[Consultant32452]

This is the result of central planning on the part of government. It allowed the AMA to do insane things like stopping new medical schools from opening for DECADES. It allows the AMA to continue to artificially limit the practitioners in all medical professions to keep wages high.

As a specific anecdote of the problem of government in healthcare: in my city a new children's hospital opened up a few years ago. The other area hospitals petitioned the government to not allow them to build the hospital until certain concessions were met. Among the concessions I'm aware of are not allowing the new hospital to own a medical chopper for 8 years. It was also not allowed to build a Level 1 trauma center. And of course that's after YEARS of not even being able to break ground while all this negotiating and concessions were being figured out. This type of interference raised the cost of healthcare for everyone in my city while likely decreasing the quality of care.

[Spooky23]

There's more to that story. Typically the problem is that there are too many hospital beds, not too few.

Outpatient treatment is increasingly more popular and more cost effective. Hospitals often raise costs by introducing massive capital costs that need to be amortized as well as other overheads.

With the exception of lower-cost, higher value primary care, there are rarely any meaningful access issues to doctors in metro areas. Those shortages are largely being addressed with PAs and NPs.

[Consultant32452]

>Typically the problem is that there are too many hospital beds, not too few.

I'd be interested in a citation for this because it's counter to basic economic theory of supply and demand. If the supply outpaces demand, then the price should be going down, not up.

[Spooky23]

ECO 101 fails all over the place.

Here's an example. A quick good will find you many more. http://www.modernhealthcare.com/article/20150221/magazine/30...

Medical services are a complex market. It's nonsensical to randomly apply basic economic principles without knowing what you are doing. (Good luck telling congress that) The smart thing to do is to make primary care more accessible -- you'd be able to close many hospitals and improve outcomes.

[Consultant32452]

I see what you mean, but the over-priced beds are just a temporary phenomenon while smaller more agile competitors are killing the large facilities. In the end, cheaper service for health care is still being found from new competitors moving into the market.

[incompatible]

Why does the government care what the other hospitals think? Would they stop a new burger bar opening too close to a McDonalds, if McDonalds petitioned them for long enough?

[sliken]

Yes, it's the way the world works. Homeowners vote against new developments (which decreases the cost of their homes). Everyone with a liquor license lobbies against more liquor licenses. Every grocery store lobbies against more grocery stores. Amusingly this causes big issues between state governments (who wants growth) and cities where most voters/business owners want to limit growth to protect themselves.

[Consultant32452]

The cynical reason is because the hospitals are massive tax-bases and the owners of the hospitals are political donors.

The other reason is that the government has an interest in maximizing economic growth, among other things, which is why it has zoning power. Citizens in the area, including local businesses such as other hospitals, may raise any number of concerns about building projects. Further, any citizen (or corporation) can hold up just about any project for as long as it's willing to keep paying legal fees to fight projects based on trumped up bullshit about esoteric zoning laws that were written a century ago that they probably broke when building their own hospital.