 You know, people often complain and people often point out that, no, not Mitt Romney, but people often point out that the United States has some of the highest cost of health care in the world, and it's true, we pay a lot for health care, and there are lots of reasons for that, lots of reasons for that. But one of them certainly is the fact that the United States, on a per capita basis, has fewer doctors than almost any country in the western world. The United States has a doctor shortage, primarily primary care physicians, but generally we have, and I didn't know this, but there was an excellent article in the Atlantic Magazine illustrating this. He asked even I didn't answer the question, sorry. I thanked you for it, but I didn't answer it, and I'm not going to. The United States has fewer doctors per capita than almost any other country in the world. Countries like Switzerland have a substantially higher number of doctors per capita than we do, and a country like Sweden has, relatively speaking, a free health care system than most of Europe does, and probably in some ways, you know, less of a mess than the American health care system that's neither here nor there, and is in some respects the worst of all worlds. So I didn't realize that one of the reasons that health care costs are so high why doctors charge so much is because of shortage of doctors, and the question is why does the United States have so few doctors? And it turns out that I don't know, around 19, about 40 years ago, 45 years ago, there was doctors decided that there were too many doctors in the United States, and they basically used their influence to start dramatically shrinking medical schools. They started making it more difficult to get in, started shrinking the numbers of students going into medical schools, started shrinking the number of people studying medicine in the United States, and they dug this massive hole where, you know, we have a shortage of doctors now, but it was worse 10, 20 years ago, or 10 years ago. And even though we're now accepting more students into medical schools, it's not catching up, and part of the reason for that, of course, is, well, I mean, what happens when there's a shortage? Well, when there's a shortage of something, you can charge a higher rate for it. So doctors have been raising their fees while making sure there's no more competition. So the American Medical Association and other associations are basically being actively, actively. We're trying to restrict the number of doctors that get licensed in the United States. Yeah, now, we can get a whole debate about whether government should license doctors or not, clearly not. It's a violation of rights. Somebody should license doctors, probably medical schools and medical associations and, you know, different professional groups. But licensure is wrong. And then you use the licensure, which is what the doctors are doing, to limit the number of doctors who study in your schools. Now, it's not just that we have fewer students going in. It's also that as compared to other countries, studying for medicine is a lot longer of a process than it is as other countries. In the United States, first you go to undergrad school, and then you go and get a medical degree. And it adds, and then you do, you know, you do, in a sense, an internship, what counts as an internship for three, four years. And it's insane. The amount of debt these students go into and the amount of time it takes them. Most other countries who are under world, you can go into undergraduate as a medical student and within six years you're done. You don't do these two, four year, five year, six year things. And they don't have this crazy internship system. And they produce more doctors per capita out of their medical schools. But again, this is all meant to slow the process down, weed out people, let them drop off, and ultimately reduce the supplies so the cost can go up. But then of course, so that's one way in which they do it, then of course there's another way. One of the ways in which they do it is they dramatically restrict the ability of foreign doctors to work in the United States. Even though these foreign doctors are trained, some of them, and some of the best medical schools in the world, they can't just come to the U.S. in practice. Again, they have to get licensed, which means they have to do a whole, have to go through a whole process. I had an uncle, an uncle who lived in South Africa, who was a dentist, been a dentist his whole life. And his three daughters all moved to the United States. They all lived in LA, my first cousins, they all lived in LA. And he would have loved to move to LA and start up a dentist practice. But he couldn't. Even though he'd been a dentist all these years, fully qualified, he would have to take a test, go back to school, take a test, do all these things to get a license. That's ridiculous. So one way in which they restrict them from coming in is through licensure and through restrictions and immigration. Indeed, it turns out that when NAFTA was negotiated, you know, the North American Free Trade Agreement, so much for free trade, one of the restrictions placed in there explicitly was to limit the ability of Mexican and Canadian doctors to talk about Canada, Canadian doctors to practice in the United States. Why? Because they're not as good? No. That's not how you do with that. It's in order to maintain the shortage of doctors for the sake of American doctors, at least for the short-term superficial sense, the sake of them. This is the kind of short-term irrational thinking that permeates licensing laws, that permeates professional organizations, and that permeates politics. And it's complete insanity. In, you know, why not allow anybody with a medical degree into the United States? It's not like they're going to go on welfare. It's not like these doctors are automatically going to ruin American culture. So what is it that prevents us from allowing highly-trained doctors from all over the world to come here and practice medicine? Think about the quality of life that that would improve for all of us. Who cares that their countries need these doctors? I don't care about other countries. And who said they need those doctors? How do you know? But why are we thinking at that level? This is about individuals who want to come live here and practice medicine here and improve the quality and the cost of medicine in the United States for you and me. Instead, we've got a cartel limiting the number of doctors in the U.S. through the government, reducing the quality of our care, and increasing the price. I don't care that other people need their doctors. Other countries need their doctors. Why would anybody care? So anyway, it's, you know, there is a writer. Let me just see if I can find the article. There's a writer in the, let me do this one second. Yeah, good for Travis. That's a national socialist belief that doctors should stay in those countries because they need the doctors. It's exactly national socialism. But that's exactly the way it is. Let me just pull this up. Ah, pull this. I'll show you the, let's do a quick screenshot of that. Yeah, there's the article. It is by Derek Thompson. Derek Thompson is, he writes quite a few good things. I mean, he's obviously left of Santa, but he is pro-progress and he's looking for ways in which we can increase progress. He talks about abundance as the goal. It's a good article. I encourage you to read this article and to follow this guy. I wanted to show you the, no, not that chart, this chart. This is a chart of physicians for $10,000, 10,000 people in the population. The dark red is general practice. The light red is a specialization. And you can see here, Austria has the most doctors per capita in Norway, Lithuania, Switzerland, Germany, Denmark, Czech Republic, Spain, Italy, Iceland. What surprised me is how low Israel is. I always thought Israel had very high levels of doctors per capita, but look where the United States is. We haven't even got the United States, there's the United States, just above Mexico and just below the United Kingdom that has one of the worst socialized medicine in the world. And yet, we have fewer doctors per capita than they do. That's insane. We should have a lot more and exactly market pressures would dictate this as wages of doctors went up, as it became a more, more lucrative profession. More people would come in and places would come down. That's how markets work. And what happens when you don't allow markets to work is you get distortions. And in this case, the distortion is hurting people, hurting people, wet counts and their health. They can't get primary care physicians. And this is the little, this is, that's not the economist, it's the Atlantic magazine. These are kind of the little things that would use the quality of life, that would use the standard of living. You have to wait in line for hours to see a doctor. You can't ever see a particular kind of doctor. And for a lot of people, it's expensive. So it's good to see good articles being written out there about real problems with real solutions. The solution here is to expand our medical schools, to do away with any restrictions, to let real competition be there, to stop these controls and to open up our borders, generally, but certainly to doctors. And to get rid of licensing laws broadly. Now I know people don't like the idea of licensing laws in the United States, right? Jennifer, do you think that malpractice litigation is higher here? Yeah, much higher. There's no malpractice litigation really as an issue outside the United States. It really is an American phenomena for all kinds of reasons. Liability laws are looser here. It's much easier to sue here because of liability laws. We have a culture where that's the way in which we seek retribution. And then when you have socialized medicine and doctors, for example, in the UK, working for the government, well, who are you gonna sue? The government doesn't, you're not gonna get very far with that. I don't think doctors in the UK have to buy liability insurance because they're government employees. At least those who are not in private practice. And it's only a small number, relatively speaking, of doctors in UK who also have a private practice. What do you call a person who graduates last in their class from the worst medical school? Your argument assumes all MDs are equal skill. No, they're not all. That's why some of them work, I don't know, it's Stanford Medical Center and some of them work at Ho-Dung Hospital in the middle of nowhere, but Ho-Dung Hospital in the middle of nowhere would rather have a relatively badly trained doctor from a third-rate medical school than no doctor at all, which is the alternative that they face. And indeed hospitals and clinics in the rural parts of this country have no physicians, have no doctors. The other thing that the doctor associations have done is they've restricted the ability of nurses to do things that they shouldn't be able to do. They require that only doctors can treat XYZ when it's not true and nurses can do a lot of this stuff. Again, partially away, you know, again, let the market filter. Now, again, what happens, what about, I don't know, all the nuclear engineers who graduate and some of them graduate from Ho-Dung universities, what's gonna happen to them? They're gonna build nuclear, nuclear power plants, they're gonna implode. What's gonna happen to all the pilots? I mean, when you get on a plane, do you make sure that the pilot is the best pilot from the best school? I mean, every industry builds in mechanisms so even the people who are mediocre are not doing too much damage and the people who are bad get filtered out. But the solution to that, it's not like in Switzerland, you've got dozens of really, really bad doctors doing really, really horrible things to people. No evidence of that, no evidence of that. But markets are really good. When weeding out, people are not very good at what they do. But what we rely on is government, government licensing. Instead of allowing, instead of allowing the private sector to figure out ways to qualify doctors and to make sure that we're not letting the really bad ones in, that's what markets, markets do that brilliantly, brilliantly. Governments screw it up and they're screwing it up now because a lot of places just don't have doctors. For a second or third level, they just don't have them. And that's the worst of all worlds. Thank you for listening or watching the Iran Book Show. If you'd like to support the show, we make it as easy as possible for you to trade with me. You get value from listening, you get value from watching, show your appreciation. You can do that by going to iranbrookshow.com slash support by going to Patreon, subscribe star locals and just making a appropriate contribution on any one of those, any one of those channels. Also, if you'd like to see the Iran Book Show grow, please consider sharing our content and of course, subscribe. 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