[huitzitziltzin]

There are important differences in most of those countries including (importantly!) direct government regulation of prices, including salaries in the medical market.

British doctors, for example, work under a contract negotiated between a British version of the AMA and the British government. The government and the providers both have leverage, but the British government is the primary purchaser of services in that country. Salaries are lower since the government exerts pressure on them, as they are paid for out of direct taxation.

I understand that you feel very strongly that student debt for doctors is unjustifiable or too high or something. Student debt is not the main driver (or even a driver) of high salaries among US doctors. The level of their student debt is a completely separate topic.

[syki]

There are private doctors in Canada and the UK and they don’t make as much as their American counterparts.

Anecdotal evidence. My wife has $400,000 in med school debt. She needs a $300,000 salary to afford paying that debt off whilst also maintaining a “good” lifestyle. Med school, residency, etc. were hard and sacrifices were made to go through them. It would not be worth it to go through that without a reasonably high salary.

She’d gladly have gone through the process for a $200,000 a year job. It is certainly the case that highly motivated, highly intelligent people take into account the ability to service med school debt when deciding to become a doctor vs. another going into another field. It is obvious that high med school debt has an effect on the salary needed to attract talent.

David Carr won the Nobel Prize in part for his work questioning the traditional supply/demand view of labor economics. Here is a link to an interesting (to me) paper.

https://www.jstor.org/stable/24695058

[huitzitziltzin]

> There are private doctors in Canada and the UK and they don’t make as much as their American counterparts.

Great example. These doctors face competition from a low- or no-cost private sector. This keeps prices down since every consumer can use the state sector. This is true in many countries w/ state health sectors.

> David Carr won the Nobel Prize in part for his work questioning the traditional supply/demand view of labor economics.

Could you mean David CARD?

https://davidcard.berkeley.edu/

His work of course I know. It is related to the economics of minimum wages. I would not say it questions the traditional supply and demand framework (nor would he say that, I bet), though he does point out an empirical observation which doesn't fit well within that framework.

[syki]

Sorry. Yes, Card. Clearly I’m not an economist but I believe within the field is an emerging movement question the traditional iron clad belief in supply/demand being the explanation in labor economics.

One cannot always use the state system. For example, some elective surgeries can’t be done in the state system fast enough for the upper class and then there are those who want vanity cosmetic surgery. I don’t know what the data says but I’d be surprised if private cosmetic plastic surgeons make as much in France as they do in the U.S.

For the record I believe licensed doctors in, say, the EU should be able to practice medicine here without having to do a residency. Though there is a moral consideration in terms of draining the medical talent from countries like Greece, Romania, etc. I believe that med school in the U.S. should be free and that doctor’s salaries could correspondingly go down without decreasing the supply of people wanting to become doctors. It seems obvious to me that having $x in student loan debt is a factor in determining the required starting salary to attract enough talent. I don’t see how anyone can think otherwise. If the debt can’t be serviced easily enough while having a good enough standard of living then these talented people will do something else.

Of course, I could be wrong about everything. There are lots of “obvious” things that aren’t true.