Wednesday, July 22, 2009

TOO MANY DOCTORS?

The air waves crackle with opinions about the crisis in health care. Congress is cranking up to adopt a massive piece of legislation which will purport to make health care better, more affordable, more accessible for all Americans.

I have my doubts.

Thirty five years ago I started a law school amidst a cacophony of complaints by lawyers and laymen alike that there were too many lawyers. The Thomas M. Cooley Law School is now the largest accredited school of law in the United States with 3,700 students on four campuses and over 13,000 alumni throughout the world.

Employment in the legal profession, like employment generally, is in a downturn. We read about major law firms laying off associates and new lawyers having difficulty finding employment. What we don't hear is anyone outside the legal profession complaining that lawyers are being too competitive, and performing their services at too low a cost.

The ample supply of lawyers has lead to competition, advertising, specialization and innovative delivery of legal services.

Just about the kind of things you might expect in a free market.

Now let's take a look at the medical profession.

There is no comparable medical school to the Thomas M. Cooley Law School. Each year over 500,000 applications are filed in American medical schools, while less than 20,000 students are admitted.

Why? Very simply because the Liaison Committee for Medical School Accreditation maintains a hammerlock on admissions. They refuse to permit any medical school to increase its freshman class by more than ten percent or a maximum of 15 students. They oppose the opening of new medical schools and impose such expensive requirements that new schools or expanded schools are not economically feasible.

I have heard a lot of people complain about too many lawyers. I've never heard anyone say there are too many doctors.

Elderly doctors in small towns can't retire because there is no one to take their places. Young Americans go to the Caribbean or Eastern Europe to study medicine, while hospitals in the United States recruit interns from Pakistan and India.

Sub professional health care jobs proliferate. Medical assistants, therapists, and technicians abound while graduates of U.S. medical schools opt for high paying specialties, and leave the nitty gritty of attending to the sick to clinicians.

"Nurse Practitioners" numbering almost 150,000 try to fill the gap. I suspect the vast majority of them would have gone to medical school if the medical schools had opened the door of opportunity. I never met a paralegal who wouldn't rather be a lawyer.

For those who can afford it, the United States offers the finest health care in the world. What we have not done is to allow market forces to regulate the kind and cost of health care below the premier level.

Perhaps if we opened up medical education to all those dedicated young and not so young people who want to enter the medical profession, we might return to the day when the neighborhood doctor's office was up above the hardware store; your family physician knew your name and lived in your neighborhood; and no one expected the national government to pay the doctor's bill.

And Uncle Sam didn't tell you when it was time to think about dying.

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