[jackcosgrove]

Just to be clear the "too much coverage" argument is about physical facilities and equipment, not personnel. I think everyone is in agreement that there is a shortage of medical staff.

As far as convenience vs efficiency, the argument was that to achieve the efficiencies found in other countries, which often have longer wait times for services than the US, you do have to sacrifice convenience. The US, by treating healthcare like a consumer good rather than a rationed utility, has built out excess capacity for the sake of convenience. This is, according to the argument, part of the reason we spend more on healthcare than peers. (Healthcare must always be rationed; the US does so on price rather than wait times.)

[inferiorhuman]

It's not clear to me that wait times for e.g. imaging are due to insufficient staff. UC had two locations (for a city of 800,000) where I could've gotten an ultrasound. Getting waitlisted trying to find a GP isn't a staffing issue either. My solution was to patronize a medical practice that didn't accept insurance. I was able to make a same day appointment as a new patient. The lack of urgent care within the Kaiser network out here isn't a staffing issue. Kaiser simply hasn't built out clinics.

The lack of rural providers is largely a staffing issue, but once the staff go whole departments (e.g. obstetrics) get shuttered and it then becomes a larger problem than merely finding physicians.

Having been through the meat grinder a few times I don't think there's as much "convenience" as proponents of for-profit health care would like everyone to believe. Attributing the uneven distribution of care to convenience misses the mark. Profit incentivizes specialties that can charge higher prices and disincentives primary care. That's not convenience, it's profit. Again. St. Luke's.