November 18, 2014
I have to thank NPR for proving my point about physicians being a protected profession. You see, doctors are poor little boys and girls — must be shielded from the free market, unlike auto workers, dishwashers, and domestic care workers. How else can we explain a Morning Edition segment on the possibility of a doctor shortage that never once discussed their wages?
For the record, the average pay of doctors in the United States is roughly twice as high as the average for other wealthy countries. (Yes, they have high student loan debt. Their average debt load would be equivalent to roughly $20,000 for a typical worker.) This might be taken as prima facie evidence of doctor shortage. If there were more doctors it would presumably drive down their wages, making health care more affordable for the rest of us. (Why does everyone know that higher pay for workers in fast food restaurants means higher hamburger prices, but somehow the idea that higher pay for doctors raises health care costs seems bizarre?)
The piece in effect implies that the market relations don’t apply to physicians. In discussing the idea of training more doctors as a precaution, it tells listeners:
“But letting more people train to be doctors ‘just in case’ strikes Wilensky [Gail Wilensky, a health economist] and many other health economists as wasteful.
‘Are you really serious?’ Wilensky asks. ‘You’re talking about somebody who is potentially 12 to 15 years post high school — to invest in a skill set that we’re not sure we’re going to need?'”
Of course if we had more doctors their training would be used, they would just get paid less to use it. So what, no one forced them to become doctors? (If the market doesn’t apply to doctors, then why don’t we just cut their pay in half tomorrow and save everyone $90 billion a year? That is equal to more than half of a percentage point of GDP or 45 times the amount of improper disability payments over the last seven years that AP chose to highlight in a piece last weekend.)
Incredibly, the issue of immigration never once got mentioned in this piece. Given that immigration is front and center in the news right now and it is obviously cheaper to train doctors in other countries than in the United States, it would have been reasonable to expect that the issue would be raised. But apparently doctors are not yet ready to be exposed to the harsh winds of globalization.
Can we get another piece from David Leonhardt and the Washington Post on the mystery of stagnating middle class wages? (Yes doctors are at the high end, many are in the one percent and virtually all are in the top two percent of the income distribution.)
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