Dean Baker on the NYT’s “doctor shortage” piece:
Apparently NYT reporters never heard of immigration. This is the only way to explain a front page piece that discusses an alleged shortage of doctors in the United States that never once discusses the possibility of bringing more doctors in from other countries.
As a practical matter this should be very easy to do since doctors in the United States earn on average about twice as much as their comparably trained counterparts in Western Europe and Canada.They earn five to ten times as much as doctors in the developing world.
If the government were to set up mechanisms that could fast track the certification of doctors from other countries so that they could quickly establish that they have been trained to U.S. standards and then would be free to come to practice in the United States just as any native-born doctor, it is likely hundreds of thousands of doctors from around the world would quickly take advantage of the opportunity. (In the case of developing countries, it is easy [even a DC policy wonk could do it] to design mechanisms where they would be compensated for doctors who came to the United States so that they could train two or three doctors for every one that came to the United States. This would ensure that developing countries gained from the arrangement as well.)
The other “structural” problem here is occupational licensing. Take, for instance, this year’s scrum in Harrisburg between optometrists and opthalmologists over who’s allowed to do laser eye surgery.
As technology improves, laser eye surgery is becoming increasing automated, and there are fewer and fewer opportunities for human error. This makes it feasible for service providers with less training to offer laser eye surgery for less money. If more poor and middle class folks can afford laser eye surgery because it becomes cheaper, this is the same thing as an increase in their real wages.
Other states like Kentucky have started allowing optometrists, who do not have to go to medical school, to do laser eye surgery and some minor cosmetic procedures. This makes it easier and cheaper for Kentuckians, especially in rural areas, to access affordable care.
Opthalmologists, who do have to go to medical school, see this as a threat to their wages, and have been scrambling to prevent other states from turning this high-cost procedure into a more widely-accessible, low-cost procedure.
Some people would want to say unaffordable laser eye surgery is evidence of an “ophthalmologist shortage”, but clearly the scarcity is fake. It’s a political creation.
