You can achieve impressive results and still be "wasting money" if there were more cost efficient ways to achieve an equivalent result. I don't have an opinion on NASA but that could be the point of view those people are coming from.
In the Netherlands they have outsourced the organisation and managment of health care to the doctors themselves (roughly speaking). It is often cited as one of the main reasons the Netherlands rank #1 in health care ratings over the years.
It's also important to note that the number of medical schools isn't really artificially limited by the LCME, as they will accredit most any medical school that meets the accreditation standards.
On top of that, medical students in the US have to undergo a residency before becoming fully licensed physicians. These residencies are accredited by the Accreditation Council for Graduate Medical Education (ACGME), a separate organization.
However, while the ACGME can accredit these programs, the majority of funding for training resident physicians comes from the federal government (department of health and human services, center for medicare and medicaid services), and is capped by the Balanced Budget Act of 1997 (modified in 1999 to accommodate the rural physician shortage). Today, this costs the federal government around $11 billion each year for all of the residents in the country.
The real question, then, is who we can point to as the bottleneck for new doctors in this country. I found this article enlightening, but it may be behind a paywall:
And the idea that an industry as profitable as medicine needs the taxpayer to fund its training is preposterous. This is just a deflection from the AMA's role.
Most doctors already come from wealthy families (specifically, they have doctor parents) because in addition to the tuition of medical school, there are a variety of other expenses (board examination fees, the undergraduate requirement, interview expenses for both medical school and residency) that are difficult to fund without assistance. Also, compensation for physicians is not what you seem to think it is outside of subspecialized fields, and the expense of medical school (and the opportunity cost of residency) means that physician shortages in the general disciplines will only continue to get worse as medical students realize the only way they can pay back their loans is to subspecialize.
Also, medical schools are primarily limited by number of faculty, and it's difficult to find doctors for med school faculty roles... because they're so poorly compensated in comparison to other opportunities.
If you want more doctors, first provide incentives for doctors to teach, then provide funding for those who normally don't see medical school as an available opportunity, then incentivize people to go into general disciplines, then properly compensate residents so they're not throwing away ten years of potential income, then complain about how "doctors are overpaid but there's also a big shortage of them".
I agree that the undergrad requirement is absurd. But it is also just another part of the system that increases entry-barriers and leads to all of these problems, but makes the field more lucrative for a big segment of those who get through it.
The rest of us have to compete in a free market for our skills. Why not doctors?
Not sure why you got downvoted. The Lansley Reforms - where Primary Care Trusts were abolished and replaced by Clinical Commissioning Groups which are run by GPs and are responsible for commissioning most of the NHS services (about 2/3 of the budget) - are known to have caused severe disruption to English NHS services.
That has a far higher outcome on healthcare than taking doctors away from patients to run hospitals.
[0] https://www.dutchnews.nl/news/2018/10/slotervaart-hospital-s...
That it since followed the path of every other monopoly bureaucracy was of course unavoidable.
This is not really true, but you are taking it as axiomatic.
Even though SpaceX has to do some of this, they get to reuse quite a bit of NASA paperwork.
pareto -- 80% of work done by 20% of workers.
there's also some other law about the work being done by the square root of the total workers.
I’ve personally worked at large private firms where incompetent folks coasted for decades.
When management’s clout is measured in headcount, you get this (whether in the private or public sector)