Could you get behind loosening the AMA's grip and allowing more foreign doctors?

[Imperialism Inc.]

I keep a few right wing sources in my RSS news reader to help combat echo chamber effect. I'm not sure how well it is working since I usually find I disagree with most of what they say. On a rare occasion however I find a point of agreement. It seems many on the right agree with progressive economist Dean Baker that one way to save health care dollars is to lessen the restrictions on foreign doctors practicing in the states. Many times they have to redo their residency and exams. This is of course, at heart, a "free market" solution so it would be tough for conservatives to oppose it.

What do you think? Personally I could get behind this proposal as a future tweak to the HCR bill that just passed. I would prefer if it were coupled with other Baker proposals like rolling back patent protections (another "free market solution since patents are government granted monopolies) and finding new ways to fund drug research.

[Iggo]

1. I don't hate foreigners.

[dkf]

2. Isn't there some restriction on the number of doctors trained in the US?

I think it has to do with limiting residencies? We need to lift that first.

[SharonAnn]

4. The restrictions are meany, starting with the number of medical schools.

[Imperialism Inc.]

6. Yes. There are limits on residencies set by the AMA as well.

[SharonAnn]

3. No. let's loosen the AMA'a grip on limiting medical schools in the USA

We need more medical schools in the USA. We have qualified people who can't get into medical school because there are no "slots".

But foreign countries can have plenty of medical schools and then their students can come here?

I don't think they have more smart people than we do in the USA. We just allow the AMA to keep the number of medical schools and their size artificially small to keep the number of doctors down. It's a way of trying to protect themselves from competition which might mean lowering their incomes and their control over the medical field.

We have plenty of talented, qualified, interested people who want to become doctors. We just don't have enough schools for them.

[avaistheone1]

16. I agree. Let 's expand the role of physician assistants and nurse practitioners

and up medical school enrollments here. The AMA with support from the US government has always severely capped medical school enrollments. That needs to change.

There is no need to bring foreign docs in. We need to start employing more Americans. We need good jobs in America for Americans.

[Oregone]

5. Train your own doctors with your own subsidies & scholarships

Stop leeching off the world. :)

Ok, I understand how its alluring for a doctor to go to the US and make a crap load. One of the reasons they get paid so much is because the private health insurance industry sucks at controlling costs. But these outrageous costs not only hurt the US people, but the rest of the world that lose doctors who chase riches.

It just sorta sucks, but what you going to do?

[MattBaggins]

7. How abouts finding a way to get more 'Murikans in med schools

and stop buying the nonsense that we are too stupid and lazy and need people from Eastern countries to hold our hands.

[Imperialism Inc.]

11. Funny that I never said even one of those things.

I am not opposed to getting more US-born people in med school nor do I think US-born people are stupid and lazy.

[demosincebirth]

8. Haven't been to Kaiser, in the Bay Area, have you?

[Xithras]

9. Absolutely not. Terrible idea.

Do you have any idea how many unemployed people there are in THIS country? I would MUCH rather see us train our OWN people to be doctors, than watch yet another American job class get "outsourced" to lower cost, foreign subsidized workers. There are plenty of people in America who have the capability and willingness to become doctors, but who lack the money for med school and don't have the credit, collateral, or willingness to be saddled with the massive student loans that accompany American medicine. It is FAR better for our country, as a whole, for us to help THEM become doctors.

If you open the U.S. up to foreign doctors, you're simply going to see a flood of doctors from nations like India and China, where doctors are educated by the government at little or no cost, start flooding in. Without student loan burdens, they'll be able to work much cheaper than American doctors. If they offer their services at lower prices, the insurance companies will be able to reduce their payouts to the point that American doctors will simply be priced out of the market. Eventually, the whole field is outsourced.

There is little difference between this and H1-B outsourcing in the technology market. The result will be the same as well...financially devastated, unemployed Americans looking on as foreign temp workers take over their jobs.

[Imperialism Inc.]

10. One of Baker's points was that this would also allow US-born people to

go abroad to get training without worrying about the fact that they can't bring those skills back home.

[Xithras]

15. Which is a false point.

American citizens aren't eligible for the free medical training that is available to students in India, China, Indonesia, and other nations. U.S. citizens can take out loans and attend colleges in those other countries, but private, for-profit med school is still an expensive proposition even at overseas schools (though it's cheaper overseas than in the U.S.) Those overseas trained doctors would still be at a severe economic disadvantate to their non-citizen counterparts who were trained in other countries at the expense of their government.

Again, it's largely the same situation as exists in InfoTech. American educated workers, with student loans to pay back, simply cannot work as cheaply as their H1-B counterparts who enter the country with no debt because they were educated entirely at the expense of their home governments. You cannot have a fair, competetive market when some workers are getting a free ride at their governments expense, while others are expected to fend for themselves.

[Lance_Boyle]

20. This has always been so - look up 'Grenada' and 'medical school.'

US citizens cannot get a GOVERNMENT SUBSIDIZED medical education in other countries, but they can most certainly buy one, and have long been able to do so. And, um, you probably wouldn't want to opt for the Grenada-trained doc over the Johns Hopkins one.

The solution to a doctor shortage in the US is more medical schools and more subsidizing the costs of attending those schools, provided there are returns for those of us (taxpayers) who do the subsidizing. The solution is most certainly NOT to try to import our way out of the shortage. A race-to-the-bottom in medical care would be bad, m'kay?

[OregonBlue]

12. The world needs foreign doctors to train here and then go back to THEIR countries. They need those

doctors more than we do. We are already stealing many, many trained nurses from all over the world and it is hurting rural health programs in poor countries. We need to train more Americans not steal other country's docs and nurses. We need more medical schools to train more doctors for the whole world, not just us.

[Raineyb]

13. The AMA deliberately restricts the number of medical schools (and thus openings for new students) to

keep the number of doctors at a certain level. Allowing more schools would make more people here able to go to medical school. How exactly would allowing foreign doctors to train here in the limited number of slots available while not opening up more medical schools then sending those doctors back to their home countries help with the problems we have in this country with the number of medical personnel?

[pitohui]

14. why would you ever refuse to allow a highly qualified individual to immigrate to yr country?

i'm not sure what this has to do w. the health care bill, i'm not sure there is any reason to believe the usa ever had a policy of refusing entrance to highly qualified individuals likelegit well-qualified doctors

seems to me, highly qualified individuals like docs and ph.d's would go to the head of the line when INS is deciding who gets the green card

now if you're talking a foreign doc who went to some obscure island and got an MD of questionable validity, that's whole nother boat load of coconuts...

[OregonBlue]

18. Because by encouraging them to stay here, we are depriving their own country's of their skills.

We need more medical schools and we should be training doctors for the entire world.

[Xithras]

21. I don't think it's a question of immigration.

I actually have no problem with the notion that a doctor, trained in India with an Indian medical license, could permanently immigrate to the U.S., become a citizen, and practice medicine here.

What I have a problem with is the far more probable notion that medical outsourcing will become the norm. We already have hospitals outsourcing radiology work to foreign countries and putting American doctors out of work. A low-rate technician puts the patient on the bed and takes a scan, and an Indian doctor on the other side of the planet analyzes it in realtime and delivers a diagnosis. That is happening TODAY.

If the field is opened to everyone, you can expect to see the major in/outsourcing companies to get involved. How would you feel about opening the paper one day to discover that your local hospital had signed a deal with the Tata Group (one of the worlds largest insourcing companies) to provide doctors and medical services? Among the scores of paragraphs describing how doing so would cut costs and reduce medical inefficiencies, you might find a sentence or two mentioning how the existing medical staff would be laid off. Or, mirroring what they have done in the IT field, maybe Tata will simply build new hospitals in the major cities, offering medical services at a fraction of the cost of the domestic hospitals, using only their own employees that they have imported to staff it. No American doctors, nurses, or employees allowed. How long would it take them to put the American operated hospitals out of business?

It's not xenophobic, because it's already happened. This is how they killed IT, and if the door is opened, they'll do it to any other professional field with a decent amount of money involved. These are multibillion dollar companies that are constantly looking for new revenue streams. Medicine certainly qualifies.

[Tierra_y_Libertad]

17. Why not? We need more doctors. K&R

[amborin]

19. K&U there are already

programs in the U.S. to shorten the educ requirements

look this up in the ny times....

article a month or so ago....experimental programs to place physicians in areas of critical need....


otherwise: sorry, but foreign medical schools and training are flat out inferior; the reason Americans attend those schools is b/c they didn't get accepted into American institutions.

This is just a bad idea.