Hacker News Reader

Comment by abakker | Hacker News Reader

Calling medical education and licensing a monopoly is pretty intellectually dishonest. To borrow the OP's analogy, that is like saying drivers with licenses have a monopoly on driving. Seems like a pretty strange argument.

Certainly, the medical industry does not face the same competitive pressure from outside, but that is the nature of industry in general.

Rather than calling medicine a monopoly, it is more accurate to accuse heal care providers and practitioners of colluding to ensure prices are high. Monopolies by definition cannot collude since there would be nobody to collude with.

In the grand scheme of things, I believe medical costs are accurately priced and it is people's wages that are not adjusting correctly.

View on HN

The AMA controls the requirements for licensing, the schools that can educate for the purpose of licensing, and the number of licenses that can be issued. Exactly what is intellectually dishonest about calling that a monopoly?

http://www.economist.com/blogs/freeexchange/2007/09/a_spoonf...

> To borrow the OP's analogy, that is like saying drivers with licenses have a monopoly on driving.

Not so, as the number of medical residents is de facto set by Congress (due to how the funding system works), thereby limiting the number of doctors in each specialty.

If local production capacity is too low, why not import them?

> that is like saying drivers with licenses have a monopoly on driving.

The critical difference is that there's no limit on the number of people who can get standard driver's licenses, but there is on medical licenses.

It's not just the AMA directly, though. Residencies are funded federally, I believe. I'm pretty sure the numbers per specialty are centrally controlled, but I'm not certain how the process works. And I don't know who limits the medical school slots, but I'm under the impression medical schools can't just increase the number of students at will.

All that being said, keeping the supply artificially low probably has some benefits.

like saying drivers with licenses have a monopoly on driving

...if drivers got to set the test standard and pass rate.

Any system where they control entry not just by a passing threshold but by raw numbers or on a curved exam scale is a monopolistic regime. They aren't just looking for people who can pass the test and meet qualifications but to keep a throttle on numbers.

Reply on news.ycombinator.com