[psaintla]

It's really not that simple and I say this as someone who works in health care. Doctors control how many new doctors there will be in any given medical discipline and they do this via accreditation, residencies and fellowships. You can introduce all of the free market forces and relaxed regulations you want but until doctors no longer control the supply of doctors you're wasting your time.

[mseebach]

Doctors only have this control because regulation says so. But as long as there are such steep price differences across state borders, it seems that there are, in fact, lower hanging fruit than busting the doctors' monopoly.

[psaintla]

Strictly speaking this is not controlled by any regulation You simply aren't going to get the experience necessary to perform certain surgeries with any proficiency without the aide of the gatekeepers. Also the reason for the steep price differences from state to state is partly due to a lack of a supply of doctors with a booming population of people who are seeking more medical care so I would argue decreasing the barrier to entry into the medical field while not decreasing standards should be a part of the plan.

[mseebach]

I'm not familiar with the system, but I find it extremely unlikely if >600,000 doctors are able to organise to form a watertight gate without any help from regulation. Surely they control licensing or something?

[psaintla]

If you aren't familiar with the system why make the claim that doctors have control because regulation says so?

[mseebach]

Because of what your describe in your original post: That scenario is completely implausible, except where enforced by regulation. I don't know what the exact mechanism is, I can just tell that it must be there. It's a game of prisoner's dilemma with 600,000 participants.

[anonymoushn]

Are you saying that I can practice medicine without a relevant degree, or that the supply of the relevant degree is not controlled by the government?

[hippich]

from my personal anecdote - i had appendectomy 2 years ago. total for all bills i received during couple month after discharging was about 28k. Out of these $700 for surgery itself and $900 for anesthesia. There were some other bills where my doctor was involved, like follow up visits, but these did not get over $500 aggregated.

So looks like doctor's cost is not that big of a part of the total bill anyway.