Rich get richer / poor get poorer

[razztazz]

had the same thoughts. The "medical establishment" by whatever formal or informal organizational structure does a lot of harm related to supply of medical doctors and regulation of who can administer medicine. Many doctors tend to become very defensive about these issues when you bring them up. I'm pretty sure this all Hillary's fault.

Well it ain't just Dr's. It's anybody with aproprietary interest. Most of the anti union jibba-jabba is correct at least in principle. But the "Business Class" is as much in colusion as anybody else. It's one of those things that is a given in nearly every situation. The problem is how we choose to manage things for best results. I have no more confidence in some mystical magical unfettered free-market thingy than I have in The Big Government Store, or Divine intervention.

And I have no respect for anyone, or at least their reasoning abilities and knowledge base, who insists that this way or that is always the best way or that any way can be the only way to deal with things.

 

[ladelfina]

I guess I don't see this happening. I see a LOT of care, including prescriptions (amoxicillin included), being given out by Physician's Assistants and Nurse Practitioners.. roles that didn't even exist a few decades ago. Also, there are a lot more over-the-counter meds that used to be prescription only.

Yes, every group has an incentive to protect its interests.. but as for the licensing.. isn't there another thread going about "unemployed" lawyers?

I don't think doctors are sacrosanct but I do see that there is probably 10x more information that a doctor has to be familiar with today, compared to a generation or two ago. Back then, the doctor really was "God", whereas today the system is far more 'democratic', if you will.

Licensing laws are not "designed" to restrict supply. Under (I assume) the same regime.. a few years back there was supposedly a "glut" of physicians!!

If there is a shortage of MDs today there are probably a lot of other factors at work.. And anyway.. what's wrong with a shortage creating a situtation in which higher compensation could attract more talent? Sounds like that would be right up the Cato Institute's alley!

Am I the only one confused here..

 

[youbet]

Licensing laws are not "designed" to restrict supply.

Sadly, that's not always true.  Some are "designed" to do so.  And even if they aren't restrictive in the beginning, some become so over time and need modification.

I think we should look at the MD supply from another point of view.  What can we do as an society to aggressively promote a larger supply of medical services suppliers such as MD's, nurses, technicians, etc.?

Finances and classroom availability should not be a restriction on supply.  Everyone with the brains, integrity and ambition to served in this area should be able to do so.

When MD pay levels drive a MD supply that is at equilibrium with demand, we'll have the correct number of MD's.

 

[ash]

Sadly, that's not always true. Some are "designed" to do so. And even if they aren't restrictive in the beginning, some become so over time and need modification.

Exactly.

At the risk of doing the unmentionable and comparing doctors to cab drivers ... take NY taxicab licenses. Anyone who wanted one in the 40's went down, paid a fee and got one. Then the city stopped issuing them (because of the war IIRC) and didn't start up again because there wasn't a demand. By the time there was a shortage, the people that already had them had an interest in making sure that no one else got one. Today, a NYC taxicab license is worth tens of thousands of dollars. Want to start a taxicab service in NYC? You have to break the law or get rich first.

A license is a barrier to entry; as a barrier to entry it naturally keeps some people out. Again, we can debate whether that's good or bad, but that's what they do.

Others have commented that licensing laws have been loosened in some areas recently (citing PAs and RNPs) which is all I initially suggested!

 

[Texas Proud]

There is a difference in licensing for professionals and to mearly restrict...

I do not want to got to a doctor that does not have training... or use a lawyer that does not have training.. or CPA, or....

But, a cab driver that is only to restrict the number... hairstylist well, for the women who have a lot done to their hair, maybe it is needed, but for my haircut with a number "4".. most anybody can do it.. but I do not see a problem with making them take a test to show that they at least KNOW what they are doing.. and hence a license..

Using your cab as an example.. there is NO test involved for the tag number... they sell on the open market!!! I could go and buy one if I had about $100K.. now, I would have to take a driving test to get a correct drivers license.. but I could get one and not be able to drive a cab without the tag.. big difference than doctors..

 

[ash]

There is a difference in licensing for professionals and to mearly restrict...

I do not want to got to a doctor that does not have training... or use a lawyer that does not have training.. or CPA, or....

But, a cab driver that is only to restrict the number... hairstylist well, for the women who have a lot done to their hair, maybe it is needed, but for my haircut with a number "4".. most anybody can do it.. but I do not see a problem with making them take a test to show that they at least KNOW what they are doing.. and hence a license..

Using your cab as an example.. there is NO test involved for the tag number... they sell on the open market!!! I could go and buy one if I had about $100K.. now, I would have to take a driving test to get a correct drivers license.. but I could get one and not be able to drive a cab without the tag.. big difference than doctors..

I agree with you in that the only people who would make the quality/safety argument about restricting taxicab licenses are members of the taxicab industry!

And I understand that there is an accepted, and not unreasonable, argument that physician licensure increases both safety and quality. This can be debated, but I accept that the argument exists and is held by reasonable and intelligent people, who put forth good logic in support of it.

Nonetheless, merely because licensure might increase safety and quality is no reason to believe that it isn't also used to protect the interests of those who are already licensed. Consider this logic:

1) Licenses restrict the number of people providing a service (for better or worse).

2) If the number of persons supplying a good or service is decreased (shift of the supply curve caused by say, a license requirement), the price will go up (all things being equal).

3) Those providing the good or service now have an inherent personal and financial interest in restricting others from obtaining the license, and may use political and social forces to protect that interest, whether they be doctors, taxicab drivers, teachers or department store Saint Nicks.

Believing that doctors are somehow fundamentally immune to self-interest or economic laws doesn't make any more sense than believing that gold somehow has a gravitational advantage over lead.

 

[d]

doesn't make any more sense than believing that gold somehow has a gravitational advantage over lead

you mean it doesn't? but we do get french benefits with that, right?

 

[Texas Proud]

Ash..

You have a lot to say, but it does not pan out for most of what I see (except maybe doctors)..

There are a glut of lawyers... and you can go to MANY schools to get a degree...

There is nothing 'limiting' the number of CPAs... go to any college, get the required knowledge, take and PASS the exam.. you got it.. and in Texas at least... a glut...

Now, the taxi drivers in NY is to prevent new entrants... but except for a little bit on the side, NY has not increased in size much...you do have a limit on the number of cars that can fit on the streets..

But.. you seem to indicate that the license requirements are more for restrictiion instead of 'safety'.. I don't believe that.. now I wish they would remove the licensees from more people who 'do bad'.. but that is another discussion...

 

[ash]

There are a glut of lawyers... and you can go to MANY schools to get a degree...

There is nothing 'limiting' the number of CPAs... go to any college, get the required knowledge, take and PASS the exam.. you got it.. and in Texas at least... a glut...

(emphasis added)

Your statements support my conclusions. You assert that the licensing requirements are easier for lawyers and CPAs, and that we have a glut of those professions.