We do it all the time with lawyers and PhD scientists of all stripes. Why should doctors receive special treatment?
(Wrote this before your edit introducing the second paragraph)
(Wrote this before your edit introducing the second paragraph)
We shouldn't do that with lawyers and PhDs either. Why must everything be a race to the bottom?
In this case, perfect information of what the world will look like on the other side of an unusually long training course (how long depends on what you're training for exactly), so long that the opportunity cost can be life changing even if there was no direct cost for the course itself.
This breaks the assumption, making government intervention useful.
More to the point, nobody actually knows this exactly, not even the government, but given the choice between too many doctors and not enough, the first one is obviously better. If you have too many doctors then some of them can become researchers etc. If you don't have enough, people die.
To the extent that the government has some non-public information, they cannot always reveal it directly. Sometimes this backfires, e.g. the UK politicians blaming the EU for all the things the UK politicians wanted to do anyway but needed a scapegoat for.
Most of the people beginning this training have only just reached adulthood, and have no reason to be politically sophisticated. I sure wasn't, at that age.
Even if the government was completely open and honest, market are not efficient unless P == NP.
> More to the point, nobody actually knows this exactly, not even the government, but given the choice between too many doctors and not enough, the first one is obviously better. If you have too many doctors then some of them can become researchers etc. If you don't have enough, people die.
Yes, when resources are effectively unbounded. Even more than that, I would even argue that (owing to what I've heard on the grapevine in the UK about overtime) training more doctors and nurses would lower the cost to the taxpayer.
But resources are not unbounded, and governments have other priorities besides this. What else can be bought for the cost of a doctor? Sometimes those other things are also measured in lives, other times they're measured in the economic cost that could pay for two doctors.
Is that expected to be relevant here? What kind of secret jobs data would the government be keeping under lock and key for the security of the nation in a typical year?
> Most of the people beginning this training have only just reached adulthood, and have no reason to be politically sophisticated. I sure wasn't, at that age.
This is why adolescents have parents or, failing that, teachers and guidance counselors.
> Even if the government was completely open and honest, market are not efficient unless P == NP.
Markets don't have to be perfectly efficient, the only question is if they're more efficient than central planning, and the answer to that question is yes.
Notice that the government also has no ability to timely perform NP calculations.
> What else can be bought for the cost of a doctor?
Probably like a tenth of a mile of paved asphalt. Having a few "too many" doctors is going to be worth more than the median thing the government spends money on, because trained doctors are valuable even outside the practice of medicine, e.g. as researchers or policy advisors or simply as a buffer against undersupply, since the consequences of that are so dire.
Moreover, this isn't even a valid question when the size of any given graduating class is a small proportion of the total pool. If it takes 7 years post-bachelors to become a doctor and then you are one for 35, the total size of the pipeline is only 20% of the size of the pool. If the number of doctors in training is 50% too large, the total supply will only be in excess by 10% from the point you figure that out, and that's the single-year peak that only lasts for one graduating class before it starts edging downward again. It's just not a big problem for that to happen. These numbers are within the error bars for how precisely "oversupply" or "undersupply" can even be defined or agreed upon as a concept.
No. Where do you get that misinformation?
Yes, it's relatively easy to construct a model where perfect information and a bunch of other assumption lead to markets being great. But that merely shows that these conditions are sufficient. Not that they are necessary.
To make an analogy:
We can analyse spherical, friction-less cows in a vacuum and conclude that as long as they move less than about 10km/s the won't escape into space. If we then observe that real cows aren't spherical nor frictionless, we can't automatically assume that they'll escape into space at a lower velocity.
> This breaks the assumption, making government intervention useful.
Non sequitur? Reminds me of the famous syllogism https://en.wikipedia.org/wiki/Politician's_syllogism
Something has to be done. This is something. Thus it has to be done?
> Yes, it's relatively easy to construct a model where perfect information and a bunch of other assumption lead to markets being great. But that merely shows that these conditions are sufficient. Not that they are necessary.
"Markets are efficient if and only if P = NP": https://arxiv.org/abs/1002.2284
To quote:
"""
I prove that if markets are weak-form efficient, meaning current prices fully reflect all information available in past prices, then P = NP, meaning every computational problem whose solution can be verified in polynomial time can also be solved in polynomial time. I also prove the converse by showing how we can “program” the market to solve NP-complete problems. Since P probably does not equal NP, markets are probably not efficient.
"""
> Non sequitur? Reminds me of the famous syllogism https://en.wikipedia.org/wiki/Politician's_syllogism
I think I see what you mean, as I didn't give sufficient justification.
In this case, government control makes this sector function as a planned economy. The normal flaw in a planned economy is that it cannot respond quickly to changing consumer demand, and I do not dispute this.
In the case of medical issues, consumer demand is a lot more predictable by the government than by the general public, as the demand 20 years from now is mostly directly influenced by other government interventions in the meantime (governments have a better awareness than random 18 year olds choosing their university degree of the plausibility of a smoking ban or a sugar tax, they can change pollution rules to ban leaded fuel, etc.), and the exceptions are things like "novel global pandemic" or "we're at war now" where the government has to directly intervene in other ways anyway.
> "Markets are efficient if and only if P = NP": https://arxiv.org/abs/1002.2284
That's a very cute result, but requires a very specific definition of 'efficient market'. There's actually a range of 'efficient market' definitions, each with their own 'efficient market hypothesis'.
One of the weaker forms that I like is: 'don't expect to make any money trading stocks as an amateur on news that the full time professionals (and their computers) in the hedge funds and at Goldman have already seen.' (This one is mostly useful for internet discussions with people who believe in reading price charts etc.)
The paper basically shows that if you want to be really careful in your definition of '(weakly) efficient market', you need to take computational complexity into account. It says more about definitions, than about the economy. In any case, if you like that kind of thing, you should check out https://scottaaronson.blog/?p=735 too.
---
> In this case, government control makes this sector function as a planned economy. The normal flaw in a planned economy is that it cannot respond quickly to changing consumer demand, and I do not dispute this.
There's lots more wrong with (most) planned economies.
Eg the demand for toilet paper is---covid aside---famously easy to predict. Yet, the Soviet Union was also infamous for their toilet paper shortages.
> In the case of medical issues, consumer demand is a lot more predictable by the government than by the general public, as the demand 20 years from now is mostly directly influenced by other government interventions in the meantime [...]
The government officials in power today are most likely not the government officials in power over the next 20 years. In most cases, it's not even the same party that's in power. Current government officials don't necessarily have any special insight into long term government actions.
Not useful, but rather required. The fixpoint of a ruleset allowing free markets to exist is not free market, but rather somewhere between laissez faire and anarcho-capitalism.
Sorry, it's never a good idea to base real life policy on ideological dogma. The "free market philosophy" has some good ideas, as well as a lot of bad ones. We shouldn't blindly follow its "dictates."
In my experience, the people who dogmatically preach the free market frequently have an oversimplified understanding or use circular logic to conclude the free market is good by redefining good as whatever the free market does.
A lot of the stuff assumes that it is 1850 and everyone can buy land and farm potatoes. With "unlimited" land and tens of thousands conpetitors. No barriers of entry too.
And Im pro market.
There are bad arguments for good conclusions, yes.
Free market is not "everyone can do anything", that's somewhere between laissez faire and anarcho-capitalism. "Free market" is a theoretical model where goods, services, and, crucially, information flows freely. Or in more textbook definition, there exists perfect information symmetry.
In a functional "free market" a student would know their employment prospects before they even submit application.
EDIT, addendum: If we are talking doctors, the training takes 10 years (6 if you don't include specialist training), but that's a long time. So long that the environment itself could change dramatically, for whatever reason. Free market being free, could distort itself so much that perfect information symmetry does not translate over time.
So how do you ensure that the information which was true before training remains true after training period even if the free market mutated itself and invalidated the information? Surprise, surprise, you get government to uphold the "freedom" of the market.
What anonymous text books are you mentioning?
Under certain circumstances it makes sense to study a model of markets with perfect information symmetry. But that's a very different (and much more restricted) term than 'free market'.
In "Criticism" section we find:
> Critics of the free market also argue that it results in significant market dominance, inequality of bargaining power, or information asymmetry, in order to allow markets to function more freely.
Clicking "https://en.wikipedia.org/wiki/Inequality_of_bargaining_power" shows right at the introduction:
> Inequality of bargaining power is generally thought to undermine the freedom of contract, resulting in a disproportionate level of freedom between parties, and that it represents a place at which markets fail.
One could click on https://en.wikipedia.org/wiki/Information_asymmetry#cite_not... , to find:
> Information asymmetry is in contrast to perfect information, which is a key assumption in neo-classical economics.[11]
But that would require one more click to https://en.wikipedia.org/wiki/Neoclassical_economics:
> Neoclassical economics is an approach to economics in which the production, consumption, and valuation (pricing) of goods and services are observed as driven by the supply and demand model.
> Under certain circumstances it makes sense to study a model of markets with perfect information symmetry. But that's a very different (and much more restricted) term than 'free market'.
Again, that's exactly what "free market" is. Market that functions *solely* on interparty contracts is laissez faire.
The key difference is that in laissez faire price equilibrium is a defining property, whereas in a free market price equilibrium is an expected emergent property if perfect information symmetry is maintained.
I was specifically referring this idiosyncratic definition.
> The key difference is that in laissez faire price equilibrium is a defining property, whereas in a free market price equilibrium is an expected emergent property if perfect information symmetry is maintained.
You are mixing up `if` and `iff`.
I’m pretty much the opposite of a libertarian, but I find the very idea of restricting education and denying competent people professional certification on the grounds of limiting supply to be perverse.
There's no good accomplished by letting people waste their time, money, and talent on training they won't be able to use; and which they are counting on using to support themselves.
There’s no good accomplished by restricting education and professional certification to artificially restrict supply. All it does is create perverse incentives and harm the public good.
The people I know in similar situations regret their choices, or are at least are a little bitter.
> There’s no good accomplished by restricting education and professional certification except to destroy peoples dreams for the sake of a lucky few.
Let me put it this way: if their dreams are going to be destroyed, it's best to do that as soon a possible. Putting that off makes things worse, not better.
There are a ton of shitty doctors and entire geographic regions that are deprived of specialists because of this kind of nonsense. Your policy may help a few people but it harms all of society.
Sort of. In many areas it's possible to do a good-enough job of sorting out the people who will almost certainly succeed. It won't be perfect, but nothing is. If there are enough of those to fill a long and specialized training program to the point where actual needs are met, then you shouldn't be letting a bunch of extra "maybes" in too, because that just introduces bad outcomes at the end that could be avoided.
On the other hand, because of supply, finding a good lawyer just requires a bit of money, well within reach of the average person facing a criminal trial or some civil dispute. Finding a good doctor requires sitting on waitlists for months (if you’re lucky enough to find one taking new patients) unless you have enough money to afford a concierge service, which the vast majority of people cannot afford. I’ve had bad concierge doctors but I’ve never had a shitty lawyer paying that kind of money.
I mean really, where do we stop? There’s many more English literature graduates than jobs. Same with ____ studies and just about every other humanities degree. Do we restrict those too? How about higher education altogether?
There’s an important debate to be had about government financing and the non-dischargeability of loans and all its effects, but restricting education based on job supply is just harmful to societies on so many levels.
This is a two way street. Everybody needs medical care. Almost everyone is going to need legal advice in their lives. Depriving them of competent care and representation does far more harm than limiting supply would save. Failed medical students don’t die from the ordeal, but patients do.
The washout rate for A&P aircraft mechanics is on the order of 75%. Imagine if healthcare were as reliable as airplanes (though there’s a shortage there too).
You're getting the basic facts wrong. As least in the US, the restriction is acceptance to medical school. Part of the reasoning is they don't want to accept anyone who they think will fail years down the line, because that's bad for everyone (you, me, the failed student, and the teachers who aren't in it for the $$$). There's a surplus of residency slots (overall), because otherwise no foreign-trained doctors would ever be able to practice here.
Lots of foreign-trained doctors practice here.
My position is they need to increase medical school admissions (and residency slots), but not throw the doors wide open to all comers. The slots need to be managed such that anyone who gets can complete the program and will have a job waiting for them that pays commensurate with the amount of training they receive, but probably much less than many doctors get now.
> I mean really, where do we stop? There’s many more English literature graduates than jobs. Same with ____ studies and just about every other humanities degree.
Yes. What's happening with English literature graduates (at least on the PhD level) is an exploitative travesty.
> ...but restricting education based on job supply is just harmful to societies on so many levels.
I disagree. It's harmful to string people along with false hope, only to slam the door in their face at the end. It's harmful for society for people to waste time on a job training program (which is what medical education really is) for a job they'll never get.
There needs to be a distinction made between general education and job training. Unless you're independently wealthy, specialized formal education needs to perform both functions.
> The washout rate for A&P aircraft mechanics is on the order of 75%.
Aircraft mechanic school is about 18-24 months (https://www.indeed.com/career-advice/finding-a-job/how-long-...), and costs a few tens of thousands of dollars. That's not comparable, at all.
> Imagine if healthcare were as reliable as airplanes (though there’s a shortage there too).
Sure imagine that, but people aren't manufactured products. Not a valid comparison.
Not really relevant. We're not talking about the general concept of "success", we're talking about if the market for some profession or academic pursuit can support a certain number of people entering it. That's something that you can predict reasonably well. Not perfectly, and there can certainly be outlier events that drastically change things unexpectedly. But it's possible to have reasonably accurate forecasting here.
As for "success", sure, it's hard to tell if any individual who wants to enter a particular field will do it well enough to be successful. Admissions departments at universities can sometimes do an ok job predicting that, but they often end up being wrong (in both directions). That's just life.
The medical profession is of course doing those forecasts and then artificially restricting things further, in order to maintain high salaries and high prestige. I don't think we'd be having this argument if they weren't so greedy and set limits at reasonable levels such that we had enough doctors and specialists out there to handle patients promptly and effectively.
It could vary year by year, so a year with a really great cohort, maybe the majority would come through, whereas with a bad cohort almost all of them wouldn't make it.
What I'm arguing against is a reactionary over-correction.