CalgaryAMC

And another thing I forgot to mention is that in the US the supply of healthcare professionals is essentially fixed by government regulation.

That means, of course, that there is no free market health system in the US. If there was a flexible supply curve, then the system would be significantly less expensive than it is.

What you have now is basically a market failure by government design. The supply side is heavily regulated and oligopolized, whilst the demand side is not.

To resolve this you would have to free up the medical education system somehow, to allow more medical schools to be built using private money, and allow more people to graduate from those schools using their own money.

supernav

I'm confused. Are you referring to Canada? If you're referring to the US -- please explain further what you mean.

-= nav =-

CalgaryAMC

You cannot, in either country, buy a medical qualification off the internet. The procedure to become a doctor is regulated, and so are the institutions that are permitted by law to provide these qualifications. So the model has a fixed supply curve (except, perhaps, the very long term model).

supernav

Why would the _supply_ be limited? The US has laws to prevent more than XX # of doctors from graduating or being hired each year?

-= nav =-

Bob

Yup, it's called quota cap.

Duncs

Hmm looks like i started a row again and then left the room!

No conclusions though as usual, aside from the fact that everyone here believes in a more universal system of healthcare than Supernav. Personally i agree and am convinced that for any number of reasons both economic and social justice based that a 'free at point of delivery' system is preferable. Its pretty clear as well that it has better outcomes. The USA spends nearly 16% of its GDP on healthcare (UK around 8-9%) and yet has the one of the lowest rankings of any industrialised nation on any number of World health Organisation (WHO) rankings. Thats pretty poor and obviously economically inefficient as well, as far greater expenditure is getting worse results. The problem with heathcare really is that many of the economic problem issues arise and distort the market eg adverse selection, moral hazard etc. This is combined with a mechanism in this country that utterly distorts what market signals are available because the consumers is not the purchaser. Supernav likes comparing the car market but imagine a car market based on the system used by the Us healthcare economy. The car salesman decides for us if we need a new car, then he tells us what value of car we need and then he gets paid by a third party not by us, we would all drive a brand new lexus/mercedes/BMW. Does it really take a genius to see a recipe for rampant inefficiency and cost inflation? At least until the base cost of being in the game rises and costs some groups out so that the remaining groups keep a lexus while lots of other get to walk. All of which is of course financed through the backdoor by the government who secretly subsidise the system by taking out lots of the high risk patients (old folks, VA etc) Its laughable to describe it as a private system when the flat cost government subsidy is approching 45% of every dollar spent on healthcare and if you include the subsidy cost of tax relief more like 60%.

But we can go round and round. Supernav has brought wholesale into the idealogy of economics and will recite his '4 legs good, 2 legs bad' (private good, public bad) mantra from here until eternity. Its not a purely rational position as its based on certain idealogical assumptions about the wonders of the capitalist market economy and so no amount of evidence will persuade such a mindset.

Rousseau was probably right that "the first man to plant a fence-post, and have it acknowledged by his neighbours, was the creator" and if i ever invent a time machine i am going back to kick that mans ass.

CalgaryAMC

By regulating the procedure to become a doctor, it does so.

You must receive a degree from a government list of institutions, in accordance to a government specified program of study, and then pass a series of government prescribed exams.

Like other goods and services, the supply of education is limited and the demand for it is infinite. However, providers of education ration provision based on scholastic aptitude rather than money. For obvious reasons that causes market failure.

CalgaryAMC

Well argued.

supernav

Yes but merely requiring accredition and licensing is not equivalent to a federal restriction for employment purposes. If it were so -- there would be a limitation on lawyers (which i would definately campaign for!)

The lack or excess of competent schools is a private market decision.

There are numerous healthcare professions that can be taught at the local community college down the street.

-= nav =-

iaink

A rather sobering thread! Glad I live in Canada.<ducks>

I heard (on canadian TV) that someone in the US declares bancrupcy every 30 seconds due to medical expenses.

In practice the US sucks trained and qualified doctors out of the canadian system with the lure of more money and more modern facilities (funded by the out of control private insurance industry), and Canada doesn't help itself by making it so hard for foreign trained doctors to practice up here to fill the void.

Oh well, I'll fetch my hat!

supernav

And they shouldn't.

No Canadian is going to benefit by allowing Foreign Doctors to pass "watered down" exams in order to get a license.

If that was the case. I'd want my heart surgeon to be a full-fledged Canadian doctor who passed the whole enchilada. Not a foreigner who passed the "foreigner exam" where you only need a 50% to pass.

In the private sector we wouldn't hire someone who flashed some "Degree of Science from Zimbabwe" without him passing a reasonable exam to prove his skills as equal to every other candidate. The public sector, especially HealthCare of all professions, should be no different.

Same reason why Foreign DL's aren't valid here. If they want to drive -- they have to pass the same driving test as everyone else.

Now if the Can government won't allow them to write the exams in the first place -- that's a different issue. And a more complicated one at that. Especially for such sensitive professions such as heart surgeon.

-= nav =-

iaink

I am quite happy to be treated by an english trained doctor while I'm in the UK, why would I have any reservations about the same doctor treating me in Canada? Adequately trained doctors should not be asked to pass more exams of any type, what is needed is more international cooperation to agree on international standards of training.

The hoops that "western" trained doctors are asked to jump through, plus the fees charged to assess existing qualifications are just plain ridiculous. Its simple protectionism in practice.

supernav

The word "adequately trained" is a very loaded statement.

Not all colleges are the same. Not all country's educational systems are the same. Doctors can come from anyone of over 200 countries. Speaking a multitude of languages. Including a multitude of ways of treating various diseases and operations.

What if some regulatory body finds 3 school's in UK provide 80% of the needed curriculm and 2 schools provide 75%. Should those doctors get 80% and 75% pay respectively? What about years expereince? Does that count and make up 100%?

What about doctors that are accustomed to reading documentation in their native languge. But do not know the elongated english medical terms for various elements.

This is a VERY complicated topic. And one that ultimately should be debated by those in the medical field. As a lay-man with no medical training; i can only theorize all the complexity, education and training involved for say an open-heart bypass surgery. Equating that to a 2 hour test and a foreign piece of paper that one day could possibly result in the death of a patient -- is a very tough call to swallow.

-= nav =-

Bob

Thing is, drivers exam here is a joke compared to many other countries...and many other countries have same medical standards...so not exactly a good analogy

USBound

:scared: too many comments.... head going to EXPLODE...

everyone here has their opinion... personally I'm on the side of "Everyone But supernav" BUT... I do agree with him in some part; for most of us, our knowledge of the systems/services we claim to know is limited to that which we see in the doctors office.

The actuality is far more complex. Simplified somewhat below

US model (expensive but up to date, pressured to the point of implosion, dangerously so):

1. Wannabe doc spends 7 years training at "insert school here", there are not many of these schools and so the price to go to them (as per standard economics) is higher than normal higher education.

2. Doc then starts working, wants to pay off his debts, gets paid LOTS of money by the institutions he works for cos they KNOW about the cost of training.

3. Institutions want to offset the high pay so they charge more.

4. Joe Bloggs on the street has to pay more (or his insurance does)

5. Insurance company wants to ensure they aren't out of pocket so charge more for cover.

Uk Model (not as expensive, not pressured, slow but reliable):

1. Education is not overly cheap.. but runs a prospective doctor to 20/30 k... Government based loans (<1%)

2. Goes to work for NHS getting an ok pay, easily able to pay his loans, works a normal day of 14/18 hours. Able to sign his name on a form without charging $380.

3. THE END