| There are two parts here that are not clear, and potentially misleading for folks unfamiliar with how doctors are minted in the US. The first is the cost to the individual to become a neurosurgeon. The second is around the supply side of the health market. First, to become a practicing doctor of any sort one first completes med school then a residency and (depending on specialty) fellowship. The med school part is more or less the same for all physicians from your GP to brain surgeons to psychiatrists. Many folks take out loans to cover med school. The residency and fellowship parts are paid. In practical terms this means a person becoming a neurosurgeon needs no more loans or upfront cash than a person becoming a GP. (I assume everyone is familiar with opportunity cost so will leave that part unsaid) As an aside, much of the funding for these programs comes from the public (via Medicare). All this means, the cost of becoming a neurosurgeon is about the same as any other specialty. As for the supply side entry to med school and selection to residency programs are the big bottlenecks. Med schools are accredited via doctors trade bodies. This means doctors (not market forces) decide how many new folks can become doctors. As previously mentioned, residencies are largely funded via Medicare already. However, the number of residents has been capped since 1996. In that period of time the US population has grown by about 60 million (25%). You may have been familiar with all this, but I think the context is important for discussing market solutions to healthcare — there are a lot of distortions around the US having anything resembling market behaviors. |