The Gravy Train May Soon Run Dry

For once in his life (maybe twice or three times), Matt Yglesias is right in his point of view, this time about doctors making way too much money. The reason they make too much, as I mentioned on this blog a long time ago, was that they limit the supply by limiting enrollment in medical schools. Open up the enrollment and create more medical schools, and the income is sure to lower drastically for physicians as a group.

It always reminded me of the Jockey Club's requirement that all thoroughbred foals had to be conceived by natural means rather than by artificial insemination. By limiting the supply, the price of thoroughbred racehorses could stay high. AI would drastically lower the price of racehorses because there would be too many of them.

Getting back to doctors, there might some who make and will continue to make seven figures in areas like cosmetic surgery, but for the garden variety doc, the income will go down quite a bit.

Doctors in the old days loved the fee-for-service system because insurance companies back then would simply shell out the money and didn't question the prices the docs charged. But then things got out of hand, and we got stuck with HMOs and the like. It didn't make too much dent in the profitability of physicians' practices or in the for-profit hospital sector.

Fear of the gravy train running dry is the biggest reason why the American Medical Association was adamant in its opposition to national health insurance or single-payer. It's that simple.