Your concept of a “market” and of demand seems flawed. You speak of an increased demand and an enlarging pool of elderly Medicare beneficiaries as if they were the same thing. If the payments of those burgeoning rolls of Medicare enrollees don’t cover costs, you cannot speak of their wish to purchase services as “demand.” All they are is people who want to consume, no different than throngs of the sick and underprivileged somewhere else where there is no medical care. What you speak of is a market failure, wrought by government price controls. In the harsh real world, that invites black markets and hardship. “Demand” does not necessarily increase as the population increases, only the numbers wanting what they or their government cannot or will not let them buy. Welcome to the East Bloc, before the fall of the Iron Curtain. I hope you get to become one of the Party elite with special access to the good polyclinics.

Want cheaply produced graduates? We already have a supply of those. The USA pays nothing for IMGs’ educations, yet they have not fixed the problem of supply as you see it. When those immigrants meet the market, they aren’t bottom-fishing or seeking volume at the expense of price. They need to pay the same costs (except loans, I suppose) as everyone else. Setting aside the immorality of plundering the graduates of nations far more strapped than our own–no inconsequential thing IMO–we still can’t fix the problem. Flooding the physician labor market with “graduates” of low-quality proprietary schools and making doctors of people who cannot find their way into the large supply of seats already available is not the answer you seek. You can’t have loads of care at every age, serve a population indifferent to personal responsibility, grant nearly carte blanche to spend silly in the last months of life, give the population an entitlement to use emergency departments at their reckless discretion and not have health care cost a bundle.

The answer to this problem is not just pumping out more doctors.

The educational model here is simple. Pass the boards and complete a residency. Schools worldwide are able to produce students that are judged according to more stringent standards in regards to the former than those produced here. This is done without the CME red tape and interference of domestic schools and could be readily replicated here if not but for the intransigence of the special interest group of existing providers.

How exactly is it that we need more for-profit schools making more providers if your analogy to the independent trucker holds? Seems if the paying market won’t pay more to cover relentlessly rising costs of business to the doctor, that would suppress the demand for more doctors, schooled wherever.

If you had to add a profit margin to an educational enterprise that costs more than enough as a non-profit, what economies to you expect in a for profit venture, unless ou mean to significantly downgrade quality (night school, perhaps? Maybe distance learning? Capella, Phoenix . . . Bueller?)

I think on balance, the current earnings of most physicians pretty much meet those criteria. Some fields, like peds, are suppressed by the presence of an inordinate number of docs who don’t adequately defend their own economic position, and some others probably abuse a monopoly position in pricing certain procedures–but on balance it is pretty fair.

But the fact of the matter is that single-payer governments of Canada and Britain have had to significantly increase salaries, especially to specialists. I personally know a neurosurgeon in Windsor, Ontario, making $450,000 Canadian, which is nearly 500K USD at recent exchange rates. The government doesn’t advertise that!

Junior house officers (equal to residents) in the UK make 60-70K Pound/year. This is equivalent to a 6 figure salary in the US for a resident!

Even single-payer governments have to deal with the reality of supply and demand- especially as the economy becomes more global. When looked at in terms of the dollar value and actual hours worked, docs the US don’t really earn more in purchasing power than their European or Canadian counterparts.

Criminallopath, you need a serious reality check – there is a severe global shortage of docs and an ever increasing demand for services. Your ignorance of economics even surpasses your ignorance of medicine.