Do you accept the criticism that the US simply artificially limits the supply of doctors, which leads to overwork for physicians, and worse health outcomes for patients?
Do you think most doctors would take less hours for a somewhat lower salary if you it was possible?
Young docs would absolutely work less for less if possible, I think. Old docs wouldn't. IMO, that's reflected in the rise of big network providers such as Kaiser and friends.
In Europe, access to care is better IMO mainly because both patients and docs are far less aggressive, and often quite happy just doing nothing. Which is in fact the true problem about US healthcare: the culture of absolutism.
To pretend that the restrictions in other countries like Germany are at all comparable to the restrictions in the US is laughable. Just look at the work involved for a German doctor to legally practice in the US vs the reverse if the controls are so similarly strict (they're obviously not).
You are very clearly engaging in motivated reasoning in this thread.
> cultural issues
Within the US, the limitation of admission of US students into med school is another matter. And I think people are probably right to call out protectionism in this case. But I have no first hand experience, being a foreign graduate myself.
I'm just a random bloke having worked in Boston, though. So YMMV.
High doctor-per-capita could be a sign of inefficient use of resources rather than being a good thing.
Examples: Do you need a prescription for stuff that's otherwise over-the-counter elsewhere?
Is over-the-counter stuff paid by (state) insurance if you get a prescription for people that don't value their time?
Do people go to the doctor anyway for every possible matter (e.g. cough/cold/flu in otherwise healthy people)?
Do you have to make a pointless appointment with your GP every year to confirm you still have that incurable disease in order to keep seeing your specialist? Or renew that allergy med prescription every allergy season? Or go once for a lab test, and then again in-person just to find out the results, even if they're negative?
Who puts in most IV lines? In some places it’s a doctor, other places, nursing staff.
In Europe, they somehow get through medical school without them.
(Not that any of this would matter because the incentives of the residency system are perfectly set up to make it impossible to train any more doctors.)
It's also a meritocratic matter: you have to take a lot of risk to make a go for medical school, and the best candidates may not be able to afford the risk of failing to achieve their med school goal and ending up with a degree with ??? value, so the best may not take that path.
Or worse, taking an easier degree program (to beef up their grades and have time for other application-enhancing activities) and not getting themselves educated to their full potential.
> Do people go to the doctor anyway for every possible matter (e.g. cough/cold/flu in otherwise healthy people)?
> Do you think most doctors would take less hours for a somewhat lower salary if you it was possible?
It is possible. Lots of doctors work fractionally. It's one of the easiest fields to do it in. Given the artificial shortage, hospitals essentially have to accept it.
The reality is many doctors are simply driven people. They don't really mind the hours, but they do mind the type of work. A lot of it is just terribly unfun.
> US supply is artificially limited. There's literally no arguing this. There are essentially a fixed number of residency spots and that's basically the only way to become a physician.
I was under the impression that the limitation is a bit different in other countries. There is no hard, fixed limit. However, there is still practical limitations around how many institutions want to go through the accreditation process and support the education system. "Anyone" (hand waves a little bit) can start a program, as long as they meet the requirements.
In the US, it's a hard limit set by Congress. Even if you want to run a residency program, you can't.
Technically, there are ways around the hard limit, but they're extremely challenging to implement.
26.1 / 10000 * 336M Americans = 876960 active physicians, and the error is probably a measurement artifact (how do you define 'active physician') and the fact that both the population and number of doctors vary over time.
https://www.who.int/data/gho/data/indicators/indicator-detai...