[adharmad]

Out of curiosity, why cannot hospitals fund residency slots on their own with some riders (the resident should work in the same hospital for x years)? It seems odd that the medical profession is not willing to invest in the training of the next generation of professionals without government help.

[vineyardmike]

They do sometimes. People don’t realize how much of medicine, generally, is funded through the government. Additionally, society gives medicine a lot of leeway to act selfishly because the core practice of healing is so altruistic.

Broadly, it’s the same issue that all jobs have: it’s cheaper to hire pre-trained professionals than to hire and train.

[Spooky23]

Because they need to support their executives and capital projects / debt service. That’s the discretionary budget… training doctors doesn’t improve the bottom line.

Hospitals are really quasi-government entities. Their pricing structures have price controls based on Medicare reimbursements. A third of hospital revenue is Medicare and Medicaid.

Both programs have been slowing rate growth, which in turn impacts private insurance as well. The institutions haven’t been successful in reducing cost growth. ACA built out regional cartels^H provider networks, essentially eliminating competition.