<story><title>When Hospitals Merge to Save Money, Patients Often Pay More</title><url>https://www.nytimes.com/2018/11/14/health/hospital-mergers-health-care-spending.html</url></story><parent_chain><item><author>blakesterz</author><text>I see what you&amp;#x27;re saying there, but I&amp;#x27;m not positive  artificially capping the number of doctors minted is a terrible idea. Don&amp;#x27;t we want to make sure only the best and brightest end up being doctors? If there&amp;#x27;s a spot for everyone who applies to med school, wouldn&amp;#x27;t that leave us with far more incompetent doctors?&lt;p&gt;There should probably be more doctors, but it doesn&amp;#x27;t seem wise to lower the bar too far down.</text></item><item><author>seibelj</author><text>Even worse is that some states have legally mandated monopolies that prevent competition from opening up. See this doctor who has to fight in court to allow his clinic to offer MRI&amp;#x27;s &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.vox.com&amp;#x2F;policy-and-politics&amp;#x2F;2018&amp;#x2F;7&amp;#x2F;31&amp;#x2F;17629526&amp;#x2F;mri-cost-certificate-of-need-north-carolina-lawsuit&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.vox.com&amp;#x2F;policy-and-politics&amp;#x2F;2018&amp;#x2F;7&amp;#x2F;31&amp;#x2F;17629526&amp;#x2F;m...&lt;/a&gt;&lt;p&gt;New medical schools must be allowed by the American Medical Association, artificially capping the number of doctors minted. This is why it&amp;#x27;s so difficult to get into medical school - the supply of spaces is constrained, unlike law school, where there is a spot for everyone who applies.&lt;p&gt;Dentists in Maine vehemently opposed allowing dental hygienists with a special kind of license to fill cavities without needing a full DMD. &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.washingtonpost.com&amp;#x2F;politics&amp;#x2F;the-unexpected-political-power-of-dentists&amp;#x2F;2017&amp;#x2F;07&amp;#x2F;01&amp;#x2F;ee946d56-54f3-11e7-a204-ad706461fa4f_story.html?utm_term=.6ef22f2853d1&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.washingtonpost.com&amp;#x2F;politics&amp;#x2F;the-unexpected-polit...&lt;/a&gt;&lt;p&gt;If we want to fix the medical and legal professions, and by fix I mean make it cheaper, we need to remove the warped incentives caused by the government that prevent natural competition from fixing the issues.</text></item></parent_chain><comment><author>nowarninglabel</author><text>This is the same broken logic as people who think they need to go to the &amp;quot;world&amp;#x27;s best X doctor&amp;quot; for care. That inevitably leads to sub-standard care because everyone is trying to go to the same person for a service and getting rushed in and rushed out. Most of us don&amp;#x27;t need the best doctor at X in the world to  perform our services. It&amp;#x27;s like thinking you need James Gosling or John Carmack to write the code for your small business website.</text></comment>
<story><title>When Hospitals Merge to Save Money, Patients Often Pay More</title><url>https://www.nytimes.com/2018/11/14/health/hospital-mergers-health-care-spending.html</url></story><parent_chain><item><author>blakesterz</author><text>I see what you&amp;#x27;re saying there, but I&amp;#x27;m not positive  artificially capping the number of doctors minted is a terrible idea. Don&amp;#x27;t we want to make sure only the best and brightest end up being doctors? If there&amp;#x27;s a spot for everyone who applies to med school, wouldn&amp;#x27;t that leave us with far more incompetent doctors?&lt;p&gt;There should probably be more doctors, but it doesn&amp;#x27;t seem wise to lower the bar too far down.</text></item><item><author>seibelj</author><text>Even worse is that some states have legally mandated monopolies that prevent competition from opening up. See this doctor who has to fight in court to allow his clinic to offer MRI&amp;#x27;s &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.vox.com&amp;#x2F;policy-and-politics&amp;#x2F;2018&amp;#x2F;7&amp;#x2F;31&amp;#x2F;17629526&amp;#x2F;mri-cost-certificate-of-need-north-carolina-lawsuit&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.vox.com&amp;#x2F;policy-and-politics&amp;#x2F;2018&amp;#x2F;7&amp;#x2F;31&amp;#x2F;17629526&amp;#x2F;m...&lt;/a&gt;&lt;p&gt;New medical schools must be allowed by the American Medical Association, artificially capping the number of doctors minted. This is why it&amp;#x27;s so difficult to get into medical school - the supply of spaces is constrained, unlike law school, where there is a spot for everyone who applies.&lt;p&gt;Dentists in Maine vehemently opposed allowing dental hygienists with a special kind of license to fill cavities without needing a full DMD. &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.washingtonpost.com&amp;#x2F;politics&amp;#x2F;the-unexpected-political-power-of-dentists&amp;#x2F;2017&amp;#x2F;07&amp;#x2F;01&amp;#x2F;ee946d56-54f3-11e7-a204-ad706461fa4f_story.html?utm_term=.6ef22f2853d1&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.washingtonpost.com&amp;#x2F;politics&amp;#x2F;the-unexpected-polit...&lt;/a&gt;&lt;p&gt;If we want to fix the medical and legal professions, and by fix I mean make it cheaper, we need to remove the warped incentives caused by the government that prevent natural competition from fixing the issues.</text></item></parent_chain><comment><author>seibelj</author><text>By that logic, we should artificially cap everything. Why allow just anyone to be a programmer? Don&amp;#x27;t we only want the &lt;i&gt;best&lt;/i&gt; programmers to write our software?&lt;p&gt;Any entrepreneur should be able to open up a licensed medical school. Anyone who graduates should be able to get certified as an MD. This is how markets should work - not capping doctors on the hope that we get &amp;quot;better&amp;quot; ones.&lt;p&gt;Also, I have seen some awful doctors, so I&amp;#x27;m not sure the system is working.</text></comment>