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Comment by hristov | Hacker News Reader

There should definitely be more med school slots and more residency slots in the US. The idea of nurses prescribing pills is very bad though.

The shortage of doctors is a problem, but we should not kid ourselves -- the biggest problem in America's health care is out of control drug costs. Even with the shortage there has not been a massive inflation of doctors' salaries. In fact all of my doctor friends are constantly complaining about how they are paid less than the previous generation.

But there has been a massive inflation of drug costs.

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Prescription drugs represent about 10% of healthcare spending in the US, so while their prices are very high in the US, it's hard for them to explain very much of our high cost system. See https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

The second sentence is "We tend to blame the high prices on things like drugs and medical equipment, in part because the price tag for many life-saving drugs is less than half the U.S. price in Canada or Europe."

Its point is that drug prices are only part of the issue.

Quoting https://www.cdc.gov/nchs/fastats/health-expenditures.htm for "Percent of national health expenditures":

  * for hospital care: 32.3% (2015)
  * for nursing care facilities and continuing care retirement communities: 4.9% (2015)
  * for physician and clinical services: 19.8% (2015)
  * for prescription drugs: 10.1% (2015)

If drugs were free, expenditures would go down only 10%.

If "health expenditures for physician and clinical services" were cut in half, it would also go down 10%.

In any case, neither alone are enough to explain why we pay "more than twice as much per person for health care as other wealthy countries".

Why are nurses unable to prescribe? Nurse practitioners (mid-senior nurses) have been able to prescribe a limited set of drugs in the UK for quite some time now, quite successfully.

Nurse practitioners can prescribe in the US as well.

This right. In fact CVS MinuteClinics are usually manned by nurse practitioners. They can do many things typically associated with internal/family medicine.

Because in order to prescribe you need to be able to make a diagnosis and to make a diagnosis you need the full knowledge of a competent doctor.

And it takes years of education and training to become a nurse. Why do people think that nurses shouldn't be able to prescribe medications? Is it because of the gender they're traditionally associated with?

No. And no one made that claim.

hristov did, at the top of this thread ("The idea of nurses prescribing pills is very bad") https://news.ycombinator.com/item?id=15757283

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