HEALTHCARE
Abandon medical approbations
Professional licensing harms patients, clients and customers
Closely connected to the education-system is the topic of regulations for exercising certain professions, in particular for medical professions.
Liberalizing the education-system is important, but then one must liberate the exercise of professions as well. Most consumers do not grasp the effect regulations have in lowering quality and increasing price. Government spends other people’s money on politically convenient goals primarily to secure their own reelection and one typically doesn’t secure reelection by being a skinflint (with other people’s money). Private sector companies, in order to save unnecessary cost, never hire a PhD where a Master will do, never a Master where a Bachelor will do and so on, because a PhD is more expensive than a Master, a Master more expensive than a Bachelor and so on; the public sector however works the other way around. Questioning how those tax-dollars are spend or the value of those services provided by this spending is seen almost as an act of treason and hence nobody ever conducts a cost-benefit-analyses. Regulations (in all areas) are touted as safeguards against lack of quality, but end up being mechanisms to corner the market and eliminate the competition to benefit the providers of a particular good or service over the well-being of the consumer. Regulations in general do favor the clique of providers closest to the politicians in power. Often enough industry-groups and their connected unions blackmail politicians to implement these regulations with the ultimate killer-argument: the preservation of jobs. Politicians feel immense pressure to regulate providers, since the media often calls for protections against charlatans, therefor most politicians rather regulate too much in order to guard against criticism: Being seen as overly concerned is preferential to being accused of negligence. Especially after a scandal, consumers are told not to trust themselves to pick their own provider.
The most regulated field is the medical services-industry. People are understandably worried about the competence of the practitioner, after all one mistake by an incompetent physician may leave a patient permanently injured. So they expect Government to regulate in order to eliminate the alleged charlatans, but as with so many arenas, where Government gets involved, regulation of the medical industry is not just costly, it is actively harmful to the patient for the very reasons listed by Milton Friedman in the video above. The Government essentially regulated the medical-services-market to remove the competition to avoid lower prices or increase quality. More economic competitors or business-models are shut out of the market. Entire disciplines like psychiatry or homeopathy stand credibly accused of being scientifically worthless. The powerful physicians-unions resulting from licensing ironically enforce the interests of some of the wealthiest members of society (which so many physicians actually are), contradicting the sympathetic image of unions as guardians of the working-class-man struggling to make ends meet; these medical unions have more in common with the mafia then with any other union.
Politicians should embrace AI, automation, robotics and telemedicine to replace doctors where ever possible! There are plenty of instances, where technology outperforming doctors never entered the market due to extensive lobbying by medical unions. The media, all to eager to report on mistakes made by technology, turns a blind eye to the everyday mistakes made by human physicians as well as ignores the high number of surgeries, that are performed primarily to benefit the doctor’s pocketbook. And no medical-device-company is eager to even invest in new technology only to see their investment be buried under the usual web of bureaucratic hurdles!
Medical services are almost tailor-made to be handled by AI or automation, since the medical discipline requires by-en-large the stubborn application of textbook knowledge, after all the primary talent of a med-student is and always has been to study and practice like a robot!
The privilege to prescribe or dispense drugs should no longer be given to doctors. Anyone ought to be able to purchase drugs on the free market, after all people put those drugs into their own body and drug regulation agencies make developing new drugs needlessly expensive¹.
Hospitals should be run like any other business with a professional management and a Chief Executive at the top. Hospitals and insurance-companies shall organize health-care with maximum freedom from regulation. To have hospitals be run by physicians themselves is like having the inmates run the insane-asylum; no wonder doctors were in a position to amass privileges for themselves on the expense of the patient and less powerful employees. It is better to have management pick their employees the way they see fit and to relegate physicians to the role, where the hospital can extract the most value out of them. They should organize education of their personnel on their own responsibility and train medical staff via vocational training in their own colleges (so much of the curriculum taught in med-schools today is overkill really).
Another overlooked problem: In a powerful economy high performers ought to enroll in academies for science or engineering in order to populate Research & Development departments, but instead the best and brightest enter med-schools to waste their talent in hospitals or physician practices due to higher salaries paid to physicians. A genius mind ought to be directed towards health-science, not towards health-care!
Expensive health-care means no health care for the poor! Inexpensive but effective health-care is vital to facilitate economic growth, too: Industry loves to settle where health-care is accessible, but affordable. India facing a doctor’s-shortage should turn a liability into an asset.
Doctors are not the selfless servants society imagines them to be; one better treats them as service-providers or employees, not as saints.
¹ A drug dispensation registry makes sense to prevent harmful drugs be used as poison to murder someone; the Government shall maintain the registry.
