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Comment by Gravityloss | Hacker News Reader

If the medical system become more efficient, more money is freed to

1: increase doctor salaries so there can be more doctors and

2: develop things around doctors so their efficiency improves. (Hire assistants, write software, design better hospitals).

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I would be quite shocked if increasing the number of people who can go see a doctor, for free (or some incredibly reduced rate), somehow resulted in doctors working less.

>2: develop things around doctors so their efficiency improves. (Hire assistants, write software, design better hospitals).

As for this note, a doctors time is more valuable than basically all 3 of these. If you assume medical corporations desire making more money, then they would already be looking into this step. It's not something that would be improved by increasing the number of customers.

I don't think your "for free" comment accurately reflects what happens in a country with federally provided insurance.

> I would be quite shocked if increasing the number of people who can go see a doctor, for free (or some incredibly reduced rate), somehow resulted in doctors working less.

Preventative care is far easier than complex "shit, you've got stage four cancer because you didn't get that lump checked out". For uninsured folks, ERs wind up functioning as primary care, which is immensely wasteful use of resources.

> If you assume medical corporations desire making more money, then they would already be looking into this step.

They are. Some hospitals hire scribes for doctors, for example.

I would guess that it reduces the workload of certain doctors (like ER/Urgent Care) if more people have access to preventative care. From what I've heard, being an internist isn't as well paying/sexy so fewer residents are going that direction which might be bad since there's where a lot of the workload would shift.

I was under the impression the lack of doctors is actually due to a lack of residency training spots.

Hospitals will pay their own money for residencies in specialties that are wildly profitable. Usually, some fancy types of surgeons. Primary care, endocrinology, rheumatology, and a lot of other needed specialists are not so the limited slots are whatever the government will pay for.

Yes, that is what I've heard. During Obama's presidency, they increased the number of medical schools or openings at the existing schools but did not increase the number of residency positions.

Is there data on this?

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