• aidan@lemmy.world
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    7 months ago

    if it wasn’t for privatized insurance mucking the whole thing up

    Insurance companies aren’t saints, but their whole goal is to keep costs for themselves low so they can pocket the premiums. A lot of factors go into driving up health care costs, this is nowhere near all of them but to name a few: AMA keeping residency slots low to control supply of doctors and keep wages high, high educational cost meaning doctors require higher pay, long education needed(high lead time on new medical staff, doctors have some of the longest educational time in the US of anywhere in the world), intellectual property law enforcing drug monopolies, extremely expensive FDA approval process, (?)expensive FDA certification of some equipment(this I’m not entirely sure about- but I suspect its the case), Certificate of Need laws restricting competition in some areas.

    Everyone always jumps to defense spending which is not the problem. Defense spending creates hundreds of thousands of well paying jobs to American citizens. The large majority of the money used to produce military goods goes back into the economy.

    Sorry to say Keynesian economics died.

    Other than that, the first part of your comment is right.

    • medgremlin@midwest.social
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      7 months ago

      The number of residency slots is actually controlled by Congress as residencies are funded through Medicare. The AMA has been trying to fight back against and regulate privately funded residencies like the ones started by HCA. Those ones were created as a way to exploit residents’ labor and are of such poor quality that HCA won’t even hire their own graduates.

      • aidan@lemmy.world
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        7 months ago

        The AMA doesn’t directly control it, what it does do is lobby congress to limit it. The AMA actually is the reason the cap was put in place in 1997. Doctor administrators are also often AMA members/supporters/in some capacity bound to the AMA, so they often don’t explore other sources of funding than government for expanding residency capacity.

        • medgremlin@midwest.social
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          7 months ago

          I’m curious as to where you are getting that information. There are other explorations into funding for residency slots as it tends to benefit the institutions that have the residencies, but the issue is that there needs to be a guarantee of funding in perpetuity in order to create the slot, and many offered funding sources either cannot guarantee that perpetuity or they only offer the money with a lot of strings attached.

          I’m a medical student member of the AMA and I frequently get emails from them asking for my participation in lobbying campaigns to increase the number of residency slots. (I have written to my representatives about it a couple of times, but I don’t really have the time or resources to do much else.) The individual colleges and fellowships are also advocating for their own specialties. The ACEP and ACOEP (American College of (Osteopathic) Emergency Physicians) are both investing a lot into advocacy campaigns for the specialty.