an illegal cartel, whereas when it happens with jobs it's responsible self-regulation by a professional association.

The presumption is that under a "free market" the demand would drive more production - more doctors. But that the rules of the current system artificially restrict the supply of doctors. Some of that we want - credentials clearly serve a purpose - yet are the rules more restrictive than they should be? Should there be more residencies? Should we have more "lower-level" providers like nurse-practitioners, PAs or pharmacists that can prescribe? There is limited ability for the market to innovate in such a regulated environment.

Since people refuse to see regulatory capture as an unavoidable feature of capitalism.

Because it's factually not. At least, unless you define "capitalism" in a specific twisted way that includes "regulatory capture". Which I suppose a lot of socialists do...

It’s funny you say this has nothing to do with capitalism but all the countries you listed have largely socialized medicine.

Once capital gets power it uses a government to enforce that power.

Roughly a third of our healthcare spending is socialized medicine, and Medicare and Medicaid have the same issues we do.

1/3 < 3/3.

We do not have anything close to socialized medicine.

I don't understand what you mean, not being universal does not have any bearing on that. The care is paid out of taxes.

I am on Medicare. Because it is not universal means it is only partly socialized and still operating inside of a non-socialized system. Why does this matter? I cannot get any doctor I want, only the ones taking Medicare, which are fewer and fewer, because they would rather only take people on private insurance.

In France for example you can walk into any doctor and they will see you.

I live in a country with (mostly) free health care and we have 6-month wait lists too. Same shit in the UK, who invented the NHS.

Please stop blaming every problem on your ideological pet peeve. Society is too complex for every single issue to be caused by capitalism, financialisation, the patriarchy or systemic racism.

Then that’s not capitalism.

Veterinary care would be much closer to the model of a capitalistic solution.

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