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Comment by anon291 | Hacker News Reader

Because the American Medical Association artificially restricts residency spots in hospitals. There's really not much more to it. This explains the proliferation of NPs, PA-Cs, etc acting as GPs. In reality, we simply need more doctors, so we should uncap the # of spots.

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This can't be stated enough. I should have my comment w/ citations on standby, but I don't.

The AMA was concerned in the 90s re: "oversupply" of doctors and the impact on doctor salaries, lobbied the Republicans (around the "Contract with America" timeframe) and got language limiting NIH-funded residency slots codified.

The AMA is backpedaling on that stance now but the damage is already done.

A reasonable compromise would be a scheduled increase in the number of slots until it is eventually uncapped. Yes, this will reduce doctors salaries in the long-term. You know what else reduces doctor salaries? Importing medical doctors from foreign countries with worse wages and working conditions, and then grinding these individuals to the ground under the threat of immigration. The market finds a way, whether the AMA wants it or not. As Americans get richer, many are even just going to foreign countries to get treatment. I know several 'third world' countries have fairly good medical care available for very cheap.

Doctors salaries should be reduced, as should nurses and dentists. We pay them nearly twice as much in the US as in countries with socialized medicine.

As part of a policy position, I'm guessing that, "Doctors and nurses make too much money" ain't exactly a slam dunk.

Foreign doctors have to go through residency in the US.

What does the AMA have to do with the Clinton-era cap on federal DGME and IME residency payments? New York spends billions every year, California spends none. These are choices that Congress and California make every year, not the AMA.

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