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There exist similar systems in pretty much any other western nation. The problem is that teaching doctors is expensive and isn't something you can ramp up quickly because you need other doctors to teach the new doctors. The supply of doctors is a problem that is universal to essentially all western nations especially if you move away from metropolitan areas. It's largely due to aging populations and failure to increase spending on medical education over decades. I think the US is actually better off than many other countries, because they pay disproportionately high salaries so get more immigrants.

That said I don't think there's evidence that lack of doctors is what is driving up cost in the US. Just an example, growth in hospital administrators has significantly outpaced medical staff over the last decades, which will directly increase cost.

by estearum6 hours ago|

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Clarification because people get this wrong a lot:

There is no imposed limit on the number of residency slots.

There is a limit to the amount of money the US government is willing to spend on slots.

by triceratops6 hours ago|

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Why does the government need to spend money on slots at all? Do other countries do it like that?

by estearum6 hours ago|

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Because it makes pretty much no economic sense for anyone else to do it

One of many failure modes of the glorious and totally perfect Free Market

Yes most other countries use public money to educate their doctors

by triceratops5 hours ago|

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> Because it makes pretty much no economic sense for anyone else to do it

I think other funding models simply haven't been explored. I'll pull one out of my ass. The hospital does it themselves. In exchange the doctor works at the hospital for the next N years, or pays a contract break penalty. The hospital can pay the doctor somewhat less than market rate and doesn't have to deal with staff turnover.

It should be obvious that other funding models will be invented if government funding goes away. Because the alternative is no new doctors and people start dying without treatment.

by estearum5 hours ago|

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Residency training costs like $750,000 to $1.5MM per physician

Primary care doctors would have to work 12-15 years while giving up 25% of their gross salary just to pay for the residency program. They'd also have to pay x% of their salary to pay for their debt from med school training before the residency.

People just wouldn't go into the field, which is already happening even in a world where the residency is funded. The economics of being a doctor are simply not that great anymore, especially relative to other things you could do.

> It should be obvious that other funding models will be invented if government funding goes away. Because the alternative is no new doctors and people start dying without treatment.

There is an infinite number of jobs that would be great to have but we can't reasonably fund and so don't exist.

We currently live in a timeline where there are no new personal one-to-one tutors for middle schoolers and therefore every single middle schooler in the country receives subpar education, causing vast amounts of economics losses as compared to if they could be trained more thoroughly.

But that's just the way it is!

by triceratops4 hours ago|

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> Residency training costs like $750,000 to $1.5MM per physician

And how much do residents generate in billings?

Your numbers may also be off by a lot. It'd be great to see some sources. https://news.ycombinator.com/item?id=45507076