Earlier in the week the NYT had an editorial decrying the shortage of doctors and proposing routes to address it. (Strangely, bringing in more foreign doctors was not on the list.) Today the paper ran a number of letters responding to the editorial including one from president of the American Medical Association (A.M.A.) discussing its heroic efforts to alleviate the doctor shortage. This is opposite to the reality.
The A.M.A has long supported measures to restrict the number of doctors in order to ensure that the overwhelming majority earn salaries that put them in the top 1-2 percent of workers. This fact can be discovered simply by reading through past New York Times articles. For example, a 1997 article carried the headline "Doctors Assert There are Too Many of Them." This article reported on the complaints of doctors' organizations:
"'The United States is on the verge of a serious oversupply of physicians,' the A.M.A. and five other medical groups said in a joint statement. 'The current rate of physician supply -- the number of physicians entering the work force each year -- is clearly excessive.'
"The groups, representing a large segment of the medical establishment, proposed limits on the number of doctors who enter training programs as residents each year.
"The number of medical residents, now 25,000, should be much lower, the groups said. While they did not endorse a specific number, they suggested that 18,700 might be appropriate."
Another article, headlined "U.S. to Pay New York Hospitals not to Train Doctors, Easing Glut," told readers of a plan:
"that health experts greeted as brilliant and bizarre, Federal regulators announced yesterday that for the next six years they would pay New York State hospitals not to train physicians.
"Just as the Federal Government for many years paid corn farmers to let fields lie fallow, 41 of New York's teaching hospitals will be paid $400 million to not cultivate so many new doctors, their main cash crop.
"The plan's primary purpose is to stem a growing surplus of doctors in parts of the nation, as well as to save Government money."
Any discussion of an alleged shortage of doctors in the United States should include an account of the doctors' efforts to create this shortage to keep their salaries high. It is also striking that, unlike the case of STEM workers, nurses, or farm workers, no one discusses bringing in more foreign doctors to alleviate this shortage. There would be hundreds of thousands, perhaps millions, of foreign physicians who would be happy to train to U.S. standards and work for even half of the pay that doctors get in the United States. This would reduce the cost of health care in the United States, freeing up tens of billions of dollars to be spent in other areas creating hundreds of thousands of jobs.
And, we do know how to ensure that importing more foreign doctors does not hurt health care in the developing world. If the income taxes paid by foreign trained doctors were transferred to their home country, they could easily train 2-3 doctors for every doctor that came to the United States. This would ensure that developing countries gained from this arrangement as well.
It is striking that the same people who eagerly promote removing barriers to imported goods, putting downward pressure on the wages of manufacturing workers, and support bringing in foreign workers to put downward pressure on the wages of nurses and STEM workers seem unable to even conceptualize the possibility of bringing in foreign doctors to alleviate an alleged shortage.
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